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Arguments For Calling Obesity A Disease #1: It Impairs Health



sharma-obesity-doctor-kidFollowing my miniseries of arguments I often hear against calling obesity a disease, I now turn to reasons why I (and a number of organisations and experts) do consider obesity to be a disease.

Let us start with the most obvious reason, namely that obesity, by definition, affects health and well-being.

Remember, I am not talking about the BMI definition of obesity – I am talking about the actual WHO definition of obesity as a condition where excess or abnormal body fat affects health.

I have already discussed that there are indeed folks across a wide range of body shapes and sizes, who are perfectly healthy – by this definition they do not have obesity (no doubt, BMI and measuring tapes get this wrong).

On the other hand, even the most vehement fat acceptance enthusiasts will find it hard to argue that there are indeed many folks in whom there is indeed a direct link between excess body fat and health – be it functional limitiations or medical complications.

Thus, excess weight with sleep apnea is obesity, excess weight with type 2 diabetes is obesity, excess weight with hypertension is obesity, excess weight with reflux disease is obesity, and so on.

What some people find confusing is that fact that many of the complications of obesity can also be found in people with “normal” weight, which leads them to question the relationship between excess body fat and health.

Indeed, almost all complications of obesity can also be found in people of “normal” weight but that is because the “complications”, in turn, can have multiple causes.

Take for example fatty liver disease, the most common cause of which is alcohol, which is why in the context of obesity, we use the term – non-alcoholic fatty liver disease. But even if you exclude alcohol, there are a number of other factors that can cause fatty liver disease and these should be ruled out before jumping to conclusions that the fatty liver indeed related to the excess body fat.

The same can be said for almost any medical condition associated with excess weight – before concluding that these conditions are related to the excess weight, other possible explanations should be ruled out.

Ultimately, the test lies in observing the response to a change in body weight – does the condition get better with weight loss or worse with weight gain – if yes, it is likely related to excess weight. If it doesn’t, it probably isn’t.

When excess or abnormal body fat affects your health, it does so in the same manner as elevated blood sugars affect health in diabetes or elevated blood pressure affects health in hypertension.

Reason enough to consider it a disease.

@DrSharma
Edmonton, AB

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