Editorial: Obesity is a disease and not a behavior

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Obesity is a medical condition and not behavior deficit.  

Obesity on Scale

As a practicing medical professional with a history of military service, one of the largest challenges I have faced is redefining obesity as a disease and not a character weakness.  Most military commanders still see obesity as a matter of willpower and not a treatable medical conditions.  In fact, the military has regulations to prevent medical or surgical treatment of obesity in active duty service members.  The only treatments available are education, exercise, and behavioral modification.  

Despite the growing recognition of the potential complications of being obese, obesity has been treated as a disease process with the same

Obesity

prevention and treatment strategies for nearly a century.  Even with the increased focus over the past half-century, the American public continues to have the ever-expanding waistlines.  The obesity process is not a single disease but a group of diseases with a similar outcome.  Since there are multiple causes and disease processes, why would you treat them with a single treatment strategy?  Diets and exercise regimens often fail simply because the underlying medical pathology has not been addressed. My approach to treating an obese patient is to evaluate a patient fully and holistically by acquiring including family history, physical exam, laboratory testing to include hormones, a dietary journal to look at nutrition, and a review of activity levels to understand where I should begin in treating this disease. There is no quick or simple way to induce weight loss.

 

Burger with Tape Measure

Burger with Tape Measure

The suggestion that obesity is not a disease but rather a consequence of a poor willpower or chosen lifestyle exemplified by overeating and inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.  I am certain a person made a decision to smoke but tobacco is addictive.  Food is also addictive even if it is less addictive than tobacco (debatable).  We would do far more good to be supportive of those suffering from obesity and be less judgemental.  Obviously, vilifying them has done very little toward helping them quit thus far.  

Obesity and obesity-related illnesses such as heart disease, diabetes, metabolic syndrome, stroke, and hypertension are a huge monetary burden on the medical costs within the United States and around the world.  As obesity increases and the population ages, these illnesses will have an even larger burden and will surely bankrupt the budget of our government.  With this being said, it illustrates a problem that is in dire need of treatments and if we can just reduce the obesity rate, we will save billions.  

The bottom line: Obesity is definitely an illness or disease. Despite being declared a disease by the American Medical Association in 2013, many still treat obesity as a result of poor willpower.  We need to recognize it as an illness or disease.  We need to be more helpful and supportive and quit vilifying the suffer.  

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About the Author

ChuckH
I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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