is-obesity-a-disease-debate-stirs-in-modern-medicine

Fat shaming is the new racism. It manifests in various forms: crude jokes, mocking glances and unsolicited advice packaged as health tips. 

 

This weighty issue weighs you down as you grapple with the societal stigma attached to obesity. And, the curse of calories slowly feeds into your existential angst. 

 

The constant pressure from the wellness industry and a bunch of well-wishers, dressed up as calorie warriors, to shed your extra pounds and get into shape sends your stress levels soaring.

 

As a result, you are pushed into a vicious cycle of sinful eating and self-shaming guilt. It is as if your binge-eating has become a by-product of despair, meant to feed your bruised soul rather than your stomach.

 

But, what if our perception of obesity is all warped? What if we got it all wrong by blaming being overweight as the sole culprit for all the ailments? What if our methodology to determine fatness is all flawed? 

 

Blame it on BMI

 

For decades, BMI — body mass index — has been the go-to tool for plotting our weight into categories: underweight, normal, overweight, or obese. It is calculated by dividing an adult’s weight by the square of their height.

 

However, there is mounting evidence that the BMI is not an accurate and scientific method to determine obesity. It is an outdated system that does not take into consideration the relative proportions of bone, muscle and fat in the body. It also doesn’t measure how fat is distributed throughout the body.

 

Muscular people may end up with a BMI that categorises them as obese, despite the fact they may be fit and healthy. For instance, an athlete with much more muscle than fat can have a BMI in the overweight range.

 

BMI can be an unhelpful tool that dehumanises those who are obese or overweight, shaming them into losing weight and threatening their fragile relationship with their bodies. In a way, it is a mathematical snake oil.

 

The BMI formula was developed in the 19th century by a Belgian mathematician who was designing a population census in the Netherlands. It was never intended as a measurement of health.

 

Fat and fit

 

Many of us cling to the belief that a thin body is a healthy body, but the growing evidence suggests that’s not necessarily true. New research has shown that some people in the “overweight” BMI category have a lower risk of death from heart-related causes than those with a “normal” BMI.

 

In fact, there is no precise link between weight and health outcomes, nor is there evidence to support a fixed notion that higher weight always correlates with worsening health.

 

No simple maths formula or number on the scale can measure a person’s health. And using one for that purpose may actually cause harm.

 

A person’s weight and BMI — and the stigma when those numbers aren’t “normal” — can stand in the way of people getting the care they need.

 

It is time to shift our focus away from BMI — and the judgement that goes along with higher weight — and to concentrate on things that are consistently proven to help us live longer, healthier lives, like balanced diet, regular exercises and enduring family and social bonds.

 

Is obesity a disease?

 

Whether obesity should be considered a disease has been one of the most polarising topics in modern medicine. 

 

There is no consensus on the signs and symptoms that make obesity an illness the way high blood sugar levels are used to diagnose diabetes.

 

In declaring a disease without a clear definition, the medical community left obesity open to debate. 

 

This in turn left people with obesity vulnerable, their bodies subject to accusations and questioning, overtreatment, and mistreatment.

 

One of the complexities that physicians who treat obesity face is the fact that most popular diets do not work long term for most people, which amplifies feelings of inadequacy and failure.

 

What causes obesity is a hard question to answer. Genetics holds key in most cases. Experts say we live in an “obesogenic environment” marked by minimal physical activity, and consumption of highly processed fatty, sugary food. Some people are genetically predisposed to become obese under these conditions, while others seem immune to it.

 

Excess fat can be a symptom of illness, a disease itself or a risk factor for other health problems. 

 

The ills of excess fat can manifest in people with larger bodies and high BMIs and in people who are not large at all but harbour abnormal body fat. 

 

This makes “obesity” a surprisingly convoluted term.

 

People with obesity have to navigate unforgiving stereotypes that society imposes on them: an overweight condition is self-inflicted due to gluttony and laziness and it somehow reflects moral failing and lack of personal discipline.

 

Often, obesity and weight stigma are associated with mental health issues — not just eating disorders but also anxiety and depression.

 

Weight-loss profiteers

 

When people cannot control their body weight, they often blame themselves and feel insecure and unhappy. 

 

This creates a vast business potential for diet gurus and wellness companies, offering easy ways to win the battle against obesity.

 

If they find even a faint sign of your misery about growing BMI, they will pounce on you with a clutch of diet and fitness packages that promise to liberate you from the fatness-induced guilt.

 

No wonder that the weight loss and weight management diet market size is projected to reach $295.3 billion by 2027. 

 

In the anti-obesity gold rush, several drugs are competing for market share. But, they come with serious side-effects. Medical weight loss interventions have, over the years, led to heart damage, strokes, and nerve damage.

 

For decades, weight management has been a seasonal business with weight loss products being traditionally marketed just after holiday seasons, particularly in the initial months of the year. This is because of the consumers’ New Year’s fitness resolutions.

 

Holistic approach

 

Instead of wallowing in guilt over gaining weight, embrace a holistic health approach to manage weight. Merely focusing on the number on the scale will not get us anywhere. 

 

Instead, we need to turn our attention to healthy habits that include moderate eating and exercises and setting achievable goals.