Obesity is not a disease.

Updated 6.21.2013; reformatted 9.14.2015
I write a lot about weight loss, because it was part of my menopausal transition. (Yes, weight LOSS, not gain.) So I'm weighing in (pun intended) on the the AMA's decision to declare that obesity is a disease.

Obviously, not everyone agrees. The knee jerk presentation of athletes whose BMI technically places them in the obese category misses the point, in my view. All of the men (and all her examples were men) she mentions have low body fat percentages and thus higher muscle mass for their height. Would she support the decision if it were based on body fat percentage? Of course not, she views weight loss efforts as an attempt to eradicate fat people, which I only mention because that way of looking at it was new to me.

No, I think invoking the flaws in BMI is an attempt to obscure for the reality that most obese humans have high body fat percentages and fit the stereotypical image of what is obese. Most women carrying 300+ pounds are not highly trained athletes, they're obese. And obesity increases the odds of developing a host of health issues. The fact that not every obese person is ill is besides the point. Not every smoker gets sick either. Smoking is still bad for your health.

But this still leaves the original question, is obesity a disease, or does it cause disease? Smoking isn't a disease, but it causes a host of diseases, and so has been stigmatized. On the blog associated with this page I've linked to dozens (if not hundreds) of studies that being obese increases the risks of many diseases and unhealthy conditions. But does that make obesity a disease?

My answer is no, obesity is NOT a disease. Obesity is the result of maintaining a surplus in the energy balance. The fact that it is NOT easy to lose the weight once it is gained and keep it off doesn't change what "caused" the obesity in the first place.

Here is an author who clearly does not understand the nonlinearity of the energy balance. EVERY example he provides essentially deals with one or more terms of the energy out side of the equation. It does NOT disprove the first law of thermodynamics, though he tries to claim that it does.

One of the factoids the author offers to "prove" that obesity isn't simply related to eating more energy (calories) than you body expends in living and moving is that lab animals are getting fatter, and their intake is precisely controlled and has not increased. This suggests that some other factor (virus, bacteria, pollution and epigenetics are among the potential factors) is working to slow metabolism or increase absorption of the ingested energy. However it does NOT disprove the first law of thermodynamics.

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