American Medical Association Council: Stop Calling Obesity a 'Disease'

Your genes may make you predisposed to Cheetos. You may have a hormonal problem that causes everything you put in your mouth to attach to your hips while that one skinny girl gets to eat anything she wants. You know who I'm talking about. Anyway, the point is that because there are so many potential causes of obesity, an American Medical Association group is recommending against calling it a "disease," which is causing a bit of an outcry.

Via Medpage Today:

Obesity is hard to define and diagnose, and partly because of that is not a disease, an American Medical Association (AMA) council said in a report issued here Monday.

The report from the AMA's Council on Science and Public Health, released at the organization's annual meeting, angered many medical specialties who do consider obesity a disease.

The report panned body mass index as a proxy for obesity, saying it's limited as a stand-alone. Furthermore, calling obesity a disease may undermine prevention efforts and will do little to impact its treatment, the report said.

"Without a single, clear, authoritative, and widely accepted definition of disease, it is difficult to determine conclusively whether or not obesity is a medical disease state," the council told the AMA's policy-making House of Delegates. "Similarly, a sensitive and clinically practical diagnostic indicator of obesity remains elusive."

At the same time, there's a competing resolution that would declare the opposite – that obesity is in fact a disease given hormonal evidence. Supporters of the non-disease camp point out that this "epidemic" also coincides with an increase in caloric intake and reduction of physical activity.

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Comments

[Episiarch]

The fucking "public health" control freaks are so laughably obvious. If obesity is a disease, since we can all get obese if we just eat too much and don't exercise, then we all have the "disease", right?

Control, control, control, control. As always, it's just more people who want to control everyone else.

[entropy]

We're here, our bellies are full of beer, get used to it.

[Fatty Bolger]

Yep. If it's a disease, then the Center for Disease Control can control it, such as making people with "Obesity Disease" buy broccoli or pay a penaltax. (The courts haven't ruled on whether or not they can actually make you eat the broccoli, though my prediction is a random 5-4 decision which will depend on how the stars are aligned, and whether a butterfly flapped its wings in Brazil.)

[Nikkis enthusiastic dissent]

They can make you eat the broccoli if they send you to Gitmo first. I'm sure that won't pose too big a problem. OBESITY TERRORISTS!

[Fist of Etiquette]

We do all have the disease. It's exactly like The Walking Dead. SPOILER ALERT!

[Paul.]

If obesity is a disease, since we can all get obese if we just eat too much and don't exercise, then we all have the "disease", right?

That's why I wonder if this will last. I find it hard to believe that intensive twins studies won't somewhere show that people who are obese are genetically predisposed to become so.

Look, a whole family of fat people! Look, a whole family of thin people!

I mean, look at it this way, the early progenitors of the Disease theory of Alcoholism called it a "palsy of the will".

Is eating too damned much and sitting around watching the View a "palsy of the will"?

[MP]

I had friends growing up who were identical and identically fat. With skinny parents. It's an anecdote, but enough of one that I've always at least partially bought into genetic predisposition as a factor.

Of course, they probably had near identical diets and habits too. Not a true control group.

I know that for me to be fat as fuck I'd have to eat A LOT. But for me to have a Grover belly...well shit...I don't remember not having one. Again...genetics...plus habits.

[Fatty Bolger]

Getting fat when there is extra food to eat and not a lot of physical work to do is perfectly natural. If anything, it's the people who stay skinny who are the outliers. It's a lot like the laziness subject we touched on in A.M. links, I think. "Lazy" animals that expend minimum energy and store a maximum amount of extra energy can have a distinct advantage.

[Live Free or Diet]

"Lazy" animals that expend minimum energy and store a maximum amount of extra energy can have a distinct advantage.

Ever see a fat guy try to run? Squeeze through a narrow space? Dodge a punch? Ask a girl out?

Excess insulin production is present in over 75% of the obese population. Insulin clears glucose from the bloodstream and stores it as fat, and then blocks fatty acids from leaving the fat cells.

[Robert]

It shouldn't be called palsy of the will, because it involves an increase in the will to do something. Maybe it should be called "irritative lesion of the will" or "seizure of the will".

[Paul.]

because it involves an increase in the will to do something

As someone who could never develop a serious habit or addiction to anything, because the second I'd run out of whatever it was, I'd be like, "Fuck this, too far, I'm not getting my shoes on and leaving the house now! I'm all settled in!", I agree.

[Live Free or Diet]

As a formerly-obese person, the raging hunger I felt then would conceivably have driven me to do just about anything to satisfy it. I was often still hungry even when I could feel my stomach was full.

[kinnath]

I am not obese. I just have to shop for "husky" jeans that's all.

[Live Free or Diet]

I had more than 10 years I could not shop in regular stores, even for shoes. I had to go to the Big and Tall stores.

[Paul.]

If alcoholism is a disease, so is obesity.

I remember arguing forcefully, years ago, that if Alcoholism could be accepted as a disease, then there was no limit to what personal behaviors could be accepted. I'm glad to see the AMA dig their heels in on this one.

I'm wondering if you could find traits that predispose someone to obesity via twin studies.

[robc]

Years before that, CS Lewis pointed out (probably not the first to do so either) that certain people wanted to classify religion as a disease.

Some of those people still post on H&R.

[sarcasmic]

When I was a kid I remember being told that there are no such things as imaginary friends. When I got a little older I learned that it's OK to have an imaginary friend, as long as his name is God. Not Allah or Krishna or anything like that. Those imaginary friends are not real. Only God is real. And this imaginary friend will reward you with immortality and bring justice onto tyrants! All you have to do is believe.

[Warty]

Being a disgusting, worthless, slothful, lazy, self-loathing dickhead is sort of a disease, I guess.

[Paul.]

I'll bet the DSM IV V has something on that.

[Ted S.]

Warty may be diseased, but Warty itself isn't a disease.

[Fist of Etiquette]

As someone whose BMI averaged around 21 most of his life without regulating his diet at all, I can tell you this: Some of us are immune to the disease, so keep your overweight germs to yourselves, fatties.

[sarcasmic]

I did great until I got a sitdown job. Now I'm a belly with spindly appendages.

[Live Free or Diet]

Now I'm a belly with spindly appendages.

Sarcasmic, the "beer belly" phenomenon is visceral fat, that is, fat inside your organs. This is what causes the scarring that brings on cirrhosis. Please read "Why We Get Fat" by Gary Taubes.

[Warty]

21? What concentration camp do you live in, you disgusting sack of bones? You fucking skinnies are even worse than the fat fucks.

[Fist of Etiquette]

Boom.

[Paul.]

Lysol Touch of Foam?

Oh wait, that's the advertisement.

[Fist of Etiquette]

Yeah when are they finally going to nationalize youtube so there aren't any more ads tacked on at the beginning of videos?

[Paul.]

The People's YouTube!

[Warty]

Oh yes, women totally go for the cross-country physique. Just be careful that you don't get blown over by a stiff breeze, skinny.

[Fist of Etiquette]

You can't other me. I'm the ideal.

[Dagny T.]

Anecdotal, but I would sooner bang Louis CK than a skinny dude.

Now, in the bit, I think he's referring to that lanky, young pup look that some early-20's dudes have. Which some chicks do go for. Me, I prefer to wait until they put on their manmuscle.

[Fist of Etiquette]

The full bit is Louis talking about how he looks now is considered good for forty-something. He apparently had the same shape when he was younger, but with less success with the ladies.

[Warty]

So what you're saying is that you're totally into that old guy who shills HGH?

[Fist of Etiquette]

Very much so. Oh, wait, that was for Dagny.

[Paul.]

I prefer to wait until they put on their manmuscle.

What's your stand on Manboobs?

[Episiarch]

Let's give him a swirlie and a few charlie horses.

[Warty]

Indian burns and purple nurples.

[sarcasmic]

Supporters of the non-disease camp point out that this "epidemic" also coincides with an increase in caloric intake and reduction of physical activity.

Paging Captain Obvious! Captain Obvious to H amp R please!

[itsnotmeitsyou]

Yeah, this!

Anything that can be "cured" by eating less and going for a walk is not a disease. Same thing goes for anything that can be cured by not doing X activity, like drinking.

[PapayaSF]

It seems to have started right around the late '70s, when the government starting urging everyone to eat more carbohydrates and less meat and fat. Many manufacturers also responded by reducing the fat in processed food, and making up for the lack of taste by adding high-fructose corn syrup.

[Warty]

And as people eat more carbs, of course they eat more calories. What do you think carbs do to your appetite? Eat a pack of cookies on an empty stomach and see how hungry you are 20 minutes later.

[Brandon]

But if it's not a disease, we can't call fat people "victims" and then exert total control over their poor, pathetic lives in order to "cure" them!

[Lord Humungus]

Fatties gotta roll with it /anonbot

[Killazontherun]

OT, but a conversation I just had with the older lady receptionist and Streisand fan.

me: Your Barbra is in Israel raising hell.
she: ' seen Road Trip? So funny.
me: No.
she: In Israel? Is Barbra Jewish?
me: You're screwing with me. No way. Come on.
she: Not like I'm asking if the pope is Catholic.
me: It's exactly like that.

[PapayaSF]

Wow. If someone doesn't know Scarlett Johansson or Daniel Radcliffe is Jewish, no surprise, but Barbra practically carries a neon sign pointing this out.

"Your receptionist thought a shiksa was so perfect as Fanny Brice in Funny Girl?" /NY Jewish accent

[T]

You may have a hormonal problem that causes everything you put in your mouth to attach to your hips while that one skinny girl gets to eat anything she wants. You know who I'm talking about

No, Scott, we don't. Name names. I'm betting it's KMW.

[MJGreen]

What is obesity? Isn't it a state, a symptom, an effect of other causes? How can it ever be considered a disease?

Is sneezing or a fever a disease?

Now, the particular causes of obesity, maybe some of them are diseases. But obesity itself?

[Paul.]

I'm guessing that like the disease theory of alcoholism (which I, for the record, don't subscribe to) it's the desire to eat which is the disease. Again, a 'palsy of the will'.

[Aresen]

If it is not a disease, but a problem of personal behavior then two things happen:

1) Those who are overweight lose their license to be 'victims'
and
2) The moral crusaders against evil food companies lose the option of blaming it on 'evil korporations'.

[Homple]

Except for gay fat people. It's in their genes and they can do nothing about it.

[Live Free or Diet]

Obesity, which is defined in terms of extreme overweight, is the most obvious symptom of a disease.