Is Obesity a Disease? Sometimes, but Not Always

Introducing ‘Clinical Obesity’

Obesity is estimated to affect more than a billion people worldwide. (Rawpixel pic) Paris: Do people with obesity have an illness? A panel of global health experts looking at this controversial question announced on Wednesday that the definition of obesity should be split into two categories, and diagnosed using more accurate measurements.

The recommendations are aimed at moving past the blame and discrimination that often revolve around obesity, which is estimated to affect more than a billion people worldwide.

“The idea of obesity as a disease is at the centre of one of the most controversial and polarising debates in modern medicine,” said a paper by the 56-expert commission in the Lancet Diabetes & Endocrinology journal.

On one hand, obesity is known to lead to an increased risk of type-2 diabetes, heart disease, some cancers, and other health problems. This is why the World Health Organization, among others, consider it to be a “chronic complex disease”.

On the other hand, there are also plenty of people defined as obese who have few or no underlying health problems and lead active, healthy lives. Activists campaigning against fat shaming, for example, do not want people with obesity to automatically be considered unwell.

At the same time, some patients and doctors believe obesity needs to be considered a disease so that it receives the attention – and ambitious policy – required for such a major public health issue.

Francesco Rubino, a bariatric surgeon and professor at King’s College London who chaired the expert commission, told a press conference that the “controversy derives from the fact that perhaps not everybody is entirely right and not everybody is entirely wrong”.

The Criteria for Clinical Obesity

When obesity affects the functions of people’s organs, it should be considered a distinct illness called “clinical obesity”, the commission said. The criteria for diagnosing clinical obesity include heart, liver or breathing problems, high cholesterol, sleep apnoea, hip, knee or feet pain, or other problems that affect people’s daily lives.

A New Approach to Diagnosis

The experts also recommended healthcare workers move beyond body mass index (BMI), which measures the ratio between weight and height and is widely considered inadequate. They urged other measurements including waist circumference, waist-to-hip ratio, or even bone-density scans to get a more accurate diagnosis.

The experts also recommended that healthcare workers move beyond body mass index, which measures the ratio between weight and height and is widely considered inadequate. (Envato Elements pic)

Not Everyone’s Convinced

Some researchers not involved in the commission welcomed the recommendations. Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London, said an official recognition of clinical obesity “would hopefully persuade lawmakers to regard it as a disability”.

“This would have implications in terms of discrimination particularly in employment as well as the social stigma associated with the condition,” he added.

Conclusion

The introduction of “clinical obesity” as a distinct category aims to address the controversy surrounding obesity and its classification. While the recommendations provide a more nuanced approach to diagnosis, they may not satisfy everyone. Some argue that obesity should be recognized as a disease to receive the attention and resources needed, while others believe it should not be pathologized. Further research and discussion are necessary to clarify the implications of this new classification.

Frequently Asked Questions

* What is the definition of obesity?
+ Obesity is defined as a complex chronic disease that can lead to a range of health problems, including type-2 diabetes, heart disease, and some cancers.
* What are the new categories for obesity diagnosis?
+ The commission recommends diagnosing two categories of obesity: clinical obesity, which affects the functions of organs, and pre-clinical obesity, which does not.
* Why is the shift from BMI important?
+ BMI is an inadequate measure of obesity and may not accurately diagnose the condition. The new recommendations urge healthcare workers to use alternative measurements, such as waist circumference and bone-density scans.
* What are the implications of the new classification?
+ The classification aims to reduce blame and discrimination towards people with obesity. It also raises questions about disability and the social stigma associated with the condition.