European Commission classifies obesity as a chronic disease

[Orphia Nay]

"In March 2021, the European Commission issued a brief in which it defined obesity as a “chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases”. The brief provides obesity with the formal and bind categorisation status of a non-communicable disease (NCD)."

From The Lancet on June 1 2021:

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00145-5/fulltext

Policymakers charged with tackling obesity have tended to focus almost exclusively on prevention. In England, less than 1% of those who satisfy the clinical criteria for surgical treatment for obesity actually receive the intervention. Defining obesity as a disease would almost certainly raise take-up. Critics of the disease thesis point to the fact that it is possible for people to have a BMI higher than 30 while remaining in good health, free of risk factors such as pre-diabetes, or hypertension. Francesco Rubino, chair of metabolic and bariatric surgery at King's College London, stresses the importance of establishing better diagnostic criteria that distinguishes between individuals for whom obesity is a condition and those for whom it is a disease. He recommends learning from other health issues.

“We are pretty comfortable with the difference between depression and clinical depression; people do not expect people with clinical depression to just decide to be happy. That thinking is missing in obesity”, said Rubino. “We have a definition that is entirely based on strict BMI cutoffs, which does not accurately predict any disease state, or the risk of future disease across different ethnic groups. We need a new, smarter metric that understands that while obesity can be a disease, it is not always a disease”.

Rubino is dismissive of suggestions that patients who are told that obesity is a disease will abdicate personal responsibility for their health. “You do not see people diagnosed with type 2 diabetes or hypertension suddenly decide to stop exercising or managing their diet”, said Rubino. “If anything, there has been far too much emphasis on blame and personal responsibility, including from doctors; we need to move away from those attitudes, not closer towards them”. Classifying obesity as a disease could help reduce stigma, offer a bulwark against sham weight-loss therapies, and expand research into the mechanics of weight gain. Perhaps most importantly, it matches how patients conceive of their situation.

Will this help or hinder the obese, or neither, or something else?

 

[The Atheist]

"In March 2021, the European Commission issued a brief in which it defined obesity as a “chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases”. The brief provides obesity with the formal and bind categorisation status of a non-communicable disease (NCD)."

Reminds me of the thread I started years ago excoriating the idea that obesity is a disease.

Smoking and alcohol consumption must now be diseases as well - and at least they're both addictive substances. Not to mention the amount of tax on booze and cigs, compared to food, which in many countries doesn't even attract VAT/GST.

I call BS.

 

[angrysoba]

Reminds me of the thread I started years ago excoriating the idea that obesity is a disease.

Smoking and alcohol consumption must now be diseases as well - and at least they're both addictive substances. Not to mention the amount of tax on booze and cigs, compared to food, which in many countries doesn't even attract VAT/GST.

I call BS.

Your thread was about it being a disability.

That said, if disease is:

a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.

a particular quality or disposition regarded as adversely affecting a person or group of people.

Then I don't think calling obesity a disease is particularly inaccurate.

In fact, I much prefer saying that
obesity = a disorder causing ill health
rather than
obesity = happy, freedom, beautiful life.

 

[The Atheist]

Your thread was about it being a disability.

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

 

[angrysoba]

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

Well, the CDC define it as a disease:

Obesity is a common, serious, and costly disease

https://www.cdc.gov/obesity/data/adult.html

So does the Mayo Clinic:

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn't just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

 

[Orphia Nay]

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

What about obese children?

If someone is brought up to eat lots, and eat lots of crap, where is the cutoff between nurture and self-inflicted?

 

[angrysoba]

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

What about obese children?

If someone is brought up to eat lots, and eat lots of crap, where is the cutoff between nurture and self-inflicted?

What about liver cirrhosis caused by alcoholism or lung cancer caused by smoking? It seems to me that whether they are self inflicted or not they are both diseases.

 

[Archie Gemmill Goal]

Smoking and alcohol consumption must now be diseases as well - and at least they're both addictive substances.

If you don't think food is addictive can I suggest you try going cold turkey for a month or two and see how you get on?

 

[Darat]

"In March 2021, the European Commission issued a brief in which it defined obesity as a “chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases”. The brief provides obesity with the formal and bind categorisation status of a non-communicable disease (NCD)."

From The Lancet on June 1 2021:

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00145-5/fulltext



Will this help or hinder the obese, or neither, or something else?

Be interesting to see if it has an effect in the EU countries. Certainly our current approaches aren't working so we need to do something different then we are doing.

 

[Darat]

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

What do you think the widespread problem of obesity is?

 

[The Atheist]

What about obese children?

Easy.

Have the parents euthanised and get the kids brought up by someone who teaches them to eat properly. It's not that hard.

I see kids walking past my house that beggar belief in terms of their size. Pasifika people are even fatter than Americans, and that's not an easy task. It extends to East Asians and Indians, too - being genetically disposed to low metabolism, a lot of their kids are disgustingly obese. I see kids that have to swing their legs wide as they walk because their thighs are so fat they can't walk normally.

It really doesn't help when gigantically fat Americans come to NZ and tell everyone it's great to be disgustingly obese and downplay health risks: https://www.massey.ac.nz/massey/abo...cle_uuid=88CB5A32-157D-4E5E-85B6-ADB48361AD25

Edited by Agatha: 

Edited to remove breach of rule 0 and rule 12

 

[Darat]

Easy.

Have the parents euthanised and get the kids brought up by someone who teaches them to eat properly. It's not that hard.

I see kids walking past my house that beggar belief in terms of their size. Pasifika people are even fatter than Americans, and that's not an easy task. It extends to East Asians and Indians, too - being genetically disposed to low metabolism, a lot of their kids are disgustingly obese. I see kids that have to swing their legs wide as they walk because their thighs are so fat they can't walk normally.

It really doesn't help when gigantically fat Americans come to NZ and tell everyone it's great to be disgustingly obese and downplay health risks: https://www.massey.ac.nz/massey/abo...cle_uuid=88CB5A32-157D-4E5E-85B6-ADB48361AD25

...snip...

Fat doesn't mean obese - at least in the UK - the picture of that person is (at least to the eye) obese not fat.

 

[The Atheist]

Semantics. Fat/obese. The thing I posted the pic of is seriously obese.

And she makes a living on taxpayers' money telling people it's ok to weigh more than an All Black scrum on your own.

Bob save us.

 

[Darat]

Semantics. Fat/obese.

...snip...

I don't think it is just a matter of semantics, having some "excess" fat is not unhealthy in of itself and there is a lot of research that indicates some "excess" fat is healthy. The health problems arise when one is overweight or, at the extreme end of the scale, obese.

We also know that "fat shaming" is as useless as telling a clinically depressed person to cheer-up if you want to help someone deal with being overweight or obese.

I think part of the issue we have to face is that evolutionary we are not selected for a healthy way to consume huge excess amounts of calories, indeed we are evolutionarily selected to eat as much as we can when it is available. It is hardly surprising then that many people struggle with eating the appropriate levels of calories, we are prone by biology to eat as much as possible.

 

[angrysoba]

Semantics. Fat/obese. The thing I posted the pic of is seriously obese.

And she makes a living on taxpayers' money telling people it's ok to weigh more than an All Black scrum on your own.

Bob save us.

Yes, she is obese.

Do you think she believes that being obese is a disease? I would expect she does not. In fact, she seems to think it is totally okay to be obese. Big is Beautiful, etc...

What is your objection here? That by saying obesity is a disease is the same thing as telling people that it is not a problem? It seems that it is the opposite.

 

[Archie Gemmill Goal]

Edited by Agatha: 

Edited to match quoted post

Edited by Agatha: 

and response to same

 

[Archie Gemmill Goal]

I don't think it is just a matter of semantics, having some "excess" fat is not unhealthy in of itself and there is a lot of research that indicates some "excess" fat is healthy. The health problems arise when one is overweight or, at the extreme end of the scale, obese.

We also know that "fat shaming" is as useless as telling a clinically depressed person to cheer-up if you want to help someone deal with being overweight or obese.

I think part of the issue we have to face is that evolutionary we are not selected for a healthy way to consume huge excess amounts of calories, indeed we are evolutionarily selected to eat as much as we can when it is available. It is hardly surprising then that many people struggle with eating the appropriate levels of calories, we are prone by biology to eat as much as possible.

And as anybody who thinks about it for a second (so not the OP obviously) it is incredibly hard to manage a food issue because unlike alcohol or drugs or smoking you can't just stop doing it as a treatment approach.

 

[Archie Gemmill Goal]

What is your objection here?

The same objection that is ALWAYS the objection... some people aren't being awful to people that he doesn't approve of and are actually trying to help them rather than judging and disparaging them.

It's dull. As is the OP.

 

[Egg]

Naming it as a disease is the first step on the way.

Lots of chronic diseases are disabilities. Most of them aren't self-inflicted.

I think including "self-inflicted" as a part of a definition or classification when talking about diseases or disabilities (and in turn priorities in treatment and the potential for societal stigmatization) is opening a Pandora's box of problems. There are steps, changes in lifestyle and preventative measures that people can take to avoid a vast list of diseases, injuries and disabilities. In the end, it seems to come down to judgments about people's lives that none of us are in any position to make.

While I don't share an extreme distaste for obese people and find the concept of "fat-shaming to help fat people" entirely disingenuous, I do have a hard time having much sympathy for anti-vaxxers who get Covid, so I get the "self-inflicted" thing. But I don't see it as useful for classification, practical or something that can be applied with consistency.

 

[theprestige]

"In March 2021, the European Commission issued a brief in which it defined obesity as a “chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases”. The brief provides obesity with the formal and bind categorisation status of a non-communicable disease (NCD)."

From The Lancet on June 1 2021:

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00145-5/fulltext



Will this help or hinder the obese, or neither, or something else?

Both. It'll hinder those who have a condition that could be treated through lifestyle changes. It'll help those who have a disease that could be treated through surgical intervention.

My experience with the surgical intervention side of things is that lifestyle changes are also an important component of treatment, even when surgery is indicated. So on balance I think it will hinder the obese. As long as personal choice remains a component, anything that deprecates personal choice will tend to hinder improvement.

It's kind of a catch-22 though, since personal choice is very often insufficient, and trying and failing tends to demoralize. What's really needed, IMO, is a multi-axis approach, that recognizes the need for surgery in some cases, and provides for that need, but also recognizes the need for lifestyle changes, and encourages and supports those efforts.

---

On the other hand, it's probably neither here nor there in this particular case. The EC's classification is going to be primarily a politico-bureaucratic decision, serving primarily politico-bureaucratic ends which are probably inscrutable even to some of the commissioners in favor of the classification. Whatever they're actually trying to help or hinder with this decision, it might not be that close to the ostensible topic of the classificatoin.