More and more experts are recognising obesity as a disease. This
comes as a surprise to some and a relief to others, especially those
living with obesity. But why is obesity a disease and not simply lack
of willpower or a matter of lifestyle? Part of the answer lies in the
fact that there’s more to obesity than you can see. A lot more.
London, 2018. A group of experts attend a council meeting of the
Royal College of Physicians (RCP) to discuss whether or not obesity
should be recognised as a disease. Dr. Andrew Goddard is listening
carefully. He should be. Only a few months before he was elected the
121st president of the RCP – the youngest for 400 years.
For him, this meeting is not a word game. It’s a serious matter that
will change how people see and treat obesity. In the end, their votes
are united – obesity is a disease. A chronic yet manageable disease
that’s affected not only by our genes, but also by the modern
environment we live in.
“It is important to the health of the nation that we remove the
stigma associated with obesity. It is not a lifestyle choice caused by
individual greed, but a disease caused by health inequalities, genetic
influences and social factors,” says Dr Andrew Goddard3.
The science of obesity
Dr. Andrew Goddard’s team is not the first to sit down and discuss
obesity. Around the world, similar expert working groups have arrived
at the same conclusion that often provokes heated debates in the
media. Obesity is still widely thought of as a simple matter of
lifestyle – of how much you eat and how little you move. Of energy in
and energy out. Simple, right? But not correct according to the science.
In order to understand why, let’s start with a short thought experiment.
Imagine a disease that:
Puts people at a high risk of developing or worsening other
serious health conditions such as cardiovascular disease, type 2
diabetes, increased blood pressure, high cholesterol, obstructive
sleep apnoea, certain types of cancer, anxiety and depression.
Changes the way the body responds to treatments. What worked
before doesn’t work anymore.
Is constantly made stronger by
our everyday environment.
Affects people for life.
But people living with the disease rarely seek professional medical
help because they believe that they need to deal with it all on their own.
Now, wouldn’t you consider the disease to be a serious medical problem?
New hope for better health
This disease is neither imaginary nor invisible. It exists and it’s
called obesity. People living with obesity are reminded of it every
day – in public transportation, clothing stores, parks, or even while
eating dinner with the ones they love. But size is the least important
aspect of obesity. The important aspects are the ones you can’t see.
The good news is that obesity is a manageable disease and people who
live with it can still improve their health and wellbeing. In fact, a
weight loss of only five percent is enough to lower the risk of some
weight-related health complications, like high blood pressure.
But weight management has no quick fixes. To lose weight and keep it
off, people with obesity need proper ongoing treatment and care. This
is why it is important to recognise obesity as a disease and to treat
it using the latest scientific advancements.
For treatment, one size does not fit all
Although many people have obesity in common, they need individual
treatment plans. We all have different genes, health, life histories,
personalities, and environments. And we aren’t all motivated by the
same goals. A personalised treatment plan will probably require a
combination of different treatment options to meet an individual’s needs.
An increasing number of healthcare providers understand what it takes to help
More and more healthcare providers recognise the complexity of
obesity and are learning how to help. Their toolbox of treatment
options is also growing and is constantly being updated. Today it
includes behavioural therapy, meal replacements and low energy diets,
anti-obesity medications and bariatric surgery. They also look beyond
just what you eat and how much you move. Modern obesity management
involves understanding individual eating patterns (how, when and why
you eat) as well as patterns of mood, sleep, stress and physical activity.
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