In a new article, World Obesity Federation experts consider the argument for obesity as a chronic relapsing disease process. They note that obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe.
The question of whether obesity should be called a 'disease' has sparked controversy for most of the last century. In their Obesity Reviews position statement, Dr. George Bray and his colleagues examine how an abundance of food, low physical activity, and several other environmental factors interact with genetic susceptibility. They draw parallels to chronic diseases, noting that the magnitude of obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host.
"Accepting the concept that obesity is a chronic disease process is important for several reasons," said Dr. Bray. "First, it removes the feeling that patients alone are responsible for their excess weight. It also focuses attention on the ways in which this disease process can be tackled. And finally, it shows that if we can successfully treat obesity, many of its associated diseases will be eliminated."
In an accompanying letter to the editor, experts agree that declaring obesity to be a disease could benefit those people who are suffering with obesity and wish to have access to medical advice and support, "whilst also strengthening the call for dealing with the social determinants, obesogenic environments and systemic causes of individual weight gain." They also note that recognizing obesity as a disease may reduce individuals' internalized stigma, change the public discourse about blame for the condition, and have benefits in countries where health service costs are funded from insurance schemes that limit payments for non-disease conditions or risk factors.
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G.A. Bray et al, Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation, Obesity Reviews (2017). DOI: 10.1111/obr.12551