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Essay on the Medicalization of Obesity...

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The Medicalization of Obesity Over the past 30 years, medicalization has been a product of the rapid advancement of science. It refers to the process in which health conditions and behaviors are labeled and treated as medical issues, that usually have not been labeled as so in the past. Obesity is a perfect example of medicalization. What used to be seen as someone simply being overweight, has spawned an entire industry of health products, weight loss medications and surgeries, and referral services and centers. Critics have labeled this over-medicalization or disease-mongering, since by labeling normal health variants as pathological states, medical industries have made enormous profits. The obsession with weight-loss began back in the 1920’s and 1930’s when weight-loss products such as diuretics, laxatives, and diet pills hit the mainstream (Blackburn, 2011). However, the obsession really took off in 1942 when the Metropolitan Life Insurance Company created charts of age, weight, and mortality numbers for 5 million citizens in the U.S. and Canada (Blackburn, 2011). These charts were designed to model as the standard for what people “should” weigh, based on their height and age. With the creation of these charts, clinical-like terminology began to arise, including words like overweight, adipose (used for the storage of fat), and obese. Not only did these terms start to sound like weight was something to be treated by doctors, they also had a very strong sense of moral judgement attached to them. Following the creation of the BMI charts, in 1949, a group of people united to form the National Obesity Society with the intent to make obesity more than just a social or personal problem. This spurred the first of many professional associations and annual conferences regarding obesity, and it began to inspire the idea that obesity was something to be medically treated. Many decades later, in June 2013, members of the American Medical Association met to establish Resolution 420, which

stated, “Our AMA recognizes obesity as a disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention” (Policy Finder AMA, 2013). In other words, this marked the day that obesity officially became medicalized and was no longer just a public health concern. It’s increasing prevalence and criticalness in society finally led for it to be sanctioned as a “true” disease. While obesity is undoubtedly a major problem in society, labelling it as a disease and something to be treated my medical doctors, raises a number of complications. To begin with, the definition of obesity is based on BMI (Body Mass Index), which measures height and weight. More specifically, it is a measure of physical appearance, not physical health (Bacon, 2015). This makes it look like the AMA is basing obesity as a disease off physical appearance, and not the actual health of an individual. If the AMA is so concerned about disease, then the BMI would not be an appropriate measure of obesity, rather, looking at the “symptoms” would make more sense. With that said, there are actually many “obese” people who are not harmed by obesity nor do they have any symptoms of a disease (Chang, et. al, 2002). For one thing, a disease is a “condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms” (Merriam-Webster Dictionary, 2019). Obesity does not fit this definition, as those who are put in the obesity category are able to function normally, and live long, healthy, lives without any the complications that accompany a medical disease (Chang, et. al, 2002). Besides that, medicalizing obesity has the potential to perpetuate the stigma surrounding weight, leading to more discrimination and prejudice for those who are deemed as obese (Oliver, 2006). There is already plenty of bias in the medical profession towards those who are overweight or obese, and the recognition of obesity as a disease will continue to drive that prejudice. Not only that, but categorizing obesity as a disease implies that

it is something people have zero control over. In reality, people can control their lifestyle by changing their diet or choosing to be physically active. Telling all obese people that they have a disease could end up reducing their sense of control over their ability to change their diet or exercise patterns. As experience with addictions has shown, giving people the sense that they suffer from a disease that is out of their control can become self-defeating (Conrad, 1992). Nevertheless, obese people are still put into categories and are told that their obesity is a medical issue and out of their own hands.. Furthermore, this could lead to people turning to unnecessary surgeries, drug treatments, or other interventions that are unsustainable and come with significant side effects (Oliver, 2006). Most of the time, the medical treatments for obesity are high-risk and expensive (e.g., bariatric surgery), which ends up doing more harm than good. Rather than telling obese people how to make sustainable, healthy lifestyle changes, they are advised to spend all of their money on medical treatment. This is only a quick fix, and most of the time obese people will just return back to their previous size, prior to treatment (Blackburn, 2011). Overall, all of this does not discount the fact that weight is indeed connected to higher risk of some health problems, such as heart disease and diabetes (Blackburn, 2011). But, there is still considerable caution in viewing obesity itself as a disease. Some obese people have food addictions they cannot control, that may be driven by genetic and metabolic conditions that are clearly not simply failures of willpower. But, not everyone who is obese has such problems. The medicalization of obesity has sparked much controversy over the past years, as there has been a lot of debate still whether or not it should be defined as a disease. Most agree that the disease label should be used sparingly, just as not all drinking is alcoholism, and not all overeating is pathological.

References Bacon, L., PhD. (2015, February). AMA Misfire: All That's Wrong with Medicalizing "Obesity"[PDF]. www.lindabacon.org. Blackburn, G. L., MD, PhD. (2011). Medicalizing Obesity: Individual, Economic, and Medical Consequences. AMA Journal of Ethics,13(12), 890-895. doi:10.1001/virtualmentor.2011.13.12.pfor1-1112 Chang, V. W., & Christakis, N. A. (2002). Medical modelling of obesity: A transition from action to experience in a 20th century American medical textbook. Sociology of Health & Illness,24(2), 151-177. doi:10.1111/1467-9566.00289 Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology,18(1), 209-232. doi:10.1146/annurev.so.18.080192.001233 Oliver, J. E. (2006). The Politics of Pathology: How Obesity Became an Epidemic Disease. Perspectives in Biology and Medicine,49(4), 611-627. doi:10.1353/pbm.2006.0062 Policy Finder, AMA. (2013). Retrieved from https://policysearch.ama-assn.org/policyfinder/detail/H-440.842?uri=/AMADoc/HOD.x ml-0-3858.xml...