Is Not Calling Obesity A Disease Discrimination?



sharma-obesity-policy1In the many discussions I have had about calling obesity a disease, I have often heard the argument that calling obesity a disease somehow discriminates against larger people.

Indeed, there are people who consider “obesity” to be largely a “social construct” invented by the “medical establishment” to “medicalize” something that is simply a natural part of the spectrum of human shape and size.

Funnily enough, some of the most passionate opposition to calling obesity a disease, comes from that very same “medical establishment” – doctors who don’t want to see providing obesity care as part of their job, hospital administrators who think providing obesity treatments takes resources away from dealing with “real” diseases, and payers who fear having to shell out millions of dollars for expensive obesity treatments.

Indeed, if I had to point to one single factor that has in fact stopped the “medical establishment” from finding better treatments and providing access to effective and compassionate care for people struggling with excess weight, it is their refusal to consider obesity a disease.

The paradox in all this would be funny if it were not so sad – it turns out that many in the very same “medical establishment” that is being sharply criticized by social scientists and the size-acceptance crowd for “medicalizing” obesity, are in fact fighting as hard as they possibly can to NOT have obesity declared a disease.

So oddly, the people who appear so concerned that labeling obesity a disease could somehow discriminate against people of size,  are widely supported by the general public, many of who would think the notion of obesity as a disease ridiculous, given that in their view, being large is simply a matter of poor choices.  Sounds to me, like a rather uncanny alliance between the far left and the far right.

While I fully understand that for some people, being “labeled” as having a disease may be traumatic, I see this as no more or less traumatic than being “labeled” as having hypertension, diabetes, arthritis, sleep apnea, or for that matter, cancer.

Does this mean some people for who their excess weight poses no medical risk will get mislabeled? Sure it does. But there are also many otherwise healthy folks “labeled” as having hypertension, diabetes or even cancer, who will live to a ripe old age – good for them!

I am also the first to celebrate size and shape diversity and readers may recall that I invented the Edmonton Obesity Staging System to deal with the issue of “healthy” obesity.

However for those, struggling with the health consequences of excess weight, if calling obesity a disease gets them better access to treatments – so be it!

Case in point – the American Medical Association‘s declaration of obesity as a chronic disease has been one of the key drivers of policy decisions to include obesity treatment in various care plans across the US.

So before we accuse anyone of discriminating against larger people by calling obesity a “disease”, let’s dare ask the question – who do we harm by refusing to do so?

@DrSharma
Edmonton, AB