Is obesity a disease?
Social, environmental, cultural factors play role in obesity
By Molly O’Dell
I believe there are more significant issues related to obesity than whether it is a classified disease:
1) Obesity is a health disparity. That is, obesity is disproportionately represented in subsets of the population (persons of color, people who live with less socioeconomic advantages and rural Americans) than the population as a whole.
Among the major sex-age groups, the prevalence of obesity is lower among whites than among blacks and Mexican-Americans. An inverse association exists between family income and obesity prevalence among white females and white males, but the association is weak among other groups. A higher percentage of WIC-enrolled 2-year-olds in rural Montgomery County are obese compared to the urban 2-year-old WIC enrollees of Roanoke city.
2) Obesity is an epidemic that accounts for 10 percent of all U.S. medical spending, nearly $150 billion a year.
3) Whether a person is obese or not is influenced more by social, cultural, environmental and policy factors than by individual behavior choices. Some people of privilege can access resources to attain healthy weight whereas some cannot. How we’ve built our communities does not support safe walks to school, secure playgrounds in every neighborhood, active transportation for daily activities or breastfeeding, and many people do not have access to affordable fruits and vegetables within a one-mile radius of home. Fast foods are cheapest. Processed foods with high fructose corn syrup have long shelf lives. Cities like New York and Anchorage have dramatically reversed childhood obesity rates through policies in day care, schools and community that support breastfeeding, physical activity, fresh fruits and vegetable access and limited screen time and sugar-sweetened beverages.
The doctor-patient relationship is a powerful context to address obesity, but all of us need to exert personal responsibility for ourselves and institutional and community decisions that promote healthy living.
O’Dell is the director of the New River Health District, Virginia Department of Health.
Only thing average person needs to do is stick to a diet
By Steve Siebold
Dr. Molly O’Dell makes one correct point: Obesity is an epidemic. Unfortunately, like the rest of her medical colleagues, she does nothing but complicate the issue, offering the detailed intricacies that make it more confusing than it has to be, and offers no real solution to fixing the problem.
It’s time we leave these complex explanations of obesity to the scientists and doctors, because to the average person it’s meaningless and intimidating. The only thing the average person needs to focus on is sticking to the diet.
If you’re going to get thin and healthy, you are going to pay a price. But you’re paying a price now for being fat, aren’t you? The fact is, a price will be paid one way or another, so why not choose the one that offers the most benefits? Unrestricted eating will eventually lead to disease and death. This is one of the reasons fit people see getting fit as a simple decision, followed by a short period of heavy discipline that eventually leads to a light discipline for life.
Dr. O’Dell argues we need to “build environmental changes in our communities to create the conditions for all of us to eat healthy and move more in our daily lives.” Most communities around the country have multiple parks, gyms, walking paths and community pools, yet we’re still a nation of fat people who are getting fatter.
Asking the government to intervene and spend more tax dollars to build more facilities is not the answer. The answer is a simple choice that must be made by each of us. Do you want to die fat? Or, do you want to get tough and finally get healthy? It’s your life. It’s your decision.
Siebold is the author of “Die Fat or Get Tough: 101 Differences in Thinking Between Fat People and Fit People” and a mental toughness coach who has helped people lose weight.