Arguments Against Obesity As A Disease #5: Reduces Personal Responsibility

In my miniseries on arguments that I often hear against calling obesity a chronic disease, I now turn to the objection that declaring obesity a disease would reduce or even abolish personal responsibility.

The argument being, that the term “disease” carries the connotation of being inevitable and will thus reduce motivation in patients to do anything about it.

This is complete nonsense!

When has calling something a disease ever taken away an individuals “responsibility” to do what they can to avoid or ameliorate it?

Take for example type 2 diabetes – a very avoidable and modifiable condition. Calling diabetes a disease does not mean that the individual can do nothing to prevent it or that, once it occurs, the patient can do nothing to change the course of the disease – of course they can and should and often do!

Or take people with a high risk of heart disease or lung disease or bone and joint disease or even cancer – in no instance do we expect less of patients to do their part in helping manage these conditions just because we call them “diseases”.

There is even a term for this – it is called “self-management” – a key principle of chronic disease management.

The course of almost every chronic disease can be changed by whether or not patients change their diet, follow their exercise program, monitor their symptoms, take their medications, come in for their visits – all a matter of “responsibility” if you so wish.

So just how exactly would calling obesity a disease take away from any of this?

Frankly, I cannot help but sense that people who use this argument most often, are erring on the side of “shame and blame” and probably still see obesity largely as a matter of personal “choice” rather than the complex multifactorial problem that it actually is.

Indeed, the opponents often appear “morally” opposed to the very notion of accepting obesity as a disease, as it now gives people the “excuse” to not do anything about it. Sorry, but this whole line of arguing reeks of nothing less than weight bias and discrimination.

As far as I can tell, calling something a disease often leads to exactly the opposite response – when obesity happens (and it can happen to anyone), it places a tremendous mental, physical and social burden on the people who get it – no matter what you call it.

People living with obesity have no greater or lesser “responsibility” of contributing to the self-management of their disease, than people living with hypertension, diabetes, depression, heart disease, or cancer – people living with any disease should be doing what they can – why would obesity be any different?

@DrSharma
New Orleans, LA