The Fat’s In the Fire

venus-hug2It’s cruel to be kind, it’s hip to be square, and now it’s sick to be fat.

The American Medical Association has officially recognized obesity as a disease.

“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” Dr. Patrice Harris, a member of the association’s board, said in a statement. She suggested the new definition would help in the fight against Type 2 diabetes and heart disease, which are linked to obesity.  –– NYTimes

Now the real fun begins.

Because this is really a judgment call — there’s no universally accepted definition of a disease, and the term “obesity” is usually applied based on Body Mass Index (BMI), a simplistic calculation that often describes otherwise healthy people — not everybody is happy with this.  Fat Activists point out that

… “medicalizing” obesity by declaring it a disease would define one-third of Americans as being ill and could lead to more reliance on costly drugs and surgery rather than lifestyle changes. Some people might be overtreated because their B.M.I. was above a line designating them as having a disease, even though they were healthy.

Love the term “Fat Activists.”  While these aren’t necessarily avoirdupoidically blessed individuals — although all the ones I’ve ever met are of cattle girth — what makes them “Fat Activists” is their belief and advocacy that people should learn to accept their mammoth proportions as normal and/or beyond their control.  It’s not just a question of dropping one’s knife and fork or mixing in a salad now and then.  It’s closer to being born crippled or mentally retarded, or just ugly.  They say.  Like this one:

Linda Bacon, a nutritionist at University of California, Davis, said, “I’m appalled that the AMA chose to ignore science and name obesity a disease.”

Bacon, author of “Health at Every Size,” joins other critics in noting that the definition of obesity — basically how one’s weight and height ratio stacks up on a BMI chart — is imprecise, and only defines size not health.  “The AMA just determined that some people are sick based on how they look,” Bacon said. “What’s next? Will they pronounce being black as a disease because there are higher rates of cardiovascular disease in black communities?” — Leader-Telegram

Yeah, her name is “Bacon.”  And she really said that.  These Fat Activists are pathetically out of touch with reality.  Size 75 Enablers.  Look at this one and her “autoethnography of fat activism.”

60046939764971693735269But if you cut through to the meat of the argument, as it were, all of this has to do with just one thing: money.  If obesity becomes a disease, more people will seek medical treatment, which means medical bills, insurance reimbursement, and eventually, expensive pharmaceuticals.  It is hardly coincidental that in the last 12 months, two anti-obesity drugs have been introduced: Qsymia and Belviq.  Ka-Ching is the new fat!

It’s an old argument.  Most therapists are comfortable labeling alcoholism and drug addiction diseases, but not everybody agrees: they won’t tag what they appraise as nothing more than bad habits and self-indulgence as anything more serious than stupid, willful behavior.  “Drinking ain’t a disease!  Cancer is a disease!”  Whatever.  For the record, I consider them therapeutic medication.

I’m not a specialist, but my commonsense take on this is that some people are obese thanks to bad habits, bad diet, and bad attitude, while others thanks to a perfect storm of metabolism, heredity, and circumstance.  In other words, sometimes it is a disease, and sometimes it ain’t.  This may not sound like science to the medical establishment — you know, the people who considered homosexuality a mental illness until 1973 —  but I don’t think we’re dealing with science here as much as art.

No matter what, I like the idea of making fat people pay higher airfares and more for health insurance.

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11 Responses to The Fat’s In the Fire

  1. syrbal says:

    I hope if they are going to medicalize it, they at least come up with a definition that has common sense. When I joined the Army in 1974, I weighed 122 pounds. Now, in the year I turn 60, I weigh 144 pounds or so; and I had a little East Indian pulmonologist giving me hell about having sleep apnea, tell me that “Like ALL Americans, you are obese. You are an obese people.” I wear size 10 or 12 jeans depending upon the maker. If anything over size 4 or 6 is going to be labeled obese….the mental health crew better man up, cause it is going to get really ugly.

    Since I see so many people half my age and twice my weight, I really do think more is going on than too many malted with cheeseburgers. And sadly, “medicalizing” being fat isn’t going to mean they look at the reasons why.

    • Kim Chee says:

      I’m Korean, built much smaller than most Americans I know. I understand why somebody might say “Americans are obese people.” But it’s just wrong. If the Fat Activists are right about any one thing, it is that Americans’ obsessive focus on show business and fashion has led many to unreasonable expectations regarding their own weight and bodies, which in turn leads to anorexia, bulimia, and, oddly, obesity. Your example also demonstrates what is noted here–this is less science than art. As well as commerce.

      • syrbal says:

        Pretty much the case. To be fair, I think there is a core of Americans who know what real bodies look like…but when one uses a medical diagnosis SOMEtimes caused by obesity to justify saying “You are obese”….that is not just bad science, that verges on a sort of societal racism when it comes from someone outside that society.

        And then, we don’t know what causes true obesity. We have two cats. Each gets the same amount of the same food and they are about the same age. One is a lengthy, slinky silver tabby, the other is a tortoiseshell butterball. And the butterball rarely eats her daily allotment of food.

        And I know people with similar problems. I think it is something IN the food we eat that results in so much weight, and I am not talking mere calories.

  2. Lois Terms says:

    The overwhelming majority of overweight and obese persons got that way as a result of bad habits. Habits can be altered . Calling obesity a disease distracts us from the solution, which isn’t a “cure” so much as it is a change.

  3. Ruh Roh says:

    Fat Activists: “The Fatheads of the Land.”

  4. Paula Deen says:

    Obesity isn’t a disease. It’s an achievement.

  5. Libby Rae Shone, Ph.D. says:

    What you prefer to belittle is that the purpose of characterizing obesity as a disease is to help people who are either in danger of becoming or already obese. Most will see it as liberation and reason for hope, and while a minority might find the term stigmatizing, that minority constitutes prime candidates for therapy and treatment. On balance, as a therapist specializing in these disorders, I applaud the AMA’s move. I challenge your cynical, unfounded contention that money has anything to do with this determination.

    • Squathole says:

      Libby: If you’re challenging me to produce proof that the motivation behind this move is financial, e.g., a research document or a smoking-gun statement from a pharmaceutical exec or physician, I can’t do it. I would just ask you to regard the plain facts and sequence of events, and point to a long history of easing the label “disease” over to behavioral patterns previously considered “conditions.” Too, look at the bigger picture — how the practice of therapy has become larded with pills as “the talking cure” loses favor and becomes less of a reimbursable item. You might like this, too, particularly the last section.

      Of course, YOU favor this move by the AMA — look how it promises to send additional paying customers to your shopfront operation, especially now with the promise of insurance reimbursement. We understand. As Freud himself said, Bidness is bidness.

  6. Pompatus Of Love says:

    Arrange for someone to hold you hostage for six months with a bread and water diet.
    Poof, Miracle Cure.

  7. odtley says:

    these people will not stop until everything is a disease including rainy days and chicken dinners because thats the fastest easiest way to turn human suffering into cash cows and manufacturing meds they can sell to medicare and insurance companies by the boatload

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