Tuesday, April 22, 2014

Obesity: Disease, Genes, or Choice?

There is an ongoing battle over obesity. The AMA decided it was a disease, something that "happens", perhaps due to what a human does, but it is not the sole result of a human decision. It is like mumps, when you go to school and the other kids have it, you get exposed, and blow up. Some look for the genetic link. The refrain, "I can't help it, it is in my genes." has been sounded again and again. Then to my surprise in Nature there is a call for personal responsibility, namely they just eat too much.

The author states:

Obesity is an important contributor to the prevailing burden of chronic disease, lying on the causal pathway to much of what plagues modern society and its people — heart disease and diabetes to name two of the most serious. However, not only can these diseases develop in the absence of obesity, but not everyone with a high BMI develops any such condition.The categorization of obesity as a disease could have a pernicious influence on efforts to remedy the problem at its true origins. The treatment of diseases customarily involves drugs, medical technology, clinic visits and surgical procedures. If obesity is a disease, the therapeutic advances on which its management depends presumably reside in these domains.

 Again, for almost all people, for every 3500 excess kcal we gain a pound. If we burn 2000 kcal per day and we eat 2500 kcal per day, that is three 12 oz sodas, then we can gain a pound a week, or 52 pounds a year!

Thus it is easy to become obese. Frankly it is just as easy to reduce that process, possibly a little slower, but it can be revered.

Thus it is good to hear a voice which lays the problem at the proper doorstep.