Lifestyle

Obesity is not a choice driven by greed – it’s a disease epidemic, doctors argue

They argued the idea that being overweight is self-inflicted and an individual’s own fault is wrong.

‘It’s not your fault’

Instead, genetics plays a major role in determining if someone will be obese.

And that combined with the serious complications including type 2 diabetes, high blood pressure and some cancers, means it should be defined as a disease, they wrote in the British Medical Journal (BMJ).

Current figures show that 29 per cent of adults in England are obese.

John Wilding, professor of medicine at the University of Liverpool, and Vicki Mooney, executive director of the European Coalition for People living with Obesity, said the “prevalent view is that obesity is self-inflicted and that it is entirely the individual’s responsibility to do something about it”.

But this, they argued, was inaccurate and only reinforced stigma around being overweight.

Written in your DNA

They wrote: “The Oxford Dictionary defines disease as ‘a disorder of structure or function … especially one that produces specific symptoms … and is not simply a direct result of physical injury’.

“Obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets that definition, and the World Health Organisation has considered it a disease since 1936.

“Studies in twins show that 40-70 per cent of the variability in weight is inherited.

“More than 200 gene variations influence weight, and those that increase weight are more common in people with severe obesity and less likely to be found in people who are thin.

“Most of these genes, including those with variants that cause early onset obesity, are expressed in the brain and involved in appetite regulation.”

They said fat distribution was also influenced by genes, adding: “Thus body weight, fat distribution, and risk of complications are strongly influenced by biology – it is not an individual’s fault if they develop obesity.”

Reducing stigma

The pair argued that recognising obesity as a chronic disease with severe complications rather than a lifestyle choice “should help reduce the stigma and discrimination experienced by many people with obesity”.

They added: “Instead of discouraging them from seeking treatment it should give them permission to do so.

“The stigmatisation of obesity leaves patients fearful of discussing their weight, and they turn to fad diets or non-prescription medication because they assume that their obesity is solely their responsibility.”

In contrast, Dr Richard Pile, a GP from St Albans, said the Oxford Dictionary definition of disease “is so vague that we can classify almost anything as a disease”.

Also writing in the BMJ, he argued that recommending a change implies “current NHS and public health strategies are doomed to failure without classifying obesity as a disease”.

He said it presents “a vision of obese people hearing the announcement that obesity is a disease on the radio, getting up off the couch, and heading out of the door for a brisk walk.

“It suggests health professionals will slap themselves on the forehead in a eureka moment, shouting: ‘This changes everything.’

“Labelling obesity as a disease risks reducing autonomy, disempowering and robbing people of the intrinsic motivation that is such an important enabler of change.

“It encourages fatalism, promoting the fallacy that genetics are destiny.”