Jan 23

Is Obesity a Disease? A Post for National Obesity Awareness Week

Is obesity a disease or a lifestyle choice?  That is the question.  More and more countries are considering obesity as a disease, and calling on other nations to do the same.  Currently, Portugal is the only country in Europe that classifies obesity as a disease, joining America, Canada and, to a certain extent, Japan.
obesity statistics uk

Obesity statistics & projections for the UK

Obesity is a major public health issue.  In 2016 13% of adults around the world were obese, putting them at greater risk of diseases such as heart conditions, diabetes and certain cancers.  Most of the world’s population now lives in countries where obesity kills more people than being underweight.  It’s certainly a weighty situation, but will calling it a disease make any difference?  Today I’m sharing my thoughts with you.

‘Disease’ is a public health concern

Availability and affordability of healthy food need to be addressed at national level

Availability and affordability of healthy food need to be addressed at national level

The rationale behind classifying obesity as a disease is essentially a positive one.  It is proposed that calling obesity as a disease will remove the blame culture which surrounds people with weight issues.  From a medical perspective, diseases are caused by harmful agents in the environment.  From this perspective, obesity is not caused by the choices an individual makes, but by a harmful environment which, if changed, can reduce or even eliminate the incidence of the disease.  Recognising obesity as a disease puts more pressure on governments to deal with industry regulation, cost and availability of healthy food, detrimental workplace practices and safe spaces in which to be active, all of which have a role to play in healthy living for everyone.  These factors are beyond the remit of any individual, but need to be tackled at national level.
We also know that obesity is very poorly understood and most of the current options available to people if they choose to address it are unsuccessful.  Perhaps if obesity was understood as a disease rather than being put down to greed or laziness, we could develop more effective options for people who need them, and challenge the prejudices commonly found in the medical profession and beyond.

What’s in a Name?

Reclassifying obesity has not been shown to reduce discrimination or fat shaming.

Reclassifying obesity has not been shown to reduce discrimination or fat shaming.

But is it correct to call obesity a disease?  Will it really shift patterns of thinking or reduce bullying?  I’m sceptical.  Discrimination against fat people seems to be the last socially acceptable form of bullying, and those who like to belittle others are not going to give it up without a fight.  I think there’s a danger that re-classifying obesity will simply change the language of bullying and increase the tendency to label obese people as ‘scroungers’.  Sadly, it won’t make bullying disappear.  Since obesity was reclassified as a disease in America, fat shaming has not decreased. If anything, it has become more prevalent.
plus size woman exercising

Not all plus size people are unhealthy or have unhealthy lifestyles. We love healthy living too!

Furthermore, there’s a tendency to pity and patronise those who are considered to have a disease.  “Oh, poor you; you can’t help it – you’re ill, and you’re a victim of society”.  Personally, I hate being patronized and I certainly have no need of pity or any desire to be seen as a victim.  Even though obesity is a risk factor for many diseases people with obesity are not automatically unwell, or even physically impaired.  I am very fortunate in that I enjoy good health.  In fact, I have fewer health problems than many people my age.  I am lucky to be able to be physically active, full of energy, and enjoying healthy eating.  I know a lot of people like me.  I certainly don’t consider myself ‘diseased’, and neither should you.

‘Disease’ and ‘Cure’?

Considering obesity as a disease could lead to over-simplistic thinking.  The current model is ‘one disease, one cure’.  This could never be true of obesity, because obesity is not one disease, or indeed any disease, and there is definitely not one solution which works for everyone.  Instead, I think it’s more useful to think of obesity as a symptom of a variety of conditions, from disadvantageous genetics to hormone imbalances to social disadvantage.  People who seek to address it need bespoke solutions which take account of what underpins their specific situation.  We plus-sized folks are breaking the mould (literally!) and a cookie-cutter ‘remedy’ will never be a ‘one-size-fits-all’ solution.
It’s also worth considering that having a ‘disease’ implies that you need a ‘cure’.  Many people who are plus-sized don’t want to be ‘cured’; they’re happy with the way things are.
Obesity - Causes and Effects

Obesity is a multifactorial situation

Obesity is very frequently a symptom of some other state of suboptimal wellbeing.  It is undeniably a risk factor for several diseases.  And there are some diseases which cause obesity directly, such as Prada Willi Syndrome.  But I can’t see how classifying obesity as a disease in its own right is helpful or beneficial, either for practitioners or, more importantly, for those who experience obesity.  And at the end of the day, it’s their needs that count.
What do you think?  Is obesity a disease, a symptom or a lifestyle choice?  And how do your views influence your thinking? Let me know.


Would you love to chat about healthy food in an environment that’s body-positive?  Do you enjoy healthy recipes, tips and inspiration, and well-informed articles?  If so, come and join the conversation in my free Facebook group ‘Susannah’s Nutrition Kitchen’.








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