Here are two articles that believe obesity should not be called as a disease:

http://www.linkedin.com/today/post/article/20130621153254-23027997-obesity-as-disease-why-i-vote-no?trk=mp-reader-card

http://www.forbes.com/sites/geoffreykabat/2013/07/09/why-labeling-obesity-as-a-disease-is-a-big-mistake/

It would be interesting to hear more thoughts on this matter.

The first discussion would be "what kind of disease", behavioral or metabolic. And for this we have to start thinking of subgroups of patients. I discuss this in my recent article, attached

Article Influence of attention-deficit/hyperactivity disorder on bin...

Mohammad and Bruno - agreed - it's all about the context of how you classify disease i.e. absence of health, as ill-health or not etc. I personally think that the agenda of defining it as a disease is a 'red herring'. It's often either an attempt to 'scare-monger', 'victim-blame' - or simply raise awareness generally - rather than it being a disease in itself. Obviously, it can 'lead to diseases' - and that is probably the correct context to place it in. Some might argue that it is a 'genetic' predisposition (therefore an existing disease) - but that, again, may be too convenient.

Being obese would be a strategy of the body to deal with over-nutrition by expanding fat tissues.

Though obesity is not a disease, it may be considered as a causative risk factor for many of metabolic disorders. The same like in case of smoking with lung cancer. Yet, some studies reported that obesity per se is not a risk factor for CAD for example. Meanwhile, we need to identify the type of obesity, is it generalized obesity or a regional (central) one?.

Obesity is a disease. A disease is defined as abnormal biology that impacts an organism. How much of obesity is related to factors other than pure environmental exposure calls into question if obesity is really a condition; ultimately obesity may not be limited viewed as high fat accumulation.

I do agree. Obesity is a common share in nearly all common chronic diseases such as; cancer, diabetes, hypertension, metabolic syndrome, etc. However, the notion is whether obesity per se could lead to such diseases or it is an association. Many further studies are necessary to explore this issue

@Mostafa, If obesity is caused by factors other than social behaviors; if there is a molecular and heredity component that causes excess eating, then obesity can reasonably be thought of as a disease.

Ahhh - but Michael - is the 'jury still out' on that one? For some, there may well be a genetic disposition to obesity. in fact, in New Zealand fro instance, there is a noted strong correlation between obesity and Pacific Islanders and Maori. That said, there is also a strong social correlation with those indigenous populations and sedentary lifestyles, a cultural tradition of family gathering and unhealthy eating, and lower educational/economic status etc. I'm more inclined to think that 'genetic' predisposition might be 'too convenient' in the absence of all the other social factors. Individual's themselves may use such arguments as an 'effect heuristic' i.e. 'I was born 'big-boned' - rather than relate to the strong likelihood that health-related behaviour is more likely to be 'familial' (learnt and passed on through family generations) - rather than solely genetic. It would be great if a sole genetic link could be found and reversed but, like the 'poly-pill', would it not just encourage people to take more risks with their health?

@Dean. In chronic diseases like obesity the cause can be associated with multiple factors; lifestyle, genetics, ect.

Sure, there is a social component to eating habits, but eating behavior phenotypes exist to make people have a predisposition to certain food selection choices. It other words, certain people are born with higher risk of being obese than other individuals. The same made be said about CVD; people are born with a certain risk for CVD, but lifestyle choices play a role in the development as well. The eating behavior of any organism is highly controlled process; CAD, CCK, Leptin, Adiponectin, Gherlin all play a role in the biological regulation of weight.

Understanding obesity today requires understanding how the current food supply interfere with the biological process of weight regulation and enhances prepositions to an obese phenotype.

As far as the science behind weight control being used as a crutch for the public, this is unlikely. People understanding the risk factors allow for better lifestyle choices; ultimately allowing for more informed patients. For example, the patients that understand that they are at increased risk for developing diabetes are more adept to make food choices to prevent their glucose levels from skyrocketing.

Educate people

Michael - an informed response. However, I must be a bit more cynical than you, from clinical experience, that if an individual (or family) are 'educated' on healthy options - that they will automatically adopt them. That works on the principle that those at risk have never considered the option before - or that 'suddenly they see the light' - and change forever. Behavioural change is highly complex - mostly driven by long-standing and deeply-driven norms, attitudes and beliefs. In the perfect world - i would love to believe that 're-educating' individuals would result in radical change but, people are often either educated to their maximum, or they are resistant to education. I'm not saying 'don't try' - but I am a realist.

I do certainly take your point about 'supply and demand' of food supply to those who are at risk - but as long as convenient food supplies and fast-food corporates prevail - what can be done other than to just limit it to a level that isn't out of control?

Many thanks for these very scientific and rewarding discussions. I appreciate you would kindly have a look to this below publcation in which I thoroughly discussed association of obesity with different metabolic abnormalities.

Article Prevalence of Metabolic Abnormalities and Association with O...

@Dean, your cynicism is shared among public opinion. Behavioral change is complex, however, the question is whose behavior are we trying to change and when are trying to change it?

*Your clinical experience indicates that PREVENTION is key and that certain patient population groups are harder to change compared to others

Sure patients that are in their fifties and grossly overweight will be virtually impossible to change and are almost not worth targeting. However, efforts towards children to prevent the onset of obesity will pay off; so educational efforts should be made towards the kids of these patients about predispositions to obesity should be the focus of future efforts.

The benefits of nutritional education programs have been well documented. Educating even the most stubborn people has some effect.

Below are a few studies I have found that demonstrate the impact of nutritional education on food choices for kids:

http://www.fns.usda.gov/pressrelease/2013/fns-001313

http://www.fns.usda.gov/pressrelease/2013/fns-001313

You know from your clinical experience that obesity and poverty are correlated. The first study indicates that supplemental nutritional education via the SNAP program increased fruit/vegetable consumption for low income elementary students and decreased consumption of low fat products; First study also showed 25 % increase if healthier food options for adults as well.

Even small lifestyle improvements can lead to a higher standard of living/longer life for most people.

The second study indicates that nutritional education programs showed marked improvements in healthier fastfood consumption by teenagers; demonstrating that daily health and nutrition classes in schools can potentially result in healthier adults.

*patient food choices impacts the supply of fastfoods. Mcdonalds was a flop in the caribbean b/c people would not eat fast food(article attached); # of countries have also banned all mcdonalds.

http://www.uncommoncaribbean.com/2010/04/01/mcdonalds-failure-in-barbados-hides-in-plain-sight/

Michael - in full agreement with you. Check out my site and you will see that i devote quite a bit of time to targeting children and adolescents - and that includes maternal and kindergarden intervention; not leaving it for schools to 'take up the slack' when, perhaps, the 'horse has already bolted'. I note that you are a 'realist' on the impact of interventions for 'those who are already a little too long in the tooth'. I agree that they should still be targeted - but limited resources suggest playing it smart - and 'prevention is better than cure'.

Hi all,

Some interesting debate here folks. Speaking as a non-medical biologist, I've always preferred a catch-all definition of disease as "an (or even any) aberration from health". By this definition, obesity can certainly be included as a "disease".

Cheers, Fred.

Please have a look at this useful link.

https://www.nature.com/articles/508S57a.pdf