Nikhil Dhurandhar and I don’t have a lot in common. He is a vice president and key researcher with The Obesity Society, while I am just someone who writes about people such as Nikhil Dhurandhar. He works at the imposing Pennington Biomedical Research firm in Louisiana, while I am on the team of the far more layman-accessible CalorieLab. Say my name aloud, and people might think “German”; say his name aloud and they might think “gesundheit.” But we both have an issue with the recent decision of the American Medical Association to designate obesity as a disease. We simply disagree on what it should rightly be called. http://www.sccs.swarthmore.edu/users/09/leo/intlblogday/forum/read.php?1,2274
Dhurandhar believes that “obesity” is actually shorthand for “a number of different diseases.” My view is that obesity will come to be seen not so much as a disease or even a cluster of diseases but as a symptom. A symptom of what, you ask? Of all kinds of things. There are plenty of symptoms like that already. Got a sore on your tongue? Could be a sign of anything from herpes to cancer to a dental misalignment to too many four-alarm jalapeños. Sudden reddish patch of skin that appears out of nowhere? Could be an allergy to any one of scads of things, or a chemical reaction, or a genetic condition, or a dermatological disorder. Headache? Possible causes run to several pages, without even mentioning ice cream or sexual avoidance.
We could go on like this for awhile, but you get the point. The point, which Dhurandhar and I agree on, is that obesity is far more complicated and idiosyncratic than simply the result of too much food and too little physical activity. (It might seem that the difference between Dhurandhar’s position and mine is hair-splitting, but he regards all obesity as some form of illness or clinical condition, while my take is that a considerable amount of obesity is simply due to indifference or self-indulgence on the part of people who frankly don’t care if they’re obese, or what medical science or other people think about it if they are.)
According to Dhurandhar, who discovered a virus that is present in obese people three times as often as it is in slender people, various researchers, himself included, have identified some 85 different factors that may cause or contribute to obesity. Being the author of an e-book titled “115 Reasons Why It’s Not Your Fault If You’re Fat,” I am gratified to have him validate its premise that obesity is far more complicated that you might expect. It certainly proved more complicated than I expected. http://uchem.berkeley.edu/forum/read.php?26,500745
I originally intended “115 Reasons” to be a bunch of tongue-in-cheek items that were unscientific and/or exaggerated and designed more as amusing excuses than actual reasons. It was also just going to be “99 Reasons.” But because I did not want to seriously mislead any possible book purchasers, I decided to include those genuine contributing factors that I did come across in my research. As it turned out, there are so many legitimate obesity-linked elements in the human environment that they totally crowded out all but a handful of the jocular “reasons,” which are now little more than occasional comic relief. Indeed, I only stopped at 115 because I had to stop at some point. If I were to publish the book today, it would be more like “130 Reasons.”
All of which leads me to take a position on a controversy regarding the AMA’s obesity-as-disease announcement. Some critics have accused the AMA, which after all is an association representing the interests of practicing physicians, of using the “disease” label to generate more business for doctors, which that label very well might do. Even so, and while I’m not sure that obesity should rightly be designated as a disease (not that my opinion is in any way relevant), if giving it that designation winds up motivating obese people to consult a physician about losing weight, I’m all for it.
It is, after all, the physician’s job description and specific skill to diagnose symptoms, to determine their cause and prescribe an appropriate treatment program. And although eating too much and exerting oneself too little are obviously the primary mechanisms of weight gain, in those cases where the root cause of the obesity is hormonal or biochemical or hereditary or environmental, for example, the latest fad diet or herbal concoction or exercise device is not going to seriously address it. https://secure.web.emory.edu/forums/read.php?9,2118,2118#msg-2118
Being fat may not be an illness as we generally define the term, but if you are fat and would like to be less so, “Consult your physician” is pretty good advice.
- See more at: https://www.ag.ndsu.edu/forums/range/read.php?9,26993
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