Is Obesity a Disease?

Sara - posted on 02/15/2010 ( 21 moms have responded )

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The debate over whether or not obesity is a disease grows as obesity rates and the cost of treating obesity-related conditions increase in the United States.

Proponents stress that obesity is a disease because it is a result of genetics and biological factors, citing scientific studies that have shown a link between obesity and heredity. Certain known illnesses can also cause weight gain or obesity, including hypothyroidism, Cushing's syndrome, and polycystic ovary syndrome.

Opponents argue that obesity is not a disease because it is the result of a person's environment (i.e. residential location, social circle, economic status, etc.), lifestyle, and eating habits, citing other studies that show obesity is a result of environment and social networks.

The Centers for Disease Control and Prevention (CDC) reported an "epidemic" of 72 million obese people in the United States in 2006 with 34.3% of adults considered obese (vs. 13.4% in 1962) and 32.7% considered overweight (vs. 31.5% in 1962).

In 2005 obesity accounted for an estimated 216,000 deaths (1 in 10 deaths) among U.S. adults. It was the third-leading risk factor in U.S. adult deaths, after tobacco smoking (467,000 deaths) and high blood pressure (395,000 deaths). Obesity and obesity-related health conditions cost an estimated 10% of annual medical spending in the US, totaling $147 billion in 2008.

As of Dec. 15, 2009, the World Health Organization (WHO), FDA, and the National Institutes of Health (NIH) have all stated that obesity is a disease. The CDC and the Department of Health and Human Services (HHS) have not taken a position on whether or not obesity is a disease. The U.S. House of Representatives in its Oct. 29, 2009 health care bill H.R. 3962 included obesity as a "behavioral risk factor" and not as a disease.

So what do you all think? Should obesity be a disease and it's treatment treated as that of a disease?

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Rosie - posted on 02/18/2010

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jo, it's my sons favorite passtime to poke my belly as well. he loves watching his fingers dissapear into the rolls. he also likes to lift my stomach up (i have a ton of extra skin and it just lays there) and let it flop back down, it's a game! yaaaayyy!

?? - posted on 02/16/2010

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I don't think anyone is judging at all Lisa. I've been that fat girl who overate, I've been that skinny girl who was anarexic, I've been the alcoholic, I've been the drug addict and now I've got baby fat left over from having my son. I have absolutely no excuses for why I've got the chub... cept that I can't be bothered to care about the extra inches on my tummy right now. When I was an addict and an alcoholic I had ALL the excuses in the WORLD why I was doing those things -- now, I know I had no excuse. I was being irresponsible with my life, I was being inconsiderate of my loved ones, and I was being out of control because I didn't have the coping skills I needed to deal with my life. Now I have those, so I am in better control of myself.



I am prone to gaining weight very easily, so I just control myself as much as I care to so that the situation doesn't get out of hand like it did before when I became that 'fat girl' years ago. But that 'fat girl' was the product of my enviroment, it was easier for me to not care about anything than care about anything. So I ate, I cuddled in the corner, I ate, I drank and I didn't give a shit. I had to take responsibility for what I was doing... I have never been 'diagnosed' with any sort of disorders or diseases or any of that - I just know that only *I* control what I eat, how much I exercise, and the things that *I* can do to avoid losing control.



I have no misconceptions about anyone's personalities and I don't ignore what is 'inside' someone just because of their body types... but I don't candy coat, enable and give excuses for people who show me that despite their 'good personality' they still allow themselves to be unhealthy and refuse to take responsibility for what they can do, even if medically they can't control other aspects because of another diagnoses.



If they're bitchin about being fat, while stuffing their face with a whole table of treats, I'm not going to say "It's not your fault." or "It's ok, you're a good person!" I'm not JUDGING them either. If someone is my friend and I can see that they are self-destructing - be it food, alcohol, drugs - I will tell them what I see and if they refuse to get help, I wash my hands.

Sara - posted on 02/16/2010

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Ok, out of curiosity, do you all think that alcoholism and drug addiction are diseases? From what I've seen, that's how they are treated, recovering addicts often say "my disease" when they refer to their addiction. So, I wonder why society seems to think that those disorders are diseases, but obesity is not?

Sara - posted on 02/15/2010

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There is a social stigma associated with obesity. People think of it as a character flaw or as a lack of will power and self-control. It is now known that obesity is much more complicated than that. Various biochemical factors such as leptin, grehlin and melanocortin 4 receptor have been implicated in predisposing people to obesity (some you're even exposed to in vitro). This is an area of active research that I'm sure we'll come to find out more about in the near future.



In discussions with my doctor, he has also said that obesity seems to be a problem of too much fat rather than too much weight. The fat cells, or adipocytes, secrete substances that lead to such conditions as diabetes, high blood pressure and a host of other problems. The causes of obesity are complex. Genetics, metabolism, changes in dietary intake, an increasingly sedentary lifestyle among other things have been implicated. So yeah, I guess it is a 50/50 kind of thing between genetics and lifestyle. But, alcoholism and drug addiction are often treated as diseases. I can't help but think if obesity were treated as a disease it would help remove some of the social stigma as well as help people get treatment for it.

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I think that obesity can be as much of a disease as alcoholism is...I personally don't think of alcoholism as a disease myself, but...? I think they are about the same...some people have medical reasons for why they gain weight and some people have medical reasons for why they drink/drug (undiagnosed mental disorders for instance). Regardless of the reason someone uses their addiction of choice it is something that causes problems for society, be it socially, financially, etc...For those reasons I think that we should not hesitate to help our fellow humans and help them with their issues. Because if we don't insure them then when they get sick they will just have unpaid medical bills that they may get written off with bankrupcy or death? Unpaid medical expenses drive up costs for everyone else, sooooo give them insurance, help them pay for their health needs, and recovery and GET OVER IT!!! They whys are important for helping them through it but are not necessary for the rest of us to judge because WHO CARES! Why can't we all just help out our fellow countrymen? I understand that it sucks! I hate seeing my alcoholic father, and I hate considering that his inability to work causes tax payers to pay his way, but he does have medical issues that inable him to work (back problems, constant pain, etc) and he did work for the majority of his life paying into taxes...so I suppose he's just taking his cut now, but I hate like the rest of you the drag those people put on our respective countries...I just think we need a different approach! Like putting crazy high taxes on hugh fructose corn syrup & other sugars/syrups/salts/& unhealthy fats...make the price of whole foods/whole grains/nuts/& anything w/less then 5 ingrediants in it super cheap as well as mandatory exercise programs that are free for everyone...then again everyone should have free insurance and free schooling through college...how the hell do we pay for this? IDK and frankly I don't care... I think that we should all just put in our own 2 cents worth, work for the good of humanity and ourselves and we should all reap the rewards!

?? - posted on 02/16/2010

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I wasn't taking it as a personal attack lol I was simply saying that no one has said anything that is directed at every single person who is packing a few extra pounds - I know I am carrying some extra weight, my son is actually poking me belly right now cause his finger disappears and he finds it hilarious LOL



I guess what I was trying to say is that I think you are applying the "comfort food, control and coping mechanism" to people I'm not. You took what I said and applied it to EVERYONE, instead of applying it to the people I was talking about. I won't candy coat it, pat people on the back, tell them it's ok and support them self destructing if I truly think they are. If I tell them my concerns and they ignore me, refusing to see that they aren't being responsible with their lives, but instead are making excuses for stuffing their faces, sitting on their asses, doing drugs, drinking, binging and puking - whatever it may be that is concerning me -- then I will wash my hands clean of that situation because I don't support people being irresponsible with their own health.



I said in my first post that there are MANY situations where weight gain, being overweight and even being obese is the cause of any number of different medical, legitmate diagnoses.



Those people still have an obligation to do their part though. You can't eat junk and say "oh I'm fat cause I have hypothyroidism." You can't sit on your ass all day everyday but then say "I'm fat because I have to take these pills." There are things that we CAN control, diet and exercise are key.



Hypothyroidism is genetic in my family, there are a couple women who are slightly overweight because of it, but they eat healthy, they take their medication, they exercise daily -- if they didn't do ALL of that... they would be obese and they couldn't blame it on having hypothyroidism, it would be cause they didn't eat right and didn't exercise.



To *ME* people who are OBESE are NOT doing everything they can. I'm not talking about overweight, or even quite a bit overweight, and I am NOT talking about EVERYONE.



Of course the bigger picture is necessary to look at. And that was one of my original points. OBESITY, not just being fat, but OBESITY is a side affect of something else, in many/most cases. Medication, a disease, a syndrom, an emotional incapability to cope with life. There is something else going on to make a person unable to be in control of their weight - whether it's over eating or because of medication or because of lack of exercise, etc, etc, etc...



And, people don't start off as obese. There is a progression, and once someone starts to get to the point where they are packing on more than *just* extra pounds - it's time to TAKE CONTROL. Find out what is causing all that weight gain, is it something medical? Is it diet? Is it exercise? People who are obese, have lost control - for whatever reason, whether they can help it or not -- it's key that they understand that though, and do what they can to make sure they control everything that they CAN control.

Lisa - posted on 02/16/2010

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My post was not ment as a personal attack on you Jo, My Apoligies. I think you do make a valid points, and I really do commend you for winning the fight against your adictions. I think I do make valid points as well all be it not exactly directed at you personally. The debate was about whether obesity is a disease. I do not think obesity is a disease I just encouraged everyone to look at the bigger picture, especially in women who aren't necessarily "Obese" but carrying a few extra pounds because terms such as "comfort food, control and coping mechanism" was thrown around. Not everyone is on the road to self destruction.

?? - posted on 02/16/2010

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I have never even once implicated that I think every single person who is overweight does that. I said that the people that do - I am not going to pat their back and go along with their excuses. I will tell those people that what they are doing is their fault and it does not help and that they have to take control of the situation.

I'm not even sure why or how you got the idea that I (or anyone) think like that from any of the posts. I haven't said anything that even remotely indicates that I think EVERYONE is like that, that's just silly, pointing that out is completely irrelivant.

Lisa - posted on 02/16/2010

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Well Jo, I think you should be commended for being in control of you past addictions. I just wanted to point out that some of us who are overweight are not as you said stuffing thier faces with a whole table full of treats. Not everyone's body is the same and just because someone may not fall into what the BMI scale calls normal does not mean that they are out of contol as you put it. I am not referring to the morbidly obese but instead just your average person who carries some extra weight, I think I should have stated that more clearly in my previous post. I agree with Cathy S' good point that the BMI isn't a great way to asses wether you are over weight or not.

Lisa - posted on 02/16/2010

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I am I suppose, what a BMI scale would call over weight/obese. That having been said, I lead an active life, I swim, camp and hike in sumer, I go to a gym 3 times a week, I have a part time job and am going back to school and I'm rasing 2 kids. I have a pretty average diet, take out a few times a month but usually pretty basic home cooked stuf. My husband is thin, and trust me he packs away all the same stuff I do lol even more (lucky so and so) but to my dismay weighs in at about 150. I have P.C.O.S and I have needed anitdepressants in the past. I have allways been big, I was one of those girls in school that no one messed with, you know farm girl muscle, my hubby may be thin but I could bench press his ass lol. But all that having been said I really do believe genetics has a part in how I am built, I told the trainer at the gym that if there ever was a skinny person in my family would likly have ate them lol. I don't know if obesity is a disease and I don't really concider myself obese either but I do think there are alot of steriotypes that go along with diferent body types. I encourage people to think twice before you concider that chunky girl lazy, week willed or suffering from some "psycological" issue, truth is there are a ton of factors that can make people overweight that doesn't mean their bad people. The same as the uberthin person isn't a bad person either, please look with in and do your best not to judge

Amie - posted on 02/16/2010

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I don't think alcoholism and drug addictions are diseases though. Which is why it has helped form some of my opinion on this. I also have many family members (who we do not interact with now because of these issues and some that have limited contact) and a few ex friends who have gone through the same thing.

I have yet to meet any addict, of any kind, that did not have an excuse for the why. Why they are addicted, Why they started, Why they can't just start the road to recovery now.

It's not that I don't feel for them (to some degree) but after walking down that road too many times, I'm more apt to walk away from these people now and let them hit rock bottom alone and climb out themselves. Some pull through after hitting there and start to turn their lives around, others do not and continue to live lives that are consumed by their addiction.

I know a few "functioning" addicts too. These are the worst kind. They figure because they can manage to stay sober long enough to go to work then get home and get tanked/high all night; that they are fine. They're not fine. They are losing relationships and pushing people away because of it. They are doing damage by the lying as well. More often then not these people are lying to everyone around them (who isn't close enough to see them drunk/high every day/night) so no one has a clue.

Like obesity being a side effect of other issues (as Jo put it) I do think drug and alcohol addiction is along the same ilk. A lot of addicts use it to self medicate. It is easier to be an addict for them, then to face the harder road of dealing with whatever is causing them problems. It's a coping mechanism that's gone horribly wrong.

Jocelyn - posted on 02/15/2010

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I think that SOME people can have a genetic disposition towards obesity. But I think that for a lot of obese people, they just try and use "it's a disease" as an excuse for their lousy life style choices. My family are generally bigger people (almost every second woman has had a breast reduction lol) but we're not obese. There are a few ladies that are obese but they eat crap and don't exercise at all. All of us other woman work out, walk, eat pretty sensibly, but we're just not a small family. I myself am generally around the 160-170 lb mark, but I'm healthy. I work out, my legs are solid muscle. If I were ever to get down to like, 130 lb, I would look absolutely sick. My best friend is a bigger girl, but she eats really healthy, and she's active, still she's always around 210/220 lbs. She really struggles and just can't loose the extra weigh. While I know that she's not considered obese by society's standard, I do think that it could be considered a disease in her (or at least there is something wrong with her that we haven't found out, like a thyroid problem etc). I have one friend (ex friend) who eats crap, fast food, doesn't exercise ever, and she's huge! And she use to mope " I just don't know what I'm doing wrong, I can't loose these 20 lbs,..." whine whine whine, meanwhile she's sucking back venti fraps from starbucks with extra whip cream. Gee, really? You can't put two and two together. And I've seen the rest of her family, they are normal, her 4 sisters are all around the 10-16 size, which isn't bad at all. She can definitely try and use the "it's a disease" all she wants, but we know better.
I do think that if is truly is a disease, then in those specific cases it should be treated as a disease, and health insurance should be able to cover parts of it. Maybe offer discount gym memberships, cover nutritionists, gastric bypass, etc. But they should be closely followed by doctors, or special case workers to insure that they are doing everything that they can to loose the weight. And if they insist on having their daily venti frap, then they are dropped from the program and have to pay back the difference for their gym membership!

Rosie - posted on 02/15/2010

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i'm leaning more to a disease, although i'm not sure. i just feel that some people are genetically dispositioned to have food affect them in a way that they become addicted to it, others not so much. i do believe it has alot to do with lifestyle as well though. if your parents are obese, they probably aren't going to have the best food choices around in the house for their children, and they don't show them the appropriate times and ways to eat, so they are setting their children up for a life of obesity. i don't know, i'm kindof stuck in the middle as well.

?? - posted on 02/15/2010

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I have many different thoughts about obesity. As you will see, this post is gonna bounce around a lot.

On one side, I don't think "obesity" is a disease exactly. I think that "obesity" is a side affect of diseases. Like stated in the OP; hypothyroidism, Cushing's syndrome, and polycystic ovary syndrome are all diseases that can be the cause of obesity. So obesity, in itself, isn't a disease - it's a side affect of the various diseases - like high blood pressure, acne, heart burn - that you can do different things in your life to maintain, control and lessen the affect of.

There are genetics that play a part in 'big boned' people - I still think that there is a measure of personal control, responsibility and lifestyle / diet / exercise tendencies that individual people have to maintain and be in control of.

This is where it gets tricky for me because 'big boned' people don't start off OBESE, they may be overweight -- but they can control certain things; eating right, exercising, going out of your way to make sure you take care of your body -- those things will help to make sure you don't go from being 'overweight' to being 'obese'.

And the psychological issues, comfort food, if eating is your comfort, your release - obesity is not a disease, it's a sideaffect of using food as your crutch to deal with whatever is bothering you. It's a coping skill that is missing, leading to obesity by replacing love with food.

I don't really KNOW if it's a disease... but I think that obesity needs to be treated on so many different levels. Diet & exercise, mentally & physically... there are so many different things that are a side-affect of being obese that need to be treated as well.

And since there are 'side affects' of being obese I think it could be classified as a disease too. I think before a person gets to the point of being obese there are other things that are a cause, which is why I don't necessarily think it's a 'disease'.

So it's like, in the middle, it's the side affect of a disease, that individuals have to be aware of as a possibility and have to be in control of as to avoid that side affect... but then once it's gotten to that point, there are side affects of being obese and those things you have to be aware of, so that you can get in control of those things, so that you can get in control of your weight gain, so that you can be in control of your life.

So I don't know really. It can be, but it's not really, there's just too many things that we can control if we WANT to control and if we don't control it then we have every excuse in the book to chalk it up too... drug addicts, alcoholics... some people will say it's a disease, others will say it's not. I think "obesity" kinda fits into the same category as that... some people will say it is, some people will say it's not......

All that really matters to me though, is that people that are obese, understand why and how it happened. Because if they can grasp that - then they will get better. But if they don't even accept why and how it happened -- whatever the reason may be !! -- then they will continue to be obese and they won't get the help they need -- no matter what that help may be !!! -- in order to take control of their their disease, their actions, their behavior and just their life in general.

Krista - posted on 02/15/2010

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I think that with obesity, there are biological and genetic factors that make a person gain weight much more easily, and that predispose them to a psychological attachment to eating. Of course we still all have the choice, and I don't think that obesity is inevitable, but as someone who struggles with it myself, it is a REAL uphill battle to maintain a "normal" weight. It can be done, but there are a lot of things working against me -- I gain weight easily, lose it very slowly, and have an addictive personality when it comes to food.

While many people can maintain a healthy weight with very little effort, in order for me to get under 200lbs., I have to exercise for at least 45 minutes a day and not let ANY junk food pass my lips. And even then, the lowest weight I can attain without starving myself is 180, which, according to the BMI charts, is still overweight.

I think that it's very worthwhile to look at obesity not necessarily as the disease itself, but as a symptom or a condition CAUSED by underlying physical and psychological conditions. It does nobody any good whatsoever to just say "Well, eat less and exercise more -- all it takes is willpower!" It's not that simple. We have to look into how obese people can overcome a food addiction, how we can use psychology to help them start to develop a habit of physical activity, and yes, look at the genetic aspect and figure out what it is that makes some people gain (and hang on to) weight so easily.

Amie - posted on 02/15/2010

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I'm of the same mind as Mary. It's become too easy for the vast majority of obese (not overweight, obese) to have an excuse as to why they are the way they are.

Overweight is not the same as obese. It's not even in the same range of my thinking. I've known a few obese people. They always had an excuse. More often then not too they exacerbated the issue of being overweight by living non active lives and made poor meal choices which lead them to being obese. With McDonald's around every corner (or something of the same ilk), with your computer and t.v. in front of you for quick entertainment, with the ease of access and more often then not the "junk" life style being cheaper than the "healthy" lifestyle, many people are falling into the pattern to becoming over weight which then leads to them being obese if they do not change something.

There are some overweight people I can understand, and even sympathize for, on their issues for being overweight. I have a friend who has thyroid issues, another with fibromyalgia, another with asthma, they all have valid reasons for making it a little bit more difficult for them to lose weight. But they are trying. One had tipped the scales to the point of obesity and ended up on disability because of it. I did not agree with it at all and told her so. Her life style choices were making it that much harder for her to lose the weight she needed to, disease notwithstanding. It's been hard for her to break the poor diet choices and lack of exercise but she's getting there. While she may never be "skinny" she's on the road to getting it under control.

I do think to some degree though if it is labeled a disease; every tom, dick and harry who doesn't want to make the effort to correct the issue themselves will just say, "oh It's a disease I can't do anything about it". Much the same way I hear alcoholics in my own family using the same excuse for their alcoholism. "It's a disease."

Mary - posted on 02/15/2010

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I'm not really sure where I stand on this question. I do believe, that for some, it truly is a hereditary, genetic, or biological condition. However, I doubt that is true for the vast majority of obese people. For them, I really do think that lifestyle choices are the mjor contributing factor. Truth is, we live in a world where fast food, internet surfing, computer games, and watching TV for hours are the norm...and these are habits being passed on to our children. It's really hard to break that cycle...I find myself fighting it on a daily basis.

I look at my own family, and I have to say, my mother and sister are overweight due to lifestyle and dietary choices. My sister, in particular, is a self-confessed emotional eater. She does not exercise - ever, and she and her family eat out at least 3-4 times/week. The meals that they eat at home are not exactly healthy either (although her mac and cheese made from scratch is to die for!!). While her children are currently slender and active, I do worry about their future, and the eating habits they will develop as adults. I don't judge her; I myself have struggled with my weight since my early 20's, and will never be classified as 'skinny". I'm probably in better shape now at 39 than I was at 29...but it's a pain in the ass, and I often lack motivation. Honestly, I HATE exercising, and the only thing that makes me get out and walk 3-5 miles a day is that the dogs and Molly are so used to it, they are miserable if I try to skip a day! Otherwise, my ass could easily be sitting on the couch, watching Oprah with a bag of chips!

My point in this ramble is that for many, it is not truly a disease, but the consequences of a series of unhealthy choices and habits. I'm not genetically predisposed to either obesity or being skinny, but I choose (most days) to maintain the effort my body requires to be a healthy size. I think this is probably true for most of us for whom wieght is an issue. Unfortunately, some of us really do have to work at it harder than others.

Cassie - posted on 02/15/2010

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I'm a little torn on the issue. I believe obesity, for some, is a disease. For others, I believe it is a lifestyle choice. This holds true for many of the people I know.



For some, they have been "big" since they were children and as they grew into adults, they became obese. It wasn't necessarily something they could control. Even with diet and exercise, they may never be medically "normal" but will always fall on the obese side of the scale.



For others, it is a lifestyle choice. There is often a trigger that begins the downhill spiral into obesity. For these people, with lifestyle changes such as diet, exercise, and support, they can come out of obesity into a normal, healthy weight.



Because of this, I think it is difficult for obesity to solely be treated as a disease. I wish there was a way to identify those who truly do need their obesity to be treated like a disease and those who just need to diet and exercise their way back to a healthy weight.



I actually have a friend at this moment who is in her 40's. As a teen, she was incredibly slender and thin. She had her first child at age 17, her second at age 20. During her pregnancies, she gained a considerable amount of weight and continued gaining weight until just this year. Finally, something clicked for her and she decided she wanted to live a healthier life. In the past 6 months, she has lost nearly 75 lbs and is well on her way to being the person and size she has wanted to be for nearly 20 years. For her, it was emotional eating and an inactive lifestyle that she needed to change to overcome her obesity. She is, for me, an example of a person whose obesity is not a disease but rather a lifestyle choice.

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