Is obesity a disease? I don’t think so.
The rhetoric around obesity got more frenzied last week after the Department of Health and Human Services announced it was changing the language in its Medicare policy. The policy now considers obesity to be an illness.
To its great credit, the department made the change in order to allow Medicare to cover some weight loss treatments. That’s a good thing, because obesity-related diseases need to be prevented. However, it has succeeded in muddying the waters in a vast linguistic swamp.
For example, ABC News, among others, has a Web page devoted to the “obesity epidemic” -- complete with martial metaphors of battling the disease. The World Health Organization and the Centers for Disease Control and Prevention also describe obesity as an epidemic.
The best look at obesity, however, comes from The Onion, which interviewed Oklahoma City resident Fran Torley. She came down with obesity about two years after she got married. Her husband also caught the disease: “Some days, we sit and watch television from dawn till dusk, hoping for news of a breakthrough," she said.
The Onion describes researchers working feverishly to discover the causes of fatness. Scientists know obesity tends to run in families," says a supposed University of Chicago researcher. "But we have yet to pinpoint exactly what it is that causes, say, the Smith family to splash about their backyard pool blissfully unaffected while, just over the fence, the Jones family languishes 30 percent overweight on their barbecue deck."
An epidemic, in the strict sense of the word, is the appearance of a particular disease in a large number of people at the same time. And disease is an illness caused by an infection or by a failure of health.
Obesity itself is not a failure of health. It’s a condition that can raise the risk of health problems.
Smoking cigarettes is not an illness either. It’s a practice that considerably raises the risk of getting a fatal illness.
Describing fatness as a problem of disease and epidemics obscures the larger picture. People are fatter because of greater abundance of food, an increased prevalence of junky food and less exercise.
It’s a cultural problem, not a disease.
One solution is to change some habits that we, as a culture, have fallen into.
People don’t cook at home as often as they used to. They rely more on fast food. Regular meals aren’t as much of a ritual. Trips that used to be made on foot are made by car. Much work now consists of sitting in front of a computer for eight hours.
It’s possible to look critically at this new way of life – and choose to do things differently.
We can also look critically at the assumptions of our time. At some points in history, fatness was considered a good thing. It was a measure of abundance and of good health.
In fact, there are people who think the health problems of fatness are overblown.
Colorado professor Paul Campos, author of "The Obesity Myth," may be right when he says we have an exaggerated fear of fat.
Regardless, we can step back from the handwringing. Maybe we really should be thanking our lucky stars we have enough to eat
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