Is Obesity really a disease?

The problem with analysing a question like this one, is that it stirs up all different types of emotion. There seems to be two obvious sides to the debate. On the one hand you have the people who believe that obesity is in fact a disease based on an almost uncontrollable urge to over-consume calories resulting in a BMI (Body Mass Index) of 30+. The other side of the coin believe obesity is not a disease and merely an issue at an individual level. A chronic lack of self-discipline and control rather than an overarching condition affecting millions of people. Which one is right? Is there an element of truth in both?

In order to honestly provide a balanced answer to this question, we must be completely objective in our analysis. We need to remove all emotion from the argument. The official classification of an obese individual is someone with a BMI over 30. Your BMI is calculated by using your weight (in kilograms) over your height squared (in centimetres). The official definition of a disease in the Oxford Dictionary is “a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury”. Obesity could certainly be classed as a “disorder of structure or function in a human” reinforcing the idea that obesity is correctly classified as a disease. The risk of being classed as obese isn’t just down to the negative physical aspects of being overweight, but also the increased health risks. The NHS states that people who are classed as obese are at an increased risk of developing type 2 diabetes, coronary heart disease, strokes and developing certain types of cancer such as breast and bowel cancer. People who are obese are also more likely to suffer with psychological disorders such as depression and low self-esteem. You probably already know all of this. The debate isn’t based on whether you’d want to be classified as obese. The issue is whether the condition is correctly classed as a disease.

Those who believe obesity to be correctly classified as a disease have a very valid argument. Many people struggle with self-control and describe their relationship with food as an emotional one. This then makes it understandable to believe that daily fluctuations in emotional state might result in varying levels of food intake which would perpetuate the issue of over-eating. Is this more a lack of accountability though? I wasn’t feeling good today, so I binged on all my favourite junk foods. The people on the other side of the argument would believe so. The problem with this broad-stroke assessment is that the problem is highly individualised. The Mental Health Foundation reports that 1 in 6 people in the UK alone suffer from some sort of mental health disorder such as anxiety, depression or bipolar. This would then support the idea that daily fluctuations in mood or energy levels might result in a wide variety of calorie intake or activity levels. If you suffer from anxiety or depression, it’s probably safe to say you’re less likely to put your shoes on and go out there and do some sort of exercise or activity!? There’s also this idea of food addiction. You can become addicted to cigarettes, drugs, alcohol, pain-pills etc. Why can’t you be addicted to food? When it comes to the other types of addiction, we tend to be more supportive of the struggles of individuals and come up with practical solutions and psychological support when it comes to fixing the problem. An addiction to food though, isn’t exactly perceived in the same way. It’s probably slightly easier to negatively judge an obese individual for eating too much than a drug addict for using too much. Based on the mental health statistics and the fact that obesity has strong links to mental wellbeing, it isn’t too far-fetched to accept the idea of obesity being a clinical disease rather than a simple choice at the individual level to over-consume calories to the point it starts to negatively affect the persons health.

What about the other side of the coin? The people who believe obesity isn’t a disease and merely an issue of the individual characteristics. It’s a simple idea. You like food. You eat too much, you move too little and as a result you’re now overweight or obese (at the extreme end of the spectrum). It sounds harsh, but in order to be balanced within the argument we must explore both sides. What validity is there to this side of the debate? Well for one, if you want to link a person’s mental well-being to their food intake then one question you might ask is which comes first? It’s a bit of a chicken and egg type of debate in that is a person decline in mental health resulting in an over-consumption of calories or is it the other way around and the over-eating is what is causing a decline in the persons mental health? It’s an important question to ask because depending on what side of the argument you fall on, will likely dictate your overall opinion on the issue. The people who believe obesity is not in fact a disease is likely to suggest that a lot of the problems start with the lack of self-control with food choices and volume, then the gradual weight gain to a BMI of 30+ then has the negative impact on the persons mental health. There’s an aspect of this that is difficult to disagree with. I mean, if you know a specific behaviour that you are partaking in to be very unhelpful towards your overall health and well-being then why continue to stick with that same behaviour? Also, in today’s environment with the amount of knowledge and support on offer, surely, it’s easier for someone to get both mental and physical support before the problem gets to that extreme end of the spectrum.

In all honesty this is a debate which could be had for several days, months or even years never mind in a 1000-word blog piece. It’s easy to accept the argument that obesity is in fact a disease and not merely a simple lack of self-discipline at the individual level. This seems to be supported by the growing number of people suffering with mental health issues within our society. The other side of the argument believe that the decline in mental health is a result of the overall lack of self-control and high caloric intake of processed, sugary foods. Again, there may also be some validity in this especially considering the amount of help and support that is on offer today. The purpose of this blog isn’t to sway your opinion one way or another rather just present both arguments in a logical, objective manner. Regardless of which side of the debate you fall on, one thing is clear, with the growing strain on our NHS due to lifestyle related diseases such as Type 2 Diabetes and Heart disease, it is more important now than ever, that we look to find a solution to one of the biggest problems our society is facing today.

Author – Scott McBride (McBride Fitness)