I saw an ad the other day that bothered me (like a lot of advertisements—particularly for health and fitness products do). It made the claim that “obesity is a disease, not a decision.” The implication being that obesity is a purely biological issue that can only be solved by biological treatment—in other words, pharmaceuticals.
Be careful when someone tells you that “obesity is a disease, not a decision.” What they mean is that they want to sell you pills instead of helping you make lifestyle changes that will help you manage your health within the scope of your genetics. Obesity is a symptom of a complex health issue that has biopsychosocial dimensions.
Our health is affected by biological, psychological, and social circumstances. Obesity is a central factor in many diseases (e.g., hypertension, heart disease, diabetes, etc.). It is a central factor in metabolic syndrome—the coexistence of insulin resistance, dyslipidemia, and hypertension. It is a central among the risks for severe illness in the coronavirus pandemic. Obesity, indeed, has a genetic component, and it does meet criteria for many definitions of “disease.” Obesity is complex. To say, however, that it is “not a decision” is grossly inaccurate and misleading.
Obesity is not a single decision, of course. It is the result of countless decisions—decisions made consciously and unconsciously by individuals and communities. It requires countless decisions—changes—to fix. It requires personal responsibility and community responsibility. Behaviors need to change. Education needs to change. Community planning needs to change. Diets need to change. Policies need to change. It requires a large-scale biopsychosocial intervention. It will not be “cured” by pills.
Obesity is not a cause for acceptance or shaming. It is a health concern that warrants compassion and urgency. We must accept that maintenance of health body composition is not easy and that there is no “ideal” body type (and that over-lean has its health concerns, as well). Acceptance of one’s healthy self should be encouraged.
While there is a place for pharmaceuticals in the management of disease, it is important to understand that pills are not always the cure. Quick-fixes are not the solution to complex health issues.
Be your best today; be better tomorrow.
Carpe momento!