Sunday, July 7, 2013

Should We See Obesity as a Disease?

Recently, the American Medical Association (AMA) recognized that obesity is a disease. This decision was actually the exact opposite of the recommendations made by the AMA's own investigating committee. What was the AMA's reasoning? To try and stop the growing epidemic of obesity by changing the way doctors and insurance companies view those with a Body Mass Index (BMI) of more than 30.

For sure, obesity is starting to get out of hand. The World Health Organization (WHO) estimates that obesity affects over 500 million adults and 40 million children under the age 5 worldwide. This represents about 10 percent of the population. The WHO also believes that obesity is now the fifth leading cause of death (globally) and is strongly associated with degenerative diseases like heart disease, diabetes, and some cancers. (1)

The age-adjusted rate of obesity in the US (in 2008).

Like many other bloggers, I'm happy to hear that the medical community is taking obesity more seriously, but am also conflicted about the decision to see obesity as a disease.

Obesity as a Disease
Let me start with the most obvious question: Is obesity a disease? This question can be answered by looking at the definition of disease:
Disease (n): a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment. 
By this definition, the AMA is correct in seeing obesity as a disease, as excessive amounts of body fat can cause health problems elsewhere in the body.

For instance, researchers are finding out that body fat cells don't just store energy, they collectively act as an endocrine organ that produce both inflammatory and anti-inflammatory chemical messengers (known as cytokines). (2) The pro-inflammatory cytokines include TNF-aIL-1IL-6IL-18, and leptin. If a person has too much body fat, too much of these pro-inflammatory chemical messengers can cause a number of problems throughout the body, including rheumatoid arthritis, (3) asthma, (4) systemic inflammation, (5) diabetes, (6) atherosclerosis, (7) depression, (8) Alzheimer's Disease, (9) Celiac's Disease, (10) and certain cancers (11)