Is Obesity a Disease?

 

Obesity refers to excessive fat in the body. Obesity may increase the chance of developing health conditions like heart disease, diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and certain cancers. But there are no unique characteristics or symptoms that doctors can attribute to obesity.

The American Medical Association (AMA) recognizes obesity as a disease that involves genetic, metabolic and behavioral aspects that require medical support. The decision was initially made in 2013 and confirmed in 2023.

The US Centers for Disease Control and Prevention (CDC) also considers obesity a serious chronic disease that demands prevention and intervention strategies in children and adults. The goal of this definition is to develop clear strategies that help prevent and treat obesity-related health complications.

Other medical experts and countries, however, may disagree or feel hesitant about defining obesity as a disease because:

Lack of diagnostic criteria: Classifying a condition as a disease implies certain standards and criteria must be met for its diagnosis. Obesity does not have any characteristic or unique symptoms, and it does not always lead to the same body function impairments. The lack of consistent diagnostic criteria may make it more difficult to categorize obesity as a disease.

Inconsistent measurement standards: Because indexes and standards to measure obesity do not apply to everyone, such as endurance athletes and weightlifters. In other words, weighing more does not always mean obesity is present.

Overall health as a factor: Although obesity affects the body in many ways and may increase the risk of medical conditions like heart disease and diabetes, not everyone with obesity develops health challenges or symptoms. Also, not everyone with health challenges develops obesity.

Patient responsibility and public policies: Some people may worry that categorizing obesity as a disease may take responsibility away from the person and promote a feeling that lifestyle guidelines will not help as much if they have the disease. Instead, some people may tend to rely on weight loss medications or medical interventions to lose weight.

Although studies often suggest that obesity is a risk factor for certain health conditions, they rarely account for the role weight stigma and discrimination play in health.

Discrimination is one of the social determinants of health — the conditions in daily life that affect a person’s health — and it can and does contribute to health inequities. And experiences of weight stigma in daily life are associated with negative mental and physical health outcomes.

Weight discrimination in healthcare can prevent people with high body weights from seeking medical care — and those who do may not receive accurate diagnoses or treatment because doctors may attribute their health concerns solely to their weight.

Two common measurements used by doctors to decide if obesity is present are body mass index (BMI) and waist circumference.

Body mass index (BMI) - measured by your body weight divided by the square of your height.

The American Society for Metabolic and Bariatric Surgery defines three classes of obesity based on BMI:

• ·         class I obesity: 30–34.9
• ·         class II obesity, or serious obesity: 35–39.9
• ·         class III obesity, or severe obesity: 40 and higher

Waist circumference

Excess abdominal fat, relative to the rest of your body, may lead to a greater risk of health complications, even if your BMI does not indicate obesity.

A healthcare professional may consider you have central obesity if your waist circumference (by measuring your waist just above your hip bones) is wide or your waist-to-hip ratio is high.

According to the CDC, a person has a greater chance of obesity-related conditions when their waist circumference is more than 40 inches for males and 35 inches for females.

BMI and waist-to-hip ratio are only estimates of body fat and may not always help to establish whether someone lives with obesity. As mentioned, some bodybuilders and performance athletes have a muscular composition that may lead to a BMI that falls in the range of obesity.

There are many reasons why some people have trouble losing weight. Often, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices.

The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight.