Prevention Vs Treatment Is Not An “Either-Or” Question

Yesterday, at Obesity Week, I attended a debate on whether or not obesity is a disease (really, is anyone still debating this?).

While both sides made the usual arguments and both debaters (one perhaps more so than the other) landed heavily in favour of calling obesity a disease, the audience comments against calling obesity a disease were what you may expect.

While I get the caution against possible stigmatization and the issue that not all people living with obesity are necessarily “diseased” (we desperately need a non-weight based definition of obesity), the counterargument that to me is most irritating and holds the least merit, is the notion that calling obesity a “disease” will somehow distract from or even hinder the efforts at prevention.

This is something I simply do not get.

Indeed, I am not aware of any preventable condition (CVD, Cancer, Diabetes just to name a few) where efforts at prevention are abandoned, diminished or hindered by calling the condition a “disease”.

If anything, you would think that ‘legitimizing” a condition by calling it a (serious) disease, would lead to even more efforts at prevention – especially when we have such poor treatments.

In fact I simply do not get why one would even discuss which is more important: prevention or treatment – both are!

No amount of prevention will treat the people who already have the condition and treatments should never replace prevention.

Funnily enough, I do not believe that I have ever heard anyone who calls for better treatments (of any disease) pooh-pooh the need for prevention – at least not for conditions where prevention actually works.

The opposite, sadly, is not true.

@DrSharma
Boston, MA