AMA Declares Obesity a Disease

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Obesity results in many medical problems. Image by the CDC.

Obesity results in many medical problems. Image by the CDC.

What Causes Obesity?

The CDC states, “Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity.” It’s pretty simple; however, the cause of this imbalance can be a bit complicated. The causes of obesity includes the environment, genetics, and other factors.

Where you live, work, and play (your environment) can all influence the decisions you make. For example, the having healthy foods at schools and in the work places allow people to have a healthy food options. Having sidewalks in neighborhoods may make it more likely for people to get out and exercise.

However, the environment isn’t the only thing that causes obesity; sometimes genetics plays a role. According to Dr. Claude Bouchard from the Human Genomics Laboratory, Pennington Biomedical Research Center in Baton Rouge, LA. in his paper entitled, “Defining the genetic architecture of the predisposition to obesity: a challenging but not insurmountable task” he explains that there are 17 gene variations that have been identified, but these only account for roughly two percent of the variance in Caucasian’s BMIs.

Dr. Bouchard goes onto explain that genetics may play a role in obesity, but rarely there is a pattern of inherited obesity in a family that results from a single gene. Dr. Bouchard concludes his paper by stating, “The obesity epidemic we are facing today unfolded over the past few decades and can clearly not be explained by changes in the frequency of risk alleles . It is more likely due to a changing social and physical environment that encourages consumption and discourages expenditure of energy, behaviors that are poorly compatible with the genome that we have inherited.”

Other factors that can contribute to obesity include diseases like Cushing’s disease and polycystic ovary syndrome.  Medications such as steroids and antidepressants can also contribute to obesity. A person’s environment, their genes, preexisting conditions, and some medications can all come together to make a person more at risk for being obese. Now that we know what causes obesity, should we still consider obesity a disease? Or does it fit the ‘symptom’ definition better?

Symptom or Disease?

The A.M.A. has now classified obesity as a disease; however is it more of a symptom rather than a disease? According to the Medical Dictionary a symptom is, “any subjective evidence of disease or of a patient’s condition, i.e., such evidence as perceived by the patient; a change in a patient’s condition indicative of some bodily or mental state.” If a person becomes obese due to their environment or behavior, isn’t obesity a symptom of that situation?

Though it could also be a disease, the Medical Dictionary defines disease as, “any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown.” So if obesity can be traced back to a disease such as Cushing’s, then should obesity be categorized as a disease?

Confused? Well so are many people. The NY York Times reports that there isn’t even a definition of disease that everyone can agree upon and the A.M.A. decision to declare obesity as a disease has no legal authority.

Obesity: Symptom or Disease?

There are many reasons why people become obese, everything from genetics to lifestyle, so whether obesity seems to be more of a symptom or a disease, it probably doesn’t matter too much. What does matter is eating healthy and exercising. If classifying obesity as a disease will get more physicians to look at this problem more seriously, then it’s a good thing. However, those who are against classifying obesity as a disease, worry that it would define a third of Americans as sick and thus, will result in more people relying medication or weight loss surgery to fix the problem, rather than lifestyle changes.

Resources:

New York Times. A.M.A. Recognizes Obesity as a Disease. (2013). Accessed June 19, 2013.

USA Today. Medical Group Recognizes Obesity as a Disease. (2013). Accessed June 19, 2013.

Medical Dictionary. Disease. Symptom. (2013). Accessed June 19, 2013.

Bouchard C. The biological predisposition to obesity: beyond the thrifty genotype scenario. (2007). International Journal of Obesity 31:1337-9. Accessed June 19, 2013.

Centers for Disease Control and Prevention. Overweight and Obesity. (2012). Accessed June 19, 2013.

Centers for Disease Control and Prevention. What causes overweight and obesity? (2012). Accessed June 19, 2013.

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