Thanks for posting this question! Here are my thoughts:
I wouldn’t call obesity a disease. For the most part, obesity has been (and continues to be) a result of poor choices in diet and lifestyle. It surprises me that the AMA has declared obesity a disease. I would classify Type 2 diabetes, heart disease and other conditions that result from being obese as diseases, but not obesity itself. You’ve probably heard the term “diabesity” used to describe the cascade of ailments (insulin resistance, elevated blood sugar, blood pressure and cholesterol, pre-diabetes) resulting from poor lifestyle choices, and it’s 100% reversible. Type 1 diabetes has a genetic and autoimmune component, and cannot be cured or prevented (nor is it caused by the patient), so that’s clearly not part of this discussion. The vast majority of heart disease can be directly linked to lifestyle choices, and an even higher percentage of Type 2 diabetes is linked to lifestyle choices. Just because those who have made poor lifestyle choices eventually become obese doesn’t mean that it cannot be corrected. The fact that obesity is an epidemic doesn’t make it a disease. Obesity can be reversed and “cured” if better food choices are made and if obese people start being more active and taking responsibility for their actions. This is another example of our current society’s tendency to not accept personal responsibility. Big pharmaceutical companies are now pushing drugs and other invasive methods of treatment, when the vast majority of these cases can actually be fixed with education, improved diet, increased physical activity and personal accountability. Of course the AMA would like to declare obesity a disease because of the vast amount of revenue they and their associates make from treating obese people with pills instead of preventive measures.
In my opinion, the danger in calling obesity a disease removes some of the fault that needs to be placed on the obese individual so he or she can 1) become aware 2) accept responsibility 3) receive education and 4) make necessary changes. If these steps aren’t taken, people aren’t capable of embracing a new lifestyle and making it permanent, which is what must occur in order to rid our society of the obesity epidemic. Calling obesity a disease also opens the door with the ADA (Americans with Disabilities Act 1990), which could make obese people a protected class. That is an entirely different, disturbing conversation! My point is that by going down this road, we aren’t helping obese people get healthier—we’re just giving them a crutch so they can limp along and use more and more valuable healthcare dollars. Obesity could singlehandedly break the PPACA (Patient Protection and Affordable Care Act) because healthcare costs will skyrocket if we focus on treatment rather than prevention of a problem of such epidemic proportions. Let’s not forget that those costs will skyrocket for everyone (including healthy people like us who work hard to stay healthy) once our healthcare is regulated by the government. I’m guessing obesity will now be considered a pre-existing condition for insurance purposes too, so that will further insulate obese people from accepting any blame whatsoever, and will force the costs of their care onto others. What this also means to me as a trainer is that clients may use the “I have a disease/condition” excuse for why they can’t work out or do certain exercises. As a trainer, I’ve dedicated my life to helping people adopt healthier lifestyles. It can be very challenging at times, and I need all the reinforcement available to help some clients push through barriers. I don’t believe labeling people with a medical condition reinforces what I do in any way. I’m guessing my comments might be considered taboo, and that’s okay. I don’t dislike obese people—we all have our struggles, and I work with overweight and obese clients regularly. I just know that not making them face their demons will prevent them from becoming the healthy, happy, vibrant people they’re meant to be, and I don’t want to be part of a movement that fails one-third of Americans. There are consequences for every single action in life, and giving people the freedom to live without consequences is dangerous.