Arguments Against Obesity As A Disease #3: Obesity Is Modifiable And PreventableWednesday, June 8, 2016
Continuing in my mini series on arguments that I often hear against considering obesity a chronic disease, I turn to another common argument, “Obesity cannot be a disease because it is preventable and modifiable.”
That may well be the case (although, we must admit that we are doing a remarkably poor job of either preventing or modifying it), but so what?
There are 100s of diseases that are both preventable and modifiable – and yet no one would argue that they should not be considered diseases.
In fact, virtually all “lifestyle” diseases (by definition) are preventable and modifiable. Take for instance strokes and heart disease – most strokes and the vast majority of heart attacks are both preventable and modifiable (once they occur). So are diabetes, osteoarthritis, obstructive lung disease and many forms of cancer, not to mention the many infectious diseases that are both preventable and modifiable.
There are even a number of in-born genetic diseases that may be preventable or modifiable (e.g. phenylketonuria).
Thus, the fact that a disease can be prevented or modified (once it occurs) says nothing about whether something qualifies as a disease or not.
That said, as recently pointed out by Ted Kyle, for all practical purposes, obesity is proving pretty hard to modify and even harder to prevent in real life. It may therefore be more accurate (and honest) to say that obesity is “theoretically” preventable and modifiable – while we await large-scale real-life examples demonstrating that this is in fact the case, and not just limited to relatively rare exceptions like the 1990’s catastrophic economic crisis in Cuba.
Let’s remind ourselves that there is a vast difference between “efficacy” and “effectiveness” of proposed measures to “prevent” and “modify” obesity.
But even if we did have ample proof that obesity can indeed be prevented or modified by most people, it still says nothing that would speak against recognising excess or abnormal body fat that affects your health as a disease.
Saturday, June 11, 2016
Me yet again. 🙂
I wish the message of “obesity prevention and modification isn’t simple” would be more heard. I’m tired of the worshiping at the alters of CI/CO and TDEE.
I know you’ve discussed this in the past. Yes, you get can gain when CI is more than CO, yet where the CI goes and gets handled and how much C goes O 🙂 is variable from person to person.
I tried an experiment on myself. To make a long story short (for a change) I picked up one of those calorie tracker apps (in the old days we had to use a BOOK!) and tracked my calories for a month. The app said my TDEE was 3600 cal/day (!!!!!). I averaged 2200. The app said I’d lost 10 lbs! My doctor’s scale begged to differ.
(Of course, the hater/shamers all told me that I was lying, that I was “snacking without noticing it” (wth), etc. Shoot me now.)