Is Obesity a Disease?

Everybody knows that obesity is unsightly and unhealthy. What you may not know is just how dangerous it is. The American Society of Bariatric Physicians (ASBP) is a professional medical society composed of physicians with a special interest in the medical management and treatment of obesity. Here is a recent statement that this organization just released:

“Is obesity a disease? For several years, the American Society of Bariatric Physicians has been trying to convince insurance companies and organized medicine to recognize obesity as a disease entity. As reported by UPI, and picked up by all of the national media, a panel of experts from the National Institutes of Health officially called obesity a ‘killer disease.’ According to ASBP’s President, ‘We are pleased with this declaration by a national organization of the dangers of obesity as a disease. We endorse the findings of the National Institutes of Health and we think this action will be a significant step forward for the 34 million adult Americans who suffer from obesity and need medical attention for their problem.’

“The ASBP’s official position on obesity as a disease entity is closely related to the National Institutes of Health findings. ASBP’s expert clinicians concur with the findings of the panel of experts from the National Institutes of Health, and reaffirm that a person is considered obese when 20% above normal weight set by life insurance tables for adults. At 20% above the ideal weight, ASBP maintains a definite health hazard does exist. ASBP’s position remains that since obesity can now be treated effectively by medical and, if necessary, surgical methods, the recognition of obesity as a disease is long past due. ASBP believes that obesity is an independent risk factor and major health problem in cardiovascular disease, hypertension, adult diabetes, cancer, anesthesia, and major abdominal and thoracic surgery”

Obese people run a risk of diabetes and high blood pressure that’s three times as high as the risk for the non-obese. You already know about the increased risk of heart disease. But did you know that the obese also run a higher risk of strokes and arthritis? “At the 20% overweight level,” says Dr. Jules Hirsch of New York’s Rockefeller University, “you start putting enough weight on certain joints (the knees and lower back, for example) to make them go to pieces long before they ordinarily would.”

Severely obese (more than 40% overweight) women have a risk of developing cancer of the uterine lining that’s five times normal. They also have higher risks of cancer of the cervix and breast. Overweight men have higher rates of cancer of the rectum, prostate and colon.

And what if you’re only, say, 18 or 19% overweight? Don’t feel too comfortable with the extra flab. That 20% figure cited by the ASBP is the general figure that everyone agrees constitutes obesity. Actually, any excess fat is a bad idea. The doctor who chaired this year’s National Institutes of Health panel on obesity, warns that even five pounds of excess fat can be dangerous to people who are genetically at risk for hypertension and adult-onset diabetes.

Just how obesity works to promote diabetes is something of a mystery. The human pancreas produces insulin, but the cells of obese people seem to be insulin-resistant. Dr. Charles Kleaman of UCLA says, “The receptors on the cells that usually grab the insulin just don’t seem to operate any more. The body is producing enough insulin, but it isn’t being employed by the cells.”

The latest research also indicates that where you carry your fat has some bearing on your health. People whose fat is deposited around the waist (the classic “spare tire”) are more often victims of strokes, heart disease and diabetes than those who carry their weight on the hips and thighs. We don’t know why this should be so, but it’s something that men should watch out for, since the waist is the classic male storage area for fat. Women, on the other hand, are more often bottom-heavy. “A lot of guys,” says Dr. Hirch, “are going around with a beer belly and thinking it’s okay, sort of macho. They could be in more trouble than people with fat hips and thighs.” His NIH panel urged that we investigate a new measure of obesity: the waist-to-hip ratio. If your waist is as big around as your hips, or bigger, you could be in for a lot of trouble.

Because the ASBP believes that obesity is a disease (in fact, a “killer disease”) we think that all group medical insurance plans should include obesity coverage. Unfortunately many don’t.

Meanwhile, if you’re obese, you’re walking around with a potential killer in your body. If you’re just somewhat overweight, don’t wait until the scale shows that you’re 20% over where you should be. Chances are that if you look and feel too heavy, you are too heavy, and you may thus be predisposing yourself to any of a number of life-threatening diseases. There’s no time like now to do something about this problem.

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