A study has concluded that if obesity is thought of as a disease instead as a problem related to diet/lack of exercise, people will continue to eat high calorie foods.

Image Credits: Beth Warren.

On June 18, 2013, the American Medical Association officially recognized obesity as a disease. This was met with mixed opinions, but the largest US medical association believed that would help raise awareness toward obesity, as well as increase reimbursement for obesity-related drugs, surgery, and counseling. While this is understandable, there are some serious problems with this idea.

The first problem is defining what a disease is. Semantically, a disease is any abnormality that affects the well functioning of your body… so in that sense, yes, obesity fills every criteria needed to be a disease. The problem is, when you call it a disease, you sort of take the responsibility away from the “diseased” – you tend to think of it as something that happens to you, not something that you bring upon yourself.

Dr. David Katz, Editor-in-Chief of Childhood Obesity, is one of the strong opponents of this idea. In his paper “Are Our Children ‘Diseased’?”, he tackles some much avoided topics, and explains that obese people who aren’t sick shouldn’t  be called “sick”, and they shouldn’t be treated this way.

“We treat diseases preferentially with drugs and procedures. We treat them in hospitals and clinics and generally at high cost,” says Dr. Katz. Too often remedies for obesity in adolescents and children focus on medication or bariatric surgery, for example, instead of environmental and preventive strategies. “Clinics can and should treat complications of obesity, but the root causes reside in our culture, and the best remedies need to be directed there. An excessively medical conception of the problem may divert attention and resources away from where they are most needed, and could do the most good.”

Modern psychology backs him up. The “obesity is a disease” message actually undermines important weight-loss efforts – which are almost always not medical, but rather dietary and physical.

“The term disease suggests that bodies, physiology, and genes are malfunctioning. By invoking physiological explanations for obesity, the disease label encourages the perception that weight is unchangeable,” Crystal L. Hoyt of the University of Richmond and her colleagues wrote in their study, which was published in the April issue ofPsychological Science.

In three separate participants with over 700 participants, researchers found that obese participants who read a New York Times article about the AMA declaring obesity to be a disease were significantly less concerned about their obesity, and were more likely to continue to eat high-calorie foods. Furthermore, the report revealed that these people had a better image about their bodies, and generally felt better about themselves – which is a good thing apparently, but this is what drives them to eat more unhealthy foods. It’s like the responsibility for the disease is somehow lifted from them.

“This research illuminates the potential benefits and hidden costs associated with the message that ‘obesity is a disease’ by showing that this message cultivates increased body satisfaction but also undermines beneficial self-regulatory processes in obese individuals,” Hoyt and her colleagues wrote.

The study doesn’t make a case against classifying obesity as a disease, but rather tends to understand the implications behind this.

“We are not advocating that the ‘thin’ ideal that pervades Western culture is an admirable goal, nor that internalizing these unhealthy standards is a worthwhile strategy,” they explained. “In addition, we agree that the acceptance of diverse body sizes is laudable, as is the goal to increase medical treatment for obese individuals—themes that emerge in the argument in support of obesity as a disease.”

Personally, I believe that the improved self-image was a good thing – one that we should encourage. However, I think that people who suffer from obesity should understand that this is not something that’s happening to them through some unfortunate (in the vast majority of the cases), but it is something which they are responsible for. Also, it’s important to realize that with a healthy nutrition, and a moderate amount of exercise, obesity can be fought – that’s where the emphasis should be placed on.