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The misguided urge to pathologize this condition reflects society's failure to come to terms with the need for prevention, says D. L. Katz.
Doctors are historically ill-prepared to address the problem of obesity - with a tendency either to ignore it, or to ineffectually wag an admonishing finger1-3. To focus physicians' attention on this prevalent health issue, the American Medical Association (AMA) recently declared obesity to be a disease. This well-intentioned move by the AMA is misguided in that it implies that tens of millions of people must now have bodies or minds, or both, that are not working properly. Even seemingly healthy, but heavy, people - adults and children alike - are now, by definition, diseased4. Imposing such a status has broad ramifications for society and requires careful reflection.
The standard measure of obesity is body-mass index (BMI), which is roughly speaking the ratio of weight to height. For adults, a BMI greater than 30 is associated with increased risk of illness, disability and death. However, a risk factor is not a disease, because each can occur independently of the other.
Obesity is an important contributor to the prevailing burden of chronic disease, lying on the causal pathway to much of what plagues modern society and its people - heart disease and diabetes to name two of the most serious. However, not only can these diseases develop in the absence of obesity, but not everyone with a high BMI develops any such condition.
The categorization of obesity as...