Obesity: take a pill, or take the stairs?

With a change of leadership in Canberra, the news is filled with Labor versus Liberal arguments: the boats, the carbon tax, Work Choices, Gonski, etcetera.

Yet the elephant in the room that costs Australians $120 billion per year, or about 8 per cent of Australia's annual output, still receives little attention – obesity.

The American Medical Association released a statement two weeks ago officially concluding that obesity is, in fact, a disease. Given the US's obesity statistics mirror our own, how the US is tackling the issue may inform Australia's response.

If the Australian medical community considers making the same statement, I hope they will consider the following:


Pharmaceutical companies make billions from individuals leading unhealthy lives. Is the classification of obesity as a disease an easy way for big business to make bigger profits? When something is called a disease, it's the green light for more laboratory research that results in more surgeries, more pills, powders, and potions … and more profits.

Emotional weight gain

I'm in touch with numerous readers of this blog, many of whom tell their personal stories. One told me of their physical abuse as a child. It made me realise the 'eat less, move more' approach doesn't always apply. Once physically healthy and fit, abuse lead to this person to over-eat in order to make themselves unattractive. Is a GP's office the place to start discussing and treating such emotional issues? Running, healthy eating, or weight loss pills and surgeries aren't the cure for emotional weight cases. Doctors would need to be retrained to treat such patients … or maybe the doctor's office isn't the right place to start.

'I have a disease'


What does that mean to an individual? After the American Medical Association made its obesity declaration, one-third of adult Americans suddenly had a disease. What might be the psychological implications of such a statement to millions of Australians? In the US, only time will tell.

Common sense

Imagine an overweight Australian going to a country where people go hungry every day, where children are malnourished and underfed most days, and claiming 'I have a disease.' Sometimes some common sense has to kick in – calling gluttony a disease might be insensitive to people who don't know where their next meal is coming from.

The prescription

Will doctors prescribe weight loss pills? Or dish out “20 per cent off” coupons for a new pair of Nikes with a healthy eating plan? The former is putting a Band Aid on a gunshot wound; the latter are the tools for patients to cure themselves. I wonder which option doctors will prescribe with recurring revenue (ie. refilling medicine prescriptions) at stake? Pharmageddon lurks again.

Work issues

Imagine this SMS sent by thousands, with a doctor's note to verify it: “Boss. Too much pizza last night. Disease flared up; I'm bloated. Staying home. See you tomorrow.”

The kick in the bum

I've been that lazy, chubby chap, and I made a lifestyle change. I had done the pills and potions, but once I confessed to myself that my gut was due to way too much booze, fizzy drinks, and eating fast food meals while lounging all day … I turned it around by booting myself in the arse and changing my lifestyle.

Do it yourself

The lazy majority don't need a doctor. They don't need pills, and they don't need surgery. Just a pass to the local gym and a healthy eating plan – a simple solution that many men and women can take on without a doctor's visit.

Yep, you can probably read between the lines to sense my opinion. Yet, I definitely consider cancer a disease. Every family has been affected by it, and cancer sucks. But when an individual smokes three packs a day and contracts cancer, might that be the same situation as somebody overeating and 'contracting' obesity and its related ailments? That question alone makes my opinion waver.

Some folks think we are too liberal in calling addictive behaviours a disease – sex, gambling, and even internet and video game playing. So I'll take the stance: Obesity is not a disease.

I contacted a reader to get his 'professional' opinion. Andre is a father and husband who first got in touch with me because he wanted to eat healthier so he could spend a few more months with his family … because he has a disease more terminal than cancer called pulmonary fibrosis.

Andre says: “I think they are very, very wrong. Obesity in a person without a genetic disposition cannot be considered a disease. By definition the 'habit' can be the reason, however a conscience decision or 'habit' to me that is wrong, and can be controlled – is a choice. A choice the Western world makes numerous times incorrectly.”

Meanwhile, emeritus professor Paul O'Brien from Monash University's Faculty of Medicine states: “Yes. Obesity is a disease. First, the obese person will accumulate multiple health problems because of their obesity and can be predicted to die younger. Second, obese people are not well. They suffer numerous physical and psychosocial deprivations due to their obesity.”

Dr Andrew Rochford from Channel Ten's The Living Room program adds: “The AMA officially adopting the definition of obesity as a disease is all well and good, and I agree that it is a serious enough issue that ticks all the clinical boxes to warrant such a definition. But it is only worth changing the definition if it leads to a significant change in the nation's obesity plan of action ... at all levels, from government down. It has long been referred to as the 'obesity epidemic' so it's not a huge step to officially call it a 'disease'; I can appreciate the classification, but the fact is, action is truly what's needed.”

Opinions vary. It's an interesting discussion, a difficult one, and of enormous medical and social importance in affluent, developed societies worldwide.

I'm just not sure the doctor's office is where this discussion progresses. Joan Welsh said it best: “A man's health can be judged by which he takes two at a time - pills or stairs.”

If in the next 10 years obesity is set to cost us in excess of one trillion dollars, who should we count on to solve the problem – government, doctors, or corporate wellness programs?

One simple and inexpensive answer is staring right back at you in the mirror.

Should obesity be classified as a disease in Australia?

Email Michael here; follow him on Twitter here.