Daily Archives: February 23, 2014

Classifying obesity as a disease

In class, we talked about obesity and the multiple mechanisms of causation and how both genotype and phenotype influence the development of metabolism and progression to obesity. Essentially, there’s a full gambit of biologically tested influences  when it comes to obesity. In addition to the complex physiological components, obesity is so heavily saturated with social expectations, cultural meaning  and structural impacts. When discussing the option of classifying obesity as a disease, we primarily focused on the ideological and medical consequences – How is a disease defined? What are the required components of a disease? How would such a decision affect the “treatment” of obesity? How would it affect health insurance and payment?

An aspect we didn’t really discuss was the effect of such a classification on the public. Other questions we could have asked include: How would someone react to obesity if it’s a disease? What does that mean for healthy lifestyle choices? What does that mean for preventive care initiatives? If it’s a disease, is there a cure? What is the cure? A NYT article and journal bulletin discuss the psychological impact of classifying obesity as a disease.

“Specifically, obese participants who read the ‘obesity is a disease’ article placed less importance on health-focused dieting and reported less concern for weight relative to obese participants who read the other two articles. They also chose higher-calorie options when asked to pick a sandwich from a provided menu. Interestingly, these participants reported greater body satisfaction, which, in turn, also predicted higher-calorie food choices. ‘Together, these findings suggest that the messages individuals hear about the nature of obesity have self-regulatory consequences,’ says Hoyt,” (APS, 2014).

Over the last couple of weeks, we’ve been discussing the importance of an evolutionary understanding of medicine, health and disease, and we often talk about the advantages of comprehending the ultimate explanations of fever, malaria and more. But at the same time, we also consistently ask what this information means to the average patient. Does an individual need to understand the complex relationship between melanin, sun exposure, and vitamin D when getting diagnosed with skin cancer? Does an individual need to know the thrifty phenotype hypothesis to better understand his or her obese state? Does providing an evolutionary reasoning for the condition make the suffering more bearable? Does it change the individual’s perception and though process when it comes to treatment and lifestyle choices? The above cited articles demonstrate a very possible disadvantage to the classification of obesity as a disease. We have to ask ourselves: how much does a person need to understand and what are the associated advantages and disadvantages to that understanding?