Obesity should be recognised as a disease, medical experts say

Sarah Young

A number of medical experts are calling for obesity to be classed as a disease in order to encourage people to seek treatment.

John Wilding, professor of medicine at the institute of ageing and chronic disease at the University of Liverpool, and Vicki Mooney, executive director of the European Coalition for People living with Obesity (EASO), argue that the view obesity is “self-inflicted and that it is the individual’s responsibility to do something about it, is “inaccurate” and reinforces stigma around being overweight.

Instead, the pair believe that the role played by genetics combined with the illnesses created by obesity, such as Type 2 diabetes, high blood pressure and some cancers, means it should be defined as a disease.

According to the NHS, obesity is thought to affect around one in every four adults in the UK, and roughly one in five children aged 10 to 11.

Body mass index (BMI) is widely used as a simple and reliable way of finding out whether a person is a healthy weight for their height.

For most adults, the NHS states that having a BMI of 18.5 to 24.9 means you’re considered to be a healthy weight. A person with a BMI of 25 to 29.9 is considered to be overweight, and someone with a BMI over 30 is considered to be obese.

Wilding and Mooney add that the Oxford Dictionary supports their argument with its definition of disease as “a disorder of structure or function ... especially one that produces specific symptoms ... and is not simply a direct result of physical injury”.

They also state that obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, has been considered a disease by the World Health Organisation since 1936.

“Studies in twins show that 40-70 per cent of the variability in weight is inherited,” Wilding and Mooney write in the British Medical Journal (BMJ) to bolster the theory that obesity is influenced by genetics.

“Body weight, fat distribution, and risk of complications are strongly influenced by biology – it is not an individual’s fault if they develop obesity.”

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

They write: “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.”

However, not all medical professionals agree with Wilding and Mooney’s stance on the issue.

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, Pile argues that recommending a change implies that current NHS and public health strategies are “doomed to failure without classifying obesity as a disease“.

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

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

The debate in the BMJ follows calls from the Royal College of Physicians (RCP) in January for the Government and the NHS to urgently recognise obesity as a disease.

The RCP said it wanted to see obesity recognised as an ongoing chronic disease to allow the creation of formal healthcare policies to improve care both in doctors’ surgeries and hospitals.

It argued that obesity is not a lifestyle choice caused by individual greed “but a disease caused by health inequalities, genetic influences and social factors”.