Is Obesity a Disease?

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By Warren Heggarty

Brian Oldfield, a researcher from Monash University who is President of the Australia and New Zealand Obesity Society, recently published an article in The Australian newspaper claiming that obesity is a disease and not a matter of choice. Oldfield said that declaring obesity a disease will facilitate greater investment in research and medical remedies. He also said that treating obesity as a lifestyle choice has not worked. In fact, Oldfield claims that it is actually dangerous to assume obesity is a lifestyle choice or a lack of will. He calls it a “chronic, relapsing disease process…as much a consequence of biology and genetics as are cancer and arthritis.”

Oldfield reminds us that we don’t tell people with arthritis to “simply move more and look beyond the pain”, so why do we take that approach with obesity: “Stop eating so much and do some exercise?” Oldfield says that not only does this attitude not work, but it causes damage. 

Speaking against Oldfield’s article, one correspondent said, “labelling the condition a disease will result in individuals absolving themselves of responsibility. Medical involvement will develop an expensive industry and result in more pills and surgery; it will be catch up medicine rather than prevention.” In other words, treating obesity as a disease might potentially lead to dis-empowerment. It instils a victim mentality and a sense of helplessness, or at least that it is “not my problem” but a problem for clinicians. 

One point in Oldfield’s favour is the fact that so many of us find it very difficult to motivate ourselves (and each other) to eat better and increase our physical activity. But just because it is difficult to tackle obesity properly does not make it wise to give up and rely on pharmaceuticals. In addition to everything else, using meds for such a purpose may introduce side effects into the picture. 

Oldfield is far from alone in his views, though. There are more than 30 organisations now calling for a national strategy to tackle obesity. One of their proposed tactics is a health levy on sugary drinks. Public health campaigns notoriously do not reach the lower socioeconomic groups, however. One critic of Oldfield asks,”Why [is] this obesity gene is so prolific in the Western suburbs and…less prevalent in the more affluent areas of Sydney?”

The people least able to pay the tobacco tax are the ones who pay the tobacco tax. They will also pay the sugar tax if it comes in. Will that lead to a net benefit either for them or for society? Or will this just be another stream of revenue raising?

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