Obesity is now a Disease...

[Jetikus]

You could argue that both alcoholism and obesity are hereditary from an addiction standpoint. My mom and my brother both did/do hardcore drugs, smoke and drink heavily. They were both VERY skinny, to the point people wanted to make them eat. I have never done drugs or followed their lifestyle choices, however, I became obese. My point is that perhaps it is an addictive personality that is hereditary and I chose a different drug.

 

That's a good theory, imo. My gramps was an alcoholic (and thin as a flag pole) while my Dad is obese.

[level250geek]

You could also argue that obesity is hereditary in so much as being a learned behavior, or who knows: maybe some people are just more genetically predisposed to be obese and there's your heredity right there. I mean, how may times have we heard somebody say about another person, "He just eats and eats and eats and never gains weight!" We all know somebody like that. I have a friend who has worse eating habits than I do, never or very rarely exercises, is the same height, but weighs about 1/3 of what I do. I'm convinced that the fat gene runs in my family, making it easier for me gain weight and harder to lose it, but not in his--hence, he's the opposite. 

 

I'm convinced that, to a degree, obesity really is in our genes for some of us. Yes, you only gain weight by eating in excess and never exercising, but if you're predisposed it can only compound the difficult situation you may find yourself in--just like with alcoholism.

[Gainsdalf the Whey]

Good point. I still don't see the harm in treating the obesity as its own thing, seeing whereas it has its own set of complications and challenges and treating the "cause" of the obesity won't always help with the obesity itself.

 

For example, oftentimes the "lazy, complacent, and just not care," is, itself, a symptom of depression. If you treat the depression, those feelings become easier to overcome (they don't go away, mind you). So good: you now have more of a drive to get out the house and do things and a greater sense of self-worth--but you're still obese. Just because the depression goes away doesn't mean you become better educated about diet and exercise. That only comes with attacking the obesity directly.

 

Once again, it's a symptom because so many different things can cause it.  Calling obesity a disease is like calling a fever a disease. In your example, freeing the person of depression makes it possible for them to start reversing the damage of said disease. The symptoms of disease can do lasting damage. If I get cured of a wasting disease that causes muscle decay, I'm not going to get my muscle magically back, I'm going to have to do work to reverse the damage from the disease symptoms.

[Waldo]

 

I mean, how may times have we heard somebody say about another person, "He just eats and eats and eats and never gains weight!" We all know somebody like that.

Do you actually know them well enough to see their eating habits 24/7?

I was one of those people and still have those tendencies. Removed from a regular scheduled environment and social eating, I would absolutely revert back to that.

What you see: a skinny person absolutely outeating everyone that never gains weight. What you don't see: the next 2 days when they don't bother to or forget to eat.

[marionette]

If you want to read articles about genetic/epigenetic links and obesity here are abstracts of 157 of them. 

[Thrillho]

My wife's family is very like this.  About 1/3 of the family has a RIDICULOUSLY low body fat %, and the other two thirds are, ah... very fluffy, is the term we like to use. My BIL is on DOCTOR'S ORDERS to eat more than 3000 calories per day, and he will eat the three meals with his family, plus McDonalds and a small carton of ice cream every day, and you can see every little vein on his body because he is nearly as lean as it is possible for a human being to be. The propensity for brown fat is believed to be the culprit, and in the family members who lack this advantage they were all plump from a VERY early age, never really losing the baby fat.  Looking at family pictures, there's BIL #1 who was skinny pretty much from age 2, and everyone else in the family who looked like tiny sumo wrestlers from age 2.   BIL #2 is a heavy duty mechanic, he's a power lifter, he's a health nut, he's a super strict organic-foods eater... and he's probably 320 lbs.  He can lift ME over his head, but he also has even more body fat than I do.  By ALL accounts, he should be in Herculean body-building shape, but he has never, ever lost the fat. 

 

But I'm sure they're just not trying hard enough. 

[Jetikus]

You could also argue that obesity is hereditary in so much as being a learned behavior, or who knows: maybe some people are just more genetically predisposed to be obese and there's your heredity right there. I mean, how may times have we heard somebody say about another person, "He just eats and eats and eats and never gains weight!" We all know somebody like that. I have a friend who has worse eating habits than I do, never or very rarely exercises, is the same height, but weighs about 1/3 of what I do. I'm convinced that the fat gene runs in my family, making it easier for me gain weight and harder to lose it, but not in his--hence, he's the opposite. 

 

I'm convinced that, to a degree, obesity really is in our genes for some of us. Yes, you only gain weight by eating in excess and never exercising, but if you're predisposed it can only compound the difficult situation you may find yourself in--just like with alcoholism.

 

I can see the logic in this. In my mind, there exists the possibility that genetically some of us retain fat a lot more readily than others. Could it be a form of adaptation for survival or is it just some quirk in the genetic make up of a person to retain fat so easily? I dunno, someone smarter in this subject could tell you.

[chairohkey]

But I'm sure they're just not trying hard enough. 

 

No they're just eating under and over their respective caloric maintenance. 

[Thrillho]

[marionette]

I feel you there...

[Waldo]

 

My BIL is on DOCTOR'S ORDERS to eat more than 3000 calories per day, and he will eat the three meals with his family, plus McDonalds and a small carton of ice cream every day, and you can see every little vein on his body because he is nearly as lean as it is possible for a human being to be.

I'm becoming fairly vascular (thigh vasularity is starting to show), and cutting hard I eat around 3K cals per day. Maintain at about 3600-3700.

Over 3K isn't that high for a bigger active dude. 

[Guest Dirty Deads]

 

I'm becoming fairly vascular (thigh vasularity is starting to show), and cutting hard I eat around 3K cals per day. Maintain at about 3600-3700.

Over 3K isn't that high for a bigger active dude. 

 

 

Yeah I'm eating around 3300 right now and trying too lose weight. 3k seems like a lot more than it really is.

[Kunai]

Just gotta ask, will being underweight also be a disease now? 

[Waldo]

Anorexia, bulimia, orthorexia......

[Kunai]

Anorexia, bulimia, orthorexia......

I thought those were eating disorders not diseases. 

[nanako]

There are so many aspects to this. I think it's really impossible to pin this down to one cause. Like Gainsdalf said, it's a symptom, not a disease in itself. There's social factors, hereditary, psychological, all of these can contribute, but they needn't, not necessarily.

 

About ten years ago, I became clinically depressed. I was by no means a lazy fatso, but a "high achiever", very competitive, and really fit. I had a sixpack, a BMI of 20, and was running 5K a day. The running was my lifeline, and about the only thing I was still capable of doing at that point. I couldn't work, couldn't study, couldn't keep up contact with my friends, even leaving the house to go to the shops was a major chore. I'd basically get up, run and go back to bed to cry. Doctors were telling me to keep exercising and I basically screamed in their faces; "I AM ! I AM but it's not effing HELPING!". It took some serious therapy and medication to 'snap out of it'.

 

Then, couple of years ago, when my dad passed away, I was just seriously unhappy. His illness put a massive, massive strain on all aspects of my life - all our lives - emotional, financial, professional, family - and I was simply unable to cope with these stressors. I was miserable and turned to food and drink for comfort and my BMI soared up to 25. I was by no means depressed, but still, it took a good while until I was emotionally stable enough again to tackle this thing, snap out of denial and start caring about myself again. So.

 

Learning to take care of yourself is hard. It's good if your parents provided you with good habits, healthy eating, exercise, sleeping, relaxation, and most of all: healthy coping strategies. If not, there comes a point where you have to learn these by yourself. By the way, being super competitive and judging people (and yourself) a lot (even if it's just in your head) will feel good for some time, but it's no guarantee for happiness or even emotional stability.

 

I see a lot of people - both fit and unfit - hating themselves, and judging other people. But I've only ever met a few who can balance it all perfectly. It's not easy.

[KingZora]

I thought those were eating disorders not diseases. 

Eating disorders are considered to be mental disorders which are a classification of disease.  A disease is "an abnormal condition that affects the body of an organism".  

[Evicious]

That I understand. I have dealt with it myself for a long time and you really do have to act  to strengthen yourself during those moments of clarity.  I had moments where I didn't want to live and attempted suicide, but I did find moments where I could feel I had something to live for. I stayed pretty big, but I did do something. Whichever way you let it take you, it will snowball in that direction. If you climb back up during those moments, you can eventually get the ball rolling in the right direction. 

 

Adventures in Depression

 

Some people have a legitimate reason to feel depressed, but not me. I just woke up one day feeling sad and helpless for absolutely no reason.

 

It's disappointing to feel sad for no reason. Sadness can be almost pleasantly indulgent when you have a way to justify it - you can listen to sad music and imagine yourself as the protagonist in a dramatic movie. You can gaze out the window while you're crying and think "This is so sad. I can't even believe how sad this whole situation is. I bet even a reenactment of my sadness could bring an entire theater audience to tears."

But my sadness didn't have a purpose.  Listening to sad music and imagining that my life was a movie just made me feel kind of weird because I couldn't really get behind the idea of a movie where the character is sad for no reason.

 

 

 

Essentially, I was being robbed of my right to feel self pity, which is the only redeeming part of sadness.

And for a little bit, that was a good enough reason to pity myself.

 

Standing around feeling sorry for myself was momentarily exhilarating, but I grew tired of it quickly. "That will do," I thought. "I've had my fun, let's move on to something else now." But the sadness didn't go away.

I tried to force myself to not be sad.

 

 

 

But trying to use willpower to overcome the apathetic sort of sadness that accompanies depression is like a person with no arms trying to punch themselves until their hands grow back.  A fundamental component of the plan is missing and it isn't going to work. 

 

When I couldn't will myself to not be sad, I became frustrated and angry. In a final, desperate attempt to regain power over myself, I turned to shame as a sort of motivational tool.

 

But, since I was depressed, this tactic was less inspirational and more just a way to oppress myself with hatred.

 

 

 

Which made me more sad. 

 

Which then made me more frustrated and abusive.

 

And that made me even more sad, and so on and so forth until the only way to adequately express my sadness was to crawl very slowly across the floor.

 

The self-loathing and shame had ceased to be even slightly productive, but it was too late to go back at that point, so I just kept going. I followed myself around like a bully, narrating my thoughts and actions with a constant stream of abuse.

 

 

I spent months shut in my house, surfing the internet on top of a pile of my own dirty laundry which I set on the couch for "just a second" because I experienced a sudden moment of apathy on my way to the washer and couldn't continue. And then, two weeks later, I still hadn't completed that journey. But who cares - it wasn't like I had been showering regularly and sitting on a pile of clothes isn't necessarily uncomfortable. But even if it was, I couldn't feel anything through the self hatred anyway, so it didn't matter. JUST LIKE EVERYTHING ELSE.

 

Slowly, my feelings started to shrivel up. The few that managed to survive the constant beatings staggered around like wounded baby deer, just biding their time until they could die and join all the other carcasses strewn across the wasteland of my soul.

I couldn't even muster up the enthusiasm to hate myself anymore.

 

I just drifted around, completely unsure of what I was feeling or whether I could actually feel anything at all.

 

 

If my life was a movie, the turning point of my depression would have been inspirational and meaningful. It would have involved wisdom-filled epiphanies about discovering my true self and I would conquer my demons and go on to live out the rest of my life in happiness.

Instead, my turning point mostly hinged upon the fact that I had rented some movies and then I didn't return them for too long.

The late fees had reached the point where the injustice of paying any more than I already owed outweighed my apathy. I considered just keeping the movies and never going to the video store again, but then I remembered that I still wanted to re-watch Jumanji.

I put on some clothes, put the movies in my backpack and biked to the video store. It was the slowest, most resentful bike ride ever.

 

And when I arrived, I found out that they didn't even have Jumanji in.

Just as I was debating whether I should settle on a movie that wasn't Jumanji or go home and stare in abject silence, I noticed a woman looking at me weirdly from a couple rows over.

 

 

She was probably looking at me that way because I looked really, really depressed and I was dressed like an eskimo vagrant.

Normally, I would have felt an instant, crushing sense of self-consciousness, but instead, I felt nothing.

 

I've always wanted to not give a fuck. While crying helplessly into my pillow for no good reason, I would often fantasize that maybe someday I could be one of those stoic badasses whose emotions are mostly comprised of rock music and not being afraid of things. And finally - finally - after a lifetime of feelings and anxiety and more feelings, I didn't have any feelings left. I had spent my last feeling being disappointed that I couldn't rent Jumanji.

I felt invincible.

 

 

And thus began a tiny rebellion.

 

 

Then I swooped out of there like the Batman and biked home in a blaze of defiant glory.

 

And that's how my depression got so horrible that it actually broke through to the other side and became a sort of fear-proof exoskeleton.

 

NOTE: The cartoons shown here are only a fraction of the actual cartoon strips in the blog (use the title link) and you are seriously missing out if you don't go see the rest of them. And there's a Part 2, which is also awesomely insightful as well as inappropriately entertaining.

[Zorch]

True that the ACA law will help obese people get insurance, but by declaring that obesity is a disease obligates doctors to work with and treat their patients. Which means that they should be versed on treatment options and be able to recommend nutritionists and physiotherapists for consults. 

 

I think it is a decent step in the right direction getting doctors and medical staff into more a preventative mind set rather than fix it mind set.  

 

...but is that what will really happen?   As quoted from one of the articles linked in this thread:

 

It might also shift the nation's focus too much toward expensive drug and surgical treatments and away from measures to encourage healthy diets and regular exercise, the council wrote in a background memo for AMA members.

 

That's my concern.  The norm in the USA is to treat diseases with drugs, not to manage them with diet, lifestyle, etc.  About the only exception to this is some of the (partially misguided) nutritional advice as applies to heart disease and diabetes.

 

To me, the first line of obesity prevention treatment should be a combination of psychological/behavioral and nutritional work with the patient.  Certainly obesity is a complex problem and the root causes vary significantly from individual to individual, but my concern is that this will continue to lead to more "disease management" - i.e. long-term drug regimens, instead of trying to address root causes.

 

On the other hand, taking soda/sweetened beverages off of food stamps - good move, IMO.  Government doesn't need to be subsidizing junk food consumption.

 

For example, oftentimes the "lazy, complacent, and just not care," is, itself, a symptom of depression. If you treat the depression, those feelings become easier to overcome (they don't go away, mind you). So good: you now have more of a drive to get out the house and do things and a greater sense of self-worth--but you're still obese. Just because the depression goes away doesn't mean you become better educated about diet and exercise. That only comes with attacking the obesity directly.

 

I agree 100% - as this was a big part of my personal history.  To keep everything in context from my past, my weight issues and depression need to be considered together.  It's hardly a coincidence that I put on most of my weight when I was dealing with depression, and it got progressively better as my depression improved, largely because I suddenly had the initiative to attempt to take action.  I didn't really understand what I truly needed to do fitness-wise until a couple years later, but I still made a lot of progress because in the absence of depression, I had the energy and presence of mind to *try* to do things, which quite literally got me 2/3 of the way to where I wanted to be.  This is why I believe the psychological/behavioral aspect of obesity treatment is critical - whether it's depression, or simple mindfulness regarding one's behaviors, Obesity often has its roots in behavior, even if it's behaviors that we are not fully conscious/in control of.

[CrimsonTide2006]

It is a disease for those who are obese and cannot stop eating. The body becomes so in need of food, more than regular hunger. The want for food becomes just as intense as the need for drugs for a drug user. 

[I-Jo]

Yeah but there is an underlying issue that go you there- you didn't come out being obese and addicted to food. 

[KingZora]

The story is from http://hyperboleandahalf.blogspot.com

 

If you haven't read part 2 yet, I can't recommend it more, Allie is amazing!  And if Evicious = Allie that would be amazing!

[Gainsdalf the Whey]

It is a disease for those who are obese and cannot stop eating. The body becomes so in need of food, more than regular hunger. The want for food becomes just as intense as the need for drugs for a drug user. 

 

Once again, the disease here is the eating disorder. Obesity is a symptom, something caused by the real disease. Too often in modern medicine we just treat symptoms instead of solving the underlying issue.

[Evicious]

Yikes! Sorry for the confusion guys, I am not Allie, just another appreciative fan. Reading the comments about how obesity is often linked to depression, I just thought her cartoon might help explain the effects depression can have on people to some of NF's curious or puzzled members. It really helped me better understand it, anyway.

[Pallas Athena]

I don't think obesity is usually a disease (though there are cases where it might be due to a disease). The more I study about food production and what is done to food, the more I think obesity is at least partially due to food treatments that should be outlawed. Oh, yeah, I forgot. They ARE outlawed in most of the western world except the US. Most of it is done only to sell products, not produce healthy food.

 

Is cigarette smoking a disease? We know tobacco companies intentionally manufactured them to be as addictive as possible. Large food companies do the same thing with sugar and now dangerous artificial sweeteners. Most commercial bread has a byproduct of human hair as one of the ingredients. Chickens and cows are raised in conditions and treated in ways that would make most people vomit. Nutritional labeling has become filled with loopholes. Olive oil mostly isn't olive oil. Honey mostly isn't honey.

 

And then there's GMOs. And farm soil so depleted that the food it grows lacks major nutrients.

 

I could go on and on. I now eat almost nothing but locally grown food where I can talk to the farmer and find out exactly how it's produced. I'm convinced there literally is no other way to ensure the food you get is actually safely edible.

 

So, back to the question of whether or not obesity is a disease: I would say no. I think the epidemic of obesity is mostly due to two things--corporate greed and public ignorance, and I think both deserve equal amounts of responsibility. What I see (and what happened for me as well) is that as people find out about what's in their food, they change. They start to avoid the worst foods and eat better. They also start to pay more attention to food quality in general.

 

I think people mostly beat themselves up about being obese without really having ever learned the skills necessary to eat well and be fit. Most of us here on NF are in the process of learning those skills, and learning how to integrate them into our lives. It's particularly challenging because it's not just mental learning. Physiology is involved--things we can't see and touch. It's also challenging because the information available is so contradictory and often based on ulterior motives.

 

I think the best solution for obesity is education. It's the result of ignorance, not disease.

 

P.S. Great topic, I-Jo! Thanks!