Editorial: Obesity is a Disease


Obesity is a disease and not a choice.  


Fatphobia is the rampant in social media, the United States, and most of the World.  Most people believe that obesity is a personal weakness and choice.  Many fail to see the facts before them.  Obesity is a disease and we should not judge people that suffer its evil clutches.  Sure, obesity is less healthy than being slim, but people who suffer from having it does not make the choice to eat more and exercise less.  

Additionally, many people don’t sympathize with fat people because they feel that obesity is caused by preventable decisions. Should a person who become addicted it drugs or tobacco and thus acquire cancer be vilified?  This blaming mindset can be applied to many different situations and it is not helpful.  Sympathy and empathy are more helpful.  

Obesity is partially made in the kitchen, but it is more than just what and how much you eat.  A lot of people who struggle with obesity are in that situation because they have never been taught how to properly cook for themselves and what they should be eating.  Positive reinforcing good behavior and a little compassion, instead of blaming and bullying, will go a long way toward helping people make better choices. Who are we to judge people who got less lucky with their genetics and metabolism?

The other part of obesity is genetics and metabolism.  Equating an elevated BMI with behavior does not do justice to the now widely accepted association between the mechanism that causes the complex disease of obesity.  Most obesity is a metabolic disease that is associated with an elevated insulin resistance that results in a spiraling addition to the central abdominal girth.  Some people of genetically predisposed to this sort of weight gain.    

Individuals with obesity have an increased accumulation of fat, but it is not always caused by eating excess calories or less physical activity.  Individuals with obesity an impedance of the metabolic pathways that burn and store calories.  The disorder also results in a lack of signaling for satiety (the feeling of fullness) or excess hunger.  Because of this, they lack the off switch to stop eating or the on the switch to eating comes on prematurely.   

The most effective strategies to prevent and treat obesity are life-long changes toward healthier choices that result in a reversal of the insulin resistance.  Stepwise and subtle programs that are individually tailored to the tastes and lifestyles of each dieter are more likely to be more successful than the negative vilification, bullying, stigma, and blaming that many do today.  In fact, evidence indicates that combined lifestyle changes, that includes diet, physical activity, sleep, and stress reduction, has been shown to be quite effective in promoting weight loss and subsequent weight maintenance.  

The bottom line: Obesity is a disease.  People with obesity already face bias and discrimination in employment, health care, and interpersonal relationships. Viewing obesity as a health behavior also promotes a very narrow view of obesity that is not helpful in promoting better health.  Be more supportive of your loved ones as they try to lose weight.  

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About the Author

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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