Can People Control Obesity?

According to the World Health Organization (WHO), no other current health threats spread as fast as so-called "non-communicable diseases" (NCDs) like obesity, diabetes, heart disease and cancer. What distinguishes these from infectious illnesses is that humans bring them mostly upon themselves through poor diet and lifestyle choices. Nevertheless, the impact is very real and there is no letting up in sight.

How can that be? How can we self-inflict debilitating and potentially life-threatening diseases on a pandemic scale? How can this happen when we have a pretty good understanding of the causes and how they could be averted? And why is it that the countless messages about diet and lifestyle changes produce such meager results?

Unsurprisingly, there is great uncertainty among the experts about how to address these issues. For example, only last year, the American Medical Association (AMA) decided to classify obesity as a "disease," with the goal to bring greater attention to the urgency of the matter. Yet some have expressed skepticism about the helpfulness of such a move.

In a recent op-ed article in the New York Times, psychology professors Dr. Crystal L. Hoyt and Dr. Jeni L. Burnette, both of the University of Richmond, Virginia, suggested that the classification may in fact be counterproductive because it potentially diminishes incentives to deal effectively with weight problems.

"Calling obesity a disease provides a clear warning of the significant health risks associated with excessive weight," they wrote. "We wondered, however, if there also might be psychological ramifications inherent in that message. Would it reduce or add to the burden of body-image concerns and shame? Would it empower people to fight back, or lead to a fatalistic acceptance of being overweight?"

They both agreed that stigmatization and discrimination of any kind have no place in how we view obesity and other related health issues. On the other hand, we ought not simply relieve people of all responsibility for their own well-being.

Suggesting that someone's weight is his or her unfortunate fate, a "fixed state like a long-term disease," can make efforts of weight loss and dietary improvements seem futile and may indeed undermine them, the professors warned.

As a dietitian and health counselor, I have no problem with declaring obesity a disease, especially considering the complexity of potential causes, some of which are indeed beyond an individual's control. Having said that, I also believe that the only appropriate response to illness is to make every effort to overcome it as quickly possible. An even better approach would be prevention, so that damages don't occur in the first place. For this, I believe, we all have a duty, a personal responsibility, not to get sick as a consequence of our own actions.

Yes, there is much confusion around diet and lifestyle issues. Many people have given up and are tired of listening to oftentimes inconsistent, if not contradictory, messages. But there is also some certainty. Eating healthily by adding more fresh fruits and vegetables and cutting back on processed foods is part of that. So is observing portion sizes. Regular exercise is a must without question. Reducing stress and getting enough sleep matter as much. All these we know to be true. If we acted upon just this bit of knowledge each and every day, things could improve real fast.

Food and Health with Timi Gustafson R.D.

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