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Given that obesity now affects nearly one third (29%) of the population in England and is expected to reach 35% by 2030, should we now recognize that it is about A disease? Experts discuss the issue in The bmj aujourd & # 39; hui.
According to Professor John Wilding of the University of Liverpool and Vicky Mooney, representative of the European Coalition for People with Obesity, Obesity, in which body fat has accumulated to such an extent that health can suffering, meets the definition of "disease". ECPO).
They point out that more than 200 genes have an influence on weight, and that most of them are expressed in the brain or in adipose tissue. "Thus, biology strongly influences body weight, fat distribution and the risk of complications.It is not the fault of the individual if he develops obesity. "
They argue that the recent rapid increase in obesity is not due to genetics but to a modified environment (availability and cost of food, physical environment and social factors).
Still, the general opinion is that obesity is self-inflicted and that it is entirely up to the individual to do something about it, while health professionals seem to be hurting informed about the complexity of obesity and what patients want to obesity.
Recognizing that obesity is a chronic disease with serious complications rather than a lifestyle choice "should help reduce the stigma and discrimination suffered by many obese people," they add.
They disagree that the badertion that a large proportion of the population has a disease removes personal responsibility or may overburden health services, noting that other common diseases, such as hypertension and diabetes, require that people take steps to manage their condition.
They suggest that most obese people will eventually develop complications and those who are not obese may be considered to have no disease. "But if we do not accept that obesity is a disease, we will not be able to stop the epidemic," they conclude.
But Dr. Richard Pile, a general practitioner with a special interest in cardiology and head of the Clinical Delivery Clinical Prevention Group for Herts Valleys, says that adopting this approach "could actually result in worse results for individuals and society ".
He believes that the dictionary definition of the disease "is so vague that we can clbadify almost anything as a disease" and says that the question is not whether we can, but whether we should do it and for what purpose.
If labeling obesity as a disease was harmless, it would not really matter, he wrote. But to qualify the obesity of disease "risks to reduce the autonomy, to disempower and to deprive people of the intrinsic motivation which is an important catalyst of the change".
On the psychological level, there is a significant difference between having a risk factor for which you have a responsibility and control over it and having an illness that someone else has. another is responsible for the treatment, he says.
In addition, making obesity an illness "might not benefit patients, but health care providers and the pharmaceutical industry when health insurance and clinical guidelines would advocate treatment with drugs and surgery, "he warns.
While self-determination is the key to change, "we must recognize that the causes of obesity for most people are social, as is the solution," he adds. "If people meet, shop, cook, eat and participate in activities together, the end result will be an improved wellness and reduction of obesity will be a beneficial side effect."
Clbadifying obesity as a disease is neither essential nor beneficial. It's a lot more complicated than that, he concludes.
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External peer-reviewed? Yes
Type of evidence: Opinion
Subject: Obesity
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