By now, virtually everyone reading this is familiar with the alarming stats on obesity rates and the health outcomes associated with excess weight. And by now, we've all had a chance to develop our own opinions about what obesity is and why most of us are getting fat. Here's mine:
Obesity is a chronic medical condition -- i.e., a disease.
And few people would disagree with me ... if we all weren't so blinded by the sight of heavy people.
Let's assume, for a moment, that obesity was not associated with having excess weight. That is, imagine if eating too much led to all the health consequences of obesity, such as elevated cholesterol, "hardening" of the arteries, enlargement of the heart, growth of cancerous cells -- but not an overt and outward gaining of weight. If we were blind to the aesthetics of obesity, would anyone fail to see it as a disease?
From a technical perspective, obesity fits any reasonable definition of disease. According to my medical dictionary, a disease is:
An impairment of the body or one of its parts resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.
Let's see...
...an impairment of the body. Check. Obesity goes way beyond its outward appearance. Most affected people develop a cluster of metabolic, hormonal and cellular disruptions -- so much so that having obesity increases the risk of dozens of other chronic diseases, and ultimately premature death.
...resulting from various causes. Check. Obesity doesn't just "happen." It usually results from a constellation of drivers (genetics, environment, medical disorders, stress and many others) that interact with our conscious decision-making processes, leading to the consumption of more calories than are "burned off" by movement and metabolism.
...characterized by an identifiable group of signs or symptoms. Check. Weight gain, difficulty moving, diminished breathing capacity, skin changes, joint pain, to name a few.
A disease is a dis-ease of a part of the body. Clinical depression is a disease. So is a broken bone. So is severe acne. And so is obesity. That most people generally don't define these as diseases is a matter of convention, not fact.
Medically, obesity is no different from other chronic diseases. Consider the similarities between obesity, hypertension ("high blood pressure"), and Type 2 diabetes:
• Each involves malfunctions of intricately regulated systems: blood pressure in the case of hypertension, blood sugar in the case of diabetes and energy balance and body weight in the case of obesity.
• Each has significant genetic predispositions and can ultimately result in serious health consequences.
• Each is associated with unhealthy diets and physical inactivity. This is essential to appreciate. The eating and inactivity patterns that lead to excess weight-gain in susceptible people are the same ones that lead to chronic diseases in others -- even in "skinny" people.
The National Institutes of Health, the World Health Organization and numerous other scientific organizations regard obesity as a disease, yet most people continue to dismiss obesity as a "willful misconduct" and label people who have obesity as lazy and weak.
Sure, there's an element of choice -- personal decisions and behaviors are a central piece of most chronic diseases. But poor food and physical activity decisions aren't exclusive to people with obesity. It's just that we plainly see evidence of their unhealthy behaviors -- on their bellies and hips and thighs -- whereas thin people wear their unhealthy decisions on the inside, hidden from scrutiny.
In fact, the vast majority of Americans, regardless of weight, are eating unhealthily and barely moving. In many cases, people with obesity aren't eating worse or moving less than skinny people. Yet while we instinctively comfort and support normal-weight persons who suffer from hypertension or diabetes or other chronic diseases, even though unhealthy eating and inactivity were likely involved in developing those diseases, we ridicule and punish persons with obesity. Even doctors aren't immune to this stigma.
Such misperceptions and prejudices get in the way of our collective ability to fully understand, prevent and treat this disease.
We should extend to persons with obesity the same respect that we extend to those suffering from other chronic diseases -- including access to appropriate and evidence-based treatments. Doing so doesn't negate the importance of taking a central role in managing their health, any more than prescribing blood pressure medications to persons with hypertension obviates the need for their healthy eating and physical activity.
Most importantly, our focus needs to shift from blame and ridicule to working together to address the "obesogenic" environment, which shapes our personal decisions and health outcomes. Policies and preventive options that address the physical and social environment (such as the economics of food production, access to healthy foods, junk food marketing and many other factors) to make healthy lifestyle choices the default would benefit everyone, regardless of weight.
Follow Scott Kahan, M.D. on Twitter: www.twitter.com/scottkahan
Obesity and Overweight: Topics | DNPAO | CDC
USATODAY.com - Designate obesity as disease
Study: How a 'Fat Gene' Affects Cholesterol and Diabetes
Obesity, Cholesterol, and Heart Disease - Weighing Your Risks
Peace,
Shannon
Okay let's assume that the rash associated with measles wasn't there. Are you a doctor?
If you believe obesity to be a disease, you should infect a couple of million people in the Sudan, Duffer, Ethiopia and many other areas.
All the ill effects of obesity come from over eating just like all the ill effects of meth come from using meth. You can't separate the two.
"Policies and preventive options that address the physical and social environment (such as the economics of food production, access to healthy foods, junk food marketing and many other factors) to make healthy lifestyle choices the default would benefit everyone, regardless of weight."
Education about what it is a person is actually ingesting when they go to a fast junk place or a restaurant is the key. People like to read good things about their bad habits and bad things about good habits they don't do. I have a friend who won't use teflon pans because she's worried about cancer but she'll feed her kids mc-sonic-king 3-5 days a week and think nothing of heart disease - which is a bigger killer now than cancer.
We as a nation have come to view such places as providers of staples rather than the "every once in a while" (like once or twice a year) they should be.
As a result we are overfed and undernourished.
Any obese person who wants to get healthy needs to read McDougall, Campbell, Barnard and Novick, particularly Novick. McDougall and Novick make almost all of their information available free on the internet. They are health providers who sincerely want to help people get healthy.
I'm not sure I agree with the author that it's a disease. But I do agree with what causes obesity.
Here's an analogy: we know that UV radiation from the sun is bad for everyone, regardless of skin color, and that it increases your chance of getting melanoma and other skin cancers. However, those with fair skin are at much greater risk, so should take extra precautions. It's unwise for a dark-skinned person to stay in the sun all day without protection, but it's much much worse for a fair-skinned person to do the same. When the white guy gets cancer and the black guy doesn't, the white guy can whine all he wants about their habits being exactly the same -- it doesn't change the fact that he was the stupider of the two.
Someone who becomes obese with the identical bad habits of someone who remains skinny is the stupider of the two.
But skinny people who eat junk and burn off the calories can still have heart disease and not know it until they stroke out or have a heart attack. This is also true of people in their twenties who die in car crashes. During autopsies, alarming rates of heart disease are reported.
But there's no test for heart disease. MRI and CAT scans or other such tests don't see it. It's a silent killer.
I know plenty of "skinny" people who eat junk. They figure they're skinny - that eating junk doesn't affect them the way it does a fat person so they tuck in!
If the fat person and the skinny person both know that eating junk causes all manner of health issues, but the skinny one decides "not me" cuz they're skinny ... that's the stupider of the two.
That said ... does it matter? Eating junk is bad for you no matter how you look.
Obesity is a symptom of insulin resistance. Recognizing that, and treating the underlying cause, would go a long way to reversing the percentages of people who are overweight and obese. Both obesity and high blood glucose are easy to address by carb-restricted, preferably ketogenic, diets. No doctors, drugs, or surgery necessary.
http://weight.insulitelabs.com/Root-Cause-of-Insulin-Resistance.php
http://www.dailystrength.org/health_blogs/squevedo/article/insulin-weight-gain
This is why so many people with Type II diabetes are fat... not because fat causes insulin resistance, but because insulin resistance causes fat (although some believe it's cyclical as well... they both complicate each other).
Peace,
Shannon
It's not about "coming down with a disease" - it's about what people are doing to themselves to get it (eating a poor diet).
This is why articles like this are annoying. They say all the same things about "this is the problem we have" and then don't list (1) what causes it (bad diet, little or no exercise) and (2) how to get over it (eat healthy and exercise).
In the end, most docors today are recommending some sort of surgery to limit calories which is "eat less." That's insufficient. You CAN eat less and lose weight. If you eat only 1,000 calories from oreos every day you'll lose weight because you're only eating 1,000 calories. But you'll be really unhealthy.
And a really committed eater will be able to stretch that stomach out again and go back to eating too much.
There are no magic bullets. There are n shortcuts. It REALLY IS -
"eat right and exercise."
That's what they don't say because most people want something quick and easy.
I think the real disease is denial about they're doing every day that causes their fat.
Just my .02.
Even for people who become obese through the treatment of a disease (such as gaining weight from steroids or anti-depression meds), I consider that obesity to be a result of treatment for a disease.
I think to call it a disease provides an excuse to do nothing about it. 'I got a disease called obesity. Don't make fun of me. This is just how I am." That sort of thing.
I'm obese. I started writing down everything I was eating and it was a real awakening. Almost cathartic but I was too ticked off with myself to enjoy the revelation.
I read that and thought "Well NO WONDER I'm fat!"
It's cause and effect. Articles like this focus on effect.
Where are the articles that focus on the cause?
And I don't understand the point anyway: why is a person who never smoked and dies from lung cancer regarded so differently from a person who smoked and died from lung cancer? I know, I know, it's all about personal responsibility ... or is it? I think it's a Puritan-based concept of blame. It also has a lot to do with the belief that religions push that if you do everything right in this life, you can control what happens to you in the next life, which is ludicrous, but hundreds of millions of people find comfort in believing it.
~ to gain an extreme amount of excess fat to qualify as obese one must willfully eat excess amounts of food, how is this NOT willful misconduct ?
I suppose there are a few people who might do this but I don't know any.
I do know quite a few harried moms who lack cooking skills and have a lot of carpool duties to get done every day. Their intent is just to get something to eat in between school and soccer practice.
Now, as one of those moms, I can tell you that I've known for years that the food is unhealthy. I've also known it was the reason for my being fat.
But ... and I don't want this to sound like an excuse though it will ... at the end of the day I was usually just too tired to deal with fixing something healthy at home.
It was just easier. That's not wilfulness. That's a lack of commitment to making healthy choices and then doing them no matter how tired, grumpy, or busy I am by the end of the day.
We all lead really busy lives. It has been VERY hard to make that lifestyle change. To know how to keep healthy stuff stocked and fix it fast with minimal work.
NOW I am being wilfully healthy.
If one is not forced to do something, anything, then that is a wilful choice. That the alternative is a more difficult path doesn’t alter the defintion of wilful, it just makes the convenient choice the path of least resistance. So it comes down to how much one has thought about the consequences, short term and long term, of one’s actions.
A little forethought wrt snacks and healthy can also be convenient eg. buy a large bag of almonds and individually bag them into smaller portions, any pangs of hunger can easily be forestalled by keeping one handy.
Convenient = short term hunger fix with extended unhealthy repercussions
Less convenient = a little forethought in the short term but with long term health benefits.
Short term convenience should not be overshadowed by the long term effects of obesity, but the words and advice that are already out there are being ignored. The campaign, such as it is, by advertisers, is a huge machine that promotes the likes of big fatty burgers and greasy chicken, and the health/medical industry cannot afford, financially, to counter those, and why should they keep reminding people that high calorific intake with little or no exercise is not sustainable ?
And btw, congratulations on your new healthy lifestyle....
Stay active, eat healthy!
http://exerciseandnutritiontips.com
William Anderson, LMHC, Licensed Psychotherapist, author of 'The Anderson Method', www.TheAndersonMethod.com
I refuse to buy and cannot afford a riding lawn mower and constant
repairs on one. I have almost 2 acres of grass. It must be mowed.
There is no way around it. Hence I walk many miles pushing a mower
around and around. I try to do as many things manually as I can that
can otherwise be done with expence causing gimmics. This creates
more exercise than you might immagine. I spade my garden with a
shovel. I cut trees with an axe. I shovel snow. I rake the leaves. It
saves a lot of money and keeps me in shape. I spend more time outdoors
getting fresh air.