With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognise it as a disease? In a head-to-head article published in the BMJ, experts debate that very question.
John P H Wilding, professor of medicine at the University of Liverpool and Vicki Mooney, executive director of the European Coalition for People living with Obesity, say obesity meets the Oxford Dictionary definition of disease.
They point out that more than 200 genes have been found to influence weight. “Thus,” they say, “body weight, fat distribution, and risk of complications are strongly influenced by biology”.
They say recognising obesity as a chronic disease with severe complications rather than a lifestyle choice could help reduce the stigma and would give people with obesity “permission” to seek treatment. “Unless we accept that obesity is a disease, we are not going to be able to curb the epidemic,” they conclude.
However, Dr Richard Pile, a GP with a special interest in cardiology and Clinical Lead for Prevention for Herts Valleys Clinical Commissioning Group, disagrees. He argues that adopting this approach could result in worse outcomes for individuals and society.
He believes the dictionary definition of disease “is so vague that we can classify almost anything as a disease” and says the question is not whether we can categorise obesity as a disease, but whether we should, and to what end.
Labelling obesity as a disease “risks reducing autonomy, disempowering and robbing people of the intrinsic motivation that is such an important enabler of change”, Dr Pile says.
“Making obesity a disease may not benefit patients, but it will benefit healthcare providers and the pharmaceutical industry when health insurance and clinical guidelines promote treatment with drugs and surgery,” he says.