The trouble with labels

Physicians at the 2013 meeting of the American Medical Association (AMA) voted overwhelmingly to label obesity as a disease. One that requires a range of interventions for both prevention and treatment.

On the face of it, there’s not much to argue with here. Tackling obesity definitely involves behavioral modification–and sometimes even medication and even surgery. But still… does that make it a disease?

Personally, I think this new label is a little problematic. I’m more inclined to liken obesity to smoking, as some others have.

Yes, smoking causes lung cancer. But health officials don’t label smoking as a disease. They’ve simply restricted access to cigarettes. (If only they would do the same with sugar.)

And this, of course, raises the ongoing debate about addiction. I think compulsive overeating is a psychological disease, just like any other addiction.

But obesity? I’m still not sure.

One thing is for sure–the problem has exploded in the past 30 years. And if you take a look at what has changed in that time, the culprit is clear.

It’s not our genetic structure at work here. It’s our diet.

Our food supply has been dramatically altered over the last several decades. And our bodies obviously can’t keep up with these changes. Or with the sheer magnitude of chemicals we come into contact with via the heavily processed food we consume every day.

There are also toxins in our environment that promote obesity. I’ve talked about these insidious “obesogens” at great length before. You’ll find them in almost everything we touch or eat–from receipts, to plastic packaging, to hygiene products, to canned foods.

And then, there’s the growth hormones coursing through our food supply. Topped off with the downright erroneous information force fed to us by the same government agencies that are supposed to be there to protect us. (Yes, I’m talking about the USDA food pyramid–just to name one example.)

But despite all of these factors, there are still plenty of extremely fit people in this world. Not everyone is obese. So clearly, the issue of causality is a complicated one.

Obesity is a very serious condition. It’s affecting more Americans than ever. (The CDC reports that a shocking 35.7 percent of Americans are obese.) It’s also a factor in six of the top 10 leading causes of death in the U.S.–including heart disease, stroke, type 2 diabetes, and cancer.

I can’t argue with any of that. But is it enough to make obesity a distinct disease? I’m not convinced. Though I do think far more emphasis should be placed on prevention–with a strong focus on securing our food manufacturing complex.

And more importantly, personal responsibility.

Don’t get me wrong. There are a lot of reasons to celebrate this new classification. There are all sorts of “perks” that come with it. Most notably, obese patients will now be able to get insurance reimbursement for weight loss treatment, more financial assistance, etc.

But it also removes some of the accountability from the equation. And that’s a problem.

No doubt, the odds are stacked against us when it comes to staying lean and healthy–it really is so difficult, and I know that. But when it comes right down to it, it’s all about choices.

And if you keep choosing donuts, guess what? Eventually, you’ll end up fat. Period.

There’s no question that obesity is a huge threat to the nation’s health. And while I don’t necessarily think it’s a disease, I would love to hear your opinion on this very important topic.

So please write in and tell me what you think. I really do want to know.

AMA Declares Obesity a Disease. Medscape. Jun 19, 2013.