Dear Editor

OBESITY IS A DISEASE

Why is obesity a disease? Because the American Medical Association (AMA) designated obesity a disease in 2013.

Whether obesity should be labelled as a disease has been historically debated. In 2008 the Obesity Society officially announced their support by calling obesity a disease.

The reason the AMA decided in favour of obesity as a disease is that it will decrease the stigma of obesity that comes from the widespread thought that it is just the outcome of excessive eating and not enough exercise.

Additionally the Council on Science and Public Health recognizes that obesity fits some medical criteria of a disease, like impairing body function.

To suggest that obesity is not a disease but rather a consequence of a choice lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.

Now, four years later, the debate continues. Is obesity a disease? For some obesity as a disease invalidates the importance of discipline, proper nutrition, and exercise and enables individuals with obesity to escape responsibility. For others, obesity is a bridge to additional research, coordination of effective treatment and increased resources for weight loss.

According to my dictionary “a disease is a condition that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.” Talking about disease, “Does obesity fit the strict definition of a disease? According to Mosby’s Dictionary of  Medicine, Nursing and Health Professions, a disease is: 1. A condition of abnormal vital function  involving any structure, part,  or system of an organism. 2. A specific illness or disorder characterized  by a recognizable set of signs and symptoms  attributable  to heredity, infection, diet, or environment. Answer? It fits.

 A more comprehensive definition is provided by the Obesity Medicine Association. According to them: Obesity is defined as a “chronic, neurobehavioral disease wherein an increase in body fat  promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse biomechanical psychosocial health consequences.” 

Ouch!

Individual with obesity have an increased accumulation of fat not always attributed to eating too many calories  or lacking physical activity. Individuals with obesity impaired metabolic pathways along with disorderly signalling for hunger, satiety (the feeling of fullness). For many, efforts to lose vary with unyielding resistance or disappointing weight regain.

Now, listen to this. The pathology of obesity is vast and varies on the cause of weight gain. There is not one type of cause for obesity. Obesity subtypes include congenital menopause related and MC4R (whatever that is), deficiency to name a few. Obesity is related to genetic, psychological, physical, metabolic, neurological, and hormonal impairments. It is linked to heart disease, sleep apnea and certain cancers. Obesity is one of the few diseases that can negatively influence social and interpersonal relationships.

Here are some of the opinions of important authorities in the field of health regarding obesity.

Alfonso Torquati, MD, MS, Chairperson of the Rush University Medical Centre. April 11,2017. “ Obesity is absolutely a disease that requires a range of interventions and medical management…People may say just eat less, have will power but they just don’t understand that simple does not work for many people.”

Michael Gonzales-Campoy, MD, PhD, Medical Director and CEO of the Minnesota Centre for Obesity. “Obesity is a chronic genetically programmed disease. The environment in which we live, referred to as an obesogenic environment, certainly play a major permissive role in the expression of the many genes that lead to the accumulation of fat mass. As with any other chronic disease, obesity may be treated, managed, controlled, and even put into remission. But it can’t be cured.”

The World Health Organization (WHO), in its 2000 report “Obesity: Prevention and Managing the Global Epidemic.” Wrote: ”Obesity is a chronic disease, prevalent in both developed and developing countries and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concerns, including undernutrition and infectious disease, as one of the most significant contributors to ill health.”

The Obesity Society, provided on the AOA’S “Obesity is a Chronic Disease” “The American obesity Association believes that obesity is a disease. Obesity is an excess of fat. It is not defined as a behaviour. Consider this: most people can distinguish between smoking and lung cancer. One is a behaviour and one is a disease. Or problem drinking of alcohol and liver disease. One is a behaviour and one is a disease. Sunbathing without protection is a behaviour; skin cancer is a disease.

José Caro, MD, Vice President of Global Diabetes Care wrote on Jan.13, 2010: “Obesity is one of the most frequent and serious metabolic diseases. Furthermore, strategies for long-term reduction of body weight are largely ineffective. More than 90% of people who lose weight eventually regain it.”

GLOBAL OBESITY LEVEL

In 2016 more than 1.9 billion adults, 18 years and older were overweight. Of these over 650 million were obese. 39% of adults, 18 years  and older were overweight in 2016., and 13% were obese.

Most of the world population live in countries were overweight and obese kills more people than underweight.

MEDICATION

Some patients find that diet and exercise is not a viable option, for these patients anti-obesity drugs can be a last resort. Some prescriptions weight loss drugs are stimulants, which are recommended only for short term use and these are of limited usefulness for the extremely obese patients, who might need to reduce weight  over months or years.

As far as Samoa is concerned, we have obese people in great numbers, and per the above definition, there are all considered  diseased people. And the name of their disease? is obesity.

Heading the list is our beloved P.M. who fortunately or unfortunately is in good or bad company with the rest of the obese population. Should we fly them over to N.Z. for a three week check up? I doubt it. 

Our P.M. had a Septic  Shock due to his immune system not well. Besides he is obese, and if he says he is not diabetic he might have a skin problem. Do I sound like a doctor? No. I read and come out with my own conclusions. You can do the same.

 And when “that” time comes, most probably sooner than later, all will end up in heaven, God will not discriminate against them. Because we are a Christian State; incest and corruption included. After all, that food that has been eaten in excess, was paid for. And all those who are doing it or plan to do it “they know what they are getting into”.

*Orlando Huaman is a freelance writer, Malololelei.