Pulse of Canada

Is obesity really a disease?

The American Medical Association has voted to recognize obesity as a disease.

Why is this important? Because now physicians and insurance companies have different rules in terms of getting people treatment, and employers will be required to adhere to different guidelines when handling people who are dealing with obesity issues. It will also open new doors to resources and treatments directed at the problem.

According to Health Canada, one in four adults is now defined as obese. Statistics Canada reports that 19 per cent of males and 21 per cent of females between the ages of 20 and 39 are obese, and that percentage jumps to about one-third for people between 60 and 69.

While the Canadian Medical Association doesn't officially label obesity as a disease yet, CMA president Anna Reid called the American decision "sensible."

However, there are skeptics.

"It's certainly a choice, absolutely," said P.E.I resident Cody Ross. "It's no different than smoking or drinking. You know, people can do it, and they know the effects of it. But it's up to them if they want to stop it or treat it."

So here’s the question: Is obesity really a disease?

Thomas Bink: It’s not a disease. And I’d argue that alcoholism isn’t a disease, either. These are called life choices. People choose to eat. People choose to drink. Yes, people can become addicted and unable to control their urges. But if that’s the definition, then we should define smoking, snorting cocaine or even watching TV as diseases. To the contrary – we’ve decided that smokers are social lepers who need to be wiped from the face of the earth, we’ve got laws against drugs and we actually encourage wasting mindless hours in front of the TV. I think it’s a massive double-standard, and as such, I don’t have much sympathy for alcoholics or the obese. Make lifestyle changes if it’s a problem. That’s what we have to do about everything else.

Matthew Coutts: The complication with obesity isn’t that it is a disease, because it’s not. As Tom says, it is a choice that should be addressed with a change in lifestyle. The complication is that obesity leads to so many other health problems that officials think they need to hit the emergency button to deal with them. I have some fear that this could actually make the problem worse. Allowing those struggling with obesity to pull the “disease” card can only promote scapegoat-ism. We don’t need people throwing up their hands and demanding medical intervention for obesity. We need people to take responsibility for their own welfare.

Bink: Exactly. Again, why isn’t smoking considered a disease? It creates worse health issues, and is drastically more addictive than food, but our answer is to ostracize, humiliate and tax smokers instead. “Oh, smokers can just stop smoking.” Really? And now we say that being unable to stop drinking booze or eating pizzas is a disease? I’m aghast. Aghast!

[ Related: Obesity disease has skeptics in Charlottetown ]

Andy Radia: Gentlemen, gentlemen gentlemen. I guess I shouldn't be surprised that you two – with your svelte physiques – don't understand this issue. In its own statement, the American Medical Association concludes that this debate is a semantic one, "since there is not even a universally agreed upon definition of what constitutes a disease." They've identified obesity as such because it could help improve access to medications, surgeries, counseling and education. Those sound like noble reasons to me. Moreover, you guys are irresponsibly perpetuating the belief that obesity is simply related to people eating too much. Sure, that might be in the case a lot of instances, but not all. Genetic, environmental, behavioural, and social factors all play a role in one's weight.

Coutts: It’s been years since someone called me svelte, so thank you for that, Andy. In fact, my doctor tells me I am slightly overweight. While not near the territory of “obesity,” I have been urged to take precautions such as eating right and exercising. Now, if I ignore my doctor’s advice and eventually become obese, does that mean I can skip out of work for health reasons and be treated with kid’s gloves at the hospital? Because that sounds easier. If this is just about the AMA getting more treatments covered by U.S. health insurance plans, I’m all for that. Otherwise, I am reverting back to my call for personal responsibility. After all, I am genetically tall. Can I dismiss my doorframe-caused head scars as the natural effects of a disease?

Radia: Sure Matt, like with all things, I'm sure some people will take advantage of the new definition. Although I don't see many people purposely trying to gain weight for 'benefits'  But, what's the alternative?  Do we let the obesity epidemic become worse?  Do we sit back and wait for more cases of diabetes and heart disease? No, the AMA is doing the right thing by classifying this as a disease so they can get obese people the help they need before they get these other 'real' diseases. That's what this ruling is about. It's not some master plan to let obese people devolve themselves of personal responsibility.

Bink: I respect your argument, Andy, I'm still not on board with this.

What do you think? Have your say in the comments area below.