Obesity IS a disease

Pure and simple, obesity is a disease.

It is time to stop arguing about obesity. It’s time to stop behaving as if obesity is a thing people choose.

I could go into the larger argument about other things our culture likes to over-moralize (addiction, work ethic, academic achievement) but I’ll hold myself back… a little. There are tons of arguments regarding obesity, but there are a few things no one argues (because to do so is idiotic):

  1. Obesity increases the risk of serious medical problems, including heart disease, diabetes and cancer.
  2. The #1 cause of death in the United States is heart disease (closely followed by diabetes and stroke).
  3. The rising cost of health care represents a national crisis.

If we continue to embrace the notion that obesity, and the health problems that result from it are caused by a failure of personal responsibility we will get nowhere with solving any of these problems. The sum total of the attitude of most Americans toward this growing problem is to keep parroting the “eat less, move more” mantra.

This attitude extends into the medical community, where general practitioners treat an obese patient as if her/his problem isn’t one the doctor is responsible for. Imagine if you came to see your GP for a check-up and she discovered acute kidney failure and suggested you should drink more water and left it at that. There’s not a lot of difference between this failure to treat the patient for one life threatening condition and another, except we’ve collectively accepted the notion that obesity is always the result of an individual’s less than ideal choices.

What can you do?

First, you can stop being do damned judgy.

Be honest, you’ve probably shared one of those “people of Walmart” memes on social media. Fashion critiques aside, mostly those memes are little more than fat shaming and poverty shaming. Would you amuse yourself and your friends by sharing images of disabled people suffering from ALS? Call it “people of cancer” and it’s not funny anymore, is it?

Second, if you’re struggling with obesity yourself stop accepting shitty neglectful treatment from your doctor.

If he tells you to “just exercise more” ask for a referral to a nutritionist. If your thyroid or other hormone levels aren’t normal ask your GP for a referral to an endocrinologist and don’t assume your general practitioner has enough experience or knowledge to competently treat something that can be quite complex and have a potentially huge impact on your body composition (and general health). Like most marketplaces, health care will respond to the demands of the market. If you, the consumer, accept “just move more and eat less” as a prescription then that’s what you’ll get.

Third, stop going all tea party on suggestions that, maybe, just maybe, the food industry needs more government oversight.

When the health consequences of smoking were framed as a personal choice, and the addictive qualities (and the ways in which the tobacco industry had manipulated their products in the lab to make them more addictive) were less accepted people got righteously indignant about government regulation of tobacco, and increased, punitive taxation of tobacco products. Had the science not proved the deadly nature of tobacco smoke not just to active smokers but passive bystanders that’s probably where it would have ended. We’re at the beginning of a similar point today with the revelations of the ways in which the food industry manipulates their products to make them hyper-palatable, and the ways that these hyper-palatable food products can have dramatically negative health consequences for individuals whose genes predispose them toward obesity. Don’t buy into things like the Coca-Cola company’s campaign to blame you for being obese by sticking a label on their products and display advertising that tells you it’s your job to consume their products in moderation.

What I’m not saying here is that you have no responsibility for your health and well-being. That’s ludicrous. What I am saying is that people who try their best fail to avoid obesity because we live in an obesegenic environment, and instead of focusing 100% of our attention on blaming the obese for their condition it’s time to address that environment, and recognize that our autopilot response of blaming the patient for their illness is getting us precisely nowhere.


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