Obesity is Like...Drowning?

Say what? The podcast interview went from very interesting to downright intriguing. Dr. Michael Mantell, the ACE Senior Fitness Consultant for Behavior Sciences, was interviewing Dr. David Katz, President of the American College of Lifestyle Medicine. And, as you can imagine, given their backgrounds and personalities the entire podcast was excellent. But the element that really caught my attention was Dr. Katz's response to the American Medical Associations (AMA) recognition of obesity as a disease. He had issues with it. Say what?

When the AMA recognized obesity a few summers ago I remember thinking at first, "Alrighty then. It's about time." Officially naming obesity as a disease was a first step in legitimizing and receiving more attention from health professionals and society as a whole. This was good news because most clients are aware of the character judgements sometimes associated with being obese. In fact, this very judgement, from themselves or others, is sometimes the biggest barrier to hurdle before moving with purpose. So, the disease label from the AMA gave a sense of legitimacy and even respect to those who were struggling with weight issues. But, the labeling of obesity as a disease was tricky. If obesity is a disease, don't we need (or worse, think we deserve) a surgery or a pill to fix it? Whoa. Where does the element of choice fit in? Would labeling obesity as a disease give apathy to the power of choice and responsibility? The effect of lifestyle "choices" around food, exercise, smoking, sleep and stress on our health is unequivocable. The statistics relating choices and behavior to obesity to cost to behaviors to chronic disease to dollars spent and on and on is undeniable. So, what gives? How do we reconcile disease with choice? This was a professional and personal tightrope. "Yes, you are personally responsible for your choices." And, "Yes, this is also a disease." What is a disease anyway? The National Center for Biotechnology says that finding a good definition is "surprisingly difficult." Not surprisingly, difficult is exactly right. It is difficult to balance responsibility of choice with the undeniable need to address this very private and sometimes wrenching issue with compassion and delicacy. Body image and size has incredible power over our mental and emotional lives. There is a constant state of ache and worry and investigating and researching and trying to figure our way out of this incredibly complex issue. There is a lot of dis-ease. Dr. Katz does an amazing job of wrapping both perspectives into a very useful and plausible comparison to, of all things, drowning. He points out that drowning is a legitimate medical condition that warrants an ambulance and immediate medical attention, yet it is not labeled a disease. A body can clearly go from being perfectly healthy to unhealthy when it is exposed to certain elements over a period of time. This can happen with water. It can happen with poison. And, it can happen with food. It doesn't matter if the box is marked with a big black X warning label or a smiling cartoon character. The effect is the same. We don't choose to drown, and we don't choose to ingest pesticides. Yet we do choose, every day, to fill our bodies with chemicals and calories that are killing us just like drowning would-just a lot more slowly. So, is it a disease or are we responsible? The answer is yes. We are absolutely responsible. We are personally responsible and we are responsible as a society. We are responsible for reading and understanding the labels on our food and making healthy choices. We are responsible for parenting and educating our children at home and in school. We are responsible for protecting and caring for one another. We are responsible for creating laws, for training and educating. And we are responsible for treating all threatening situations with medical viability and urgency. Obesity is clearly threatening to individual lives. It is also a threat to our nation's longevity. We absolutely need to treat the conditions associated with obesity. And we cannot forget our responsibility to the cause of the disease itself. That is where we can make a difference both individually and collectively. If obesity is a disease, then changing behaviors, taking responsibility for our choices both personally and professionally is definitely one of the cures.

*Link to Episode 29: ACE Podcast: Dr. David Katz & Michael Mantell,PhD http://www.acefitness.org/acefit/podcast/30/29-downing-in-calories-part-2 **Report from AMA , June 18, 2013. Declaration of Obesity as a Disease