Sunday, September 9, 2012

Is Obesity a Disease?


The answer to that question depends entirely on who you ask. Personally I never even thought about this when I was overweight and  certainly never considered myself as diseased. Dr. Scott Kahan, on the other hand, absolutely thinks the answer is yes, and according to this article (Is obesity a disease?), the IRS agrees, allowing people to take deductions for expenses related to obesity. Yet the same article points out that it is possible to be obese and healthy, and that (moderate) obesity even has some benefits, particularly in older people.

So perhaps the better question is, should obesity be universally considered a disease? If so, what would that mean?

It might be nice in some sense, to get health insurance coverage for some treatment, but what, precisely, would be covered? Would I get discounts on fresh produce or gym membership, or even get them free? But what if I don’t like going to the gym - could I get mileage reimbursement for driving somewhere to climb a mountain, or to buy good hiking shoes? What would qualify as being treatment? Those questions make me nervous about forcing people into certain avenues that might not be the best fit for them.

But for me the bigger question is the societal implication. People who are overweight are already treated poorly and unfairly, in some ways like lepers. Many go out of their way to avoid looking at or touching those who are overweight. If everyone agreed to call it a disease, would this make those people feel justified in their behavior? Or would it elicit more compassion? Dr. Kahan states: “We should extend to persons with obesity the same respect that we extend to those suffering from other chronic diseases.” I don’t disagree that obese people should be treated with respect, but would that actually happen?

I also worry that qualifying it as a disease would just fuel the national obsession with equating thin and healthy. It might make certain practices common, such as the recent decision by the United States Tennis Association to deny funding to teen tennis rising star Taylor Townsend, saying that she is too fat and must first slim down. Would even more people become anorexic or bulimic in an attempt to avoid the dreaded obesity diagnosis?

Which raises another question - what qualifies as obesity? If someone like Townsend can be considered fat, what does that mean for the rest of us? If almost everyone is overweight, does it even make sense to have it as a condition? 

I am also concerned about the issue of personal responsibility. Some people might very well take it as a good reason not to even try eating better or exercising more. Or contrarily, those who are obese and healthy might be discouraged from maintaining their healthy habits if they’re still treated as if they’re diseased.

I still don’t think obesity should be classified as a disease, but opinions will differ. Regardless of the end result, I hope people take it with a grain of salt and remember that weight and the BMI charts are not the only measurements of health, and to trust their own bodies to find what’s comfortable for them.

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