Last week, The American Medical Association (AMA) reclassified obesity as a disease and people have been hotly debating the decision since. (For a great rundown of the debate, check out this post over at Obesity Panacea.)
One of the major arguments against the decision is that it risks increasing shame and stigma related to weight. In a column for the Globe and Mail, Patrick Luciani discussed the potential unintended consequences of naming obesity as disease, writing: “Defining it as an illness could further stigmatize and shame the overweight. The obese can now say, I’m not obese but ‘I have obesity.’ What will that do to the image of those struggling with their weight?”
While we should be fighting against stigma, classifying obesity as a disease probably won’t make it worse. It’s already very strong in our society. As Yoni Freedhoff writes in his response to the most common arguments against the decision: “Given weight’s visibility, they already do, except now society labels them as lazy and gluttonous. While labels are always misguided, which label do you think leads to more stigma?”
On a surface level, whether “I am obese” or “I have obesity” is just a matter of semantics. What’s important is that we recognize that individual circumstances matter; and that curing obesity requires customized approach†diees from health professionals, like doctors, nurses and dietitians. Along these lines, Dr. Arya Sharma argued for the medicalisation of obesity in a post on his blog:
“It is exactly because we do not exclusively leave the diagnosis of obesity (which I define as a condition in which excess body fat threatens or affects health) to trained, licensed, and regulated health professionals, that we have created a ‘free-for-all’ where we continue propagating the myth that everyone with a few extra pounds is unhealthy and needs to lose weight. This is the key downside of not medicalising obesity—if only a trained health professional can tell whether or not your weight is affecting your health then someone without this training, should not be making assumptions about your health simply based on your size—indeed, it will hopefully become common knowledge that only your doctor or nurse can tell whether you have obesity or not.”
When obesity is classified as something only health professionals can diagnose and treat, insurance and benefits providers are forced to consider expanding coverage. So not only can medicalising obesity help reduce the number of ineffective fad diet pushers and weight loss clinics, it can also increase the affordability and availability of proper health services.