Thinking of Obesity as a Disease, and Dieting as the Treatment Plan.
History of the Concept Weight loss is a big business which comes with a built-in supply of repeat customers, and medical doctors have been involved in that business for a long time. In 1942, Metropolitan Life Insurance Company used age, weight, and mortality numbers from nearly 5 million policies to create “desirable” height and weight charts. As a result people (and their doctors) began to compare themselves to a standardized notion of what they “should” weigh. In the 1980s, the BMI ... which is a ratio of height/weight ... became the standard for determining obesity. In 1998, the AMA lowered the BMI cutoff of "normal" weight to 25, down from the previous 27 & 28.
Overnight, millions of people became “overweight” or “obese”. Putting more people in those categories made more people eligible for medical weight-loss treatment. In 2013 the American Medical Association declared obesity to be a chronic disease. Call me cynical, but follow the money. Doctors want to be paid for weight-loss treatments, and they get insurance reimbursement for treating disease. Although labeling obesity as a disease put the insurance industry on the hook financially, it also activated the concept of obesity as a “pre-existing condition”. This could affect any person who has ever been obese … forcing such people to pay higher insurance premiums, and to face the possibly of being denied any medical insurance coverage at all. Helpful Feature of the Concept At this point, I want to set aside financial concerns about “Obesity as a Disease”, and consider how the use of this concept might be helpful to someone dealing with obesity. Heart disease, stroke, cancer, diabetes, and arthritis are all considered chronic diseases. Obesity has now been added to that list. A chronic disease doesn’t get cured by just taking a pill or a shot. The effects of a chronic disease tend to linger for long periods of time, sometimes forever.
Embracing the idea that Obesity is a Disease, and that Dieting is the required Treatment Plan, could be used to help make us realize that we need to stay active in managing our weight for all of the rest of our lives. Some might consider this to be depressing, but consider this. In order to maintain dental health you have to remember to brush your teeth multiple times a day. In order to maintain good hygiene you have to maintain a regimen of washing yourself. In order to maintain good health you have to commit to getting some sleep every day. There are thousands of routines that we do every single day for our overall health, and we do most of them without feeling resentment. We can choose to consider managing obesity as just another one of life’s daily requirements. I’ve now been successfully maintaining my body at or near my “normal” BMI for 11+ years, after spending most of my lifetime with a BMI high in the obesity range. This weight maintenance didn’t just “happen”. My maintenance success has required ongoing vigilance and … quite frankly.. a great deal of effort … every single day. For a great explanation of this issue, see: Running Down the Up Escalator.
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