Is being Obese an illness?

[agel]

Yes or No
Im really not trying to start an argument. I want to understand what people actually think/know/believe about this.

I am obese and am trying to gain some sort of control over my eating through therapy at the moment. I’ve tried diets and exercising that do work but long term I don’t seem to be able to change my lifestyle enough to keep the weight off. I hate living like this and how people treat me differently because of my size. My family don’t understand at all. My partner is not understanding and it’s seriously affecting our relationship in many ways. It seems unfair because I don’t feel I have much control over this. It’s actually very lonely being in this situation. I rarely mention the topic of my health or weight to others because pardon the pun it’s always the elephant in the room! But you can almost hear what people are thinking. I hate the judgemental looks and comments. I rarely go out now because of anxiety and panic attacks brought on by this situation.

Yes absolutely - what is so often ignores is the amount of time and energy obese people have put into resisting and exercising immense willpower. Over all these years I wonder how much weight I've lost - ten stone, fifteen stone, I reqlly couldn't guess. A stone here that goes back on with an extra half. Two stone the next time. Maybe four stone another time. Rinse and repeat across the decades. We have all done it, all spent months and years fiercely restricting and then been powerless to stop it going back on over and over. It's not a case of laziness or not knowing what willpower is, it's that it isn't possible for someone to stay on the upper hand of a battle with a body so intent on gaining it back every time in a continuous loop that gets worse every time.

I'm finding it really insightful to read everyone's experiences. I've put very little about my own as I reflected on a comment I made about the ability to train oneself to avoid UPFs etc and considered the fact that my formative years (young teens) were spent with diagnoses of Anorexia and later Bulimia and so I think my brain eventually formed in my mid twenties with a belief system and attitude towards food and eating created in a disordered mindset. So what feels like a normality to me runs the risk of offending those with opposite experiences if I explain it as such.
I've certainly experienced food noise - it's somewhat compounded in a clinical setting. I've gone through vegetarianism, veganism, the carnivore diet, low to no carb, dairy free. I stopped eating refined sugar when I was 12. I've been on a diet of some kind or another my entire life (and the sad thing is, so many of us have).
The most consistent thing has been the rebound binges that have sprung up in my body's effort to regain some of the nutrition I've been denying it the rest of the time. I've been underweight and overweight and reflected yesterday on the fact I was never happier with my weight than when it was medically classed as too low. The overweight phase occurred as a result of medication side effects and then I responded with a vengeance that threw me into the Anabulimic mess of my teens through to late twenties. I'd say 'recovery' has happened in stages throughout life. Currently I scratch cook every meal because I love cooking, I'm still reluctant towards complex carbs but meat and dairy are all on the menu.
Cracker-type carbs and toast bring out a ravenous compulsion in me that would rival wolves lol. I can't not finish packets. Left to my own devices with a knife and spread that's my modus operandi until the house has none left. So the control element happens at the point of ordering the shopping.
I think regardless of the physical weight of the person a lot of the battles going on in people's minds are very similar. Societal attitudes towards overweight and obese people needs so much work. It reminds me very much of a lot of the debates that go on regarding mental illness. We centre the issue with the individual rather than asking what happened to them we try to identify what is 'wrong' with them. The medical versus the social model of illness and disability. In the same way people will centre the issue of obesity with the individual despite all the other factors at play. The billion dollar corporations that design foods to be hyperpalatable and addictive, the infrastructure of our towns and cities dissuades the need for exercise, chronic stress and sleep issues, not to mention the socioeconomic inability for people to eat healthily. A healthy calorie costs 4X the amount of an unhealthy calorie. Large swathes of the population are priced out before they even have the chance to choose health. They're already using a larger percentage of their income on groceries and it has been shown could not afford to spend more in order to eat for best health. There is also the issue of being time poor and the pressure to purchase convenience due to this too.
There's no real message or lesson with any of this just thought I'd share a bit as most others are.

@DeliaPith321 I think your post goes to confirm how complex obesity is - individually and societally.

If it were so simple to solve as some posters would like to purport, then it would most definitely be solved and not an issue that has become a global epidemic.

@DeliaPith321 thank you for your great post. There are certain things I too just cannot have in the house or the lot will go in one go, or over the course of a few hours. Crisps, nuts, cheese, biscuits, tiger bread, pakoras, onion bahgee (even when I make my own and think they will spread a few meals). Something flicks the fuckit button with those so I just don’t buy them. The combination of that feeling hungry and then eating something that you love is too much for me so I restrict what I buy.

It is definitely a hunger feeling for me. I’ve just had my lunch - 500 cals, really nice, I’m still hungry but logic tells me I cannot be so I will sit with it till dinner time.

People won't tend to come at an anorexic and tell them should just eat more and practice self control and will power in the same way they tell obese people to simply eat less. Which is weird because they're all medical issues.
Food for thought.

It's 100% a disease.

Interesting thread
My thoughts...
I've had a lifetime of horrific obesity..as high a weight as you can imagine on a person that still manages normal.
Up and down .like a yo yo because I can't keep weight of
At the moment I'm at a normal weight
I'm only managing it because I'm on a GLP1
So while I don't actually know if it is an illness or a disease
There definitely is something missing in people's brains and systems who are obese
Because I don't have any urge to overeat or binge on this medication.for the first time in my .life I can eat normally.
And it's an amazing feeling

i Agree, what I see missing from the whole greedy, move more, train yourself, use will power, brigade is no one wants tk be fat, well very few, most abhor it, most fat people have been on every diet possible, at least once, often multiple times, and still regain the weight,

we know 80 percent of dieters regain all the weight within five years, we also know there is complex physiological reasons behind that, it isn’t simply psychological, we also know if it was simply psychological the weight loss drugs wouldn’t work, as we can push through,

lastly we know before the meds no one was haunting other diet sub forums on here , they still aren’t today, from low carb to slimming world, telling people how greedy they are, how they should just use will power, how slim people struggle.

but at the success if the weight loss injections for some reason drives those not on them to want to discuss obesity and provide instruction to those on them,

Sadly I also read that 2/3 of people who use the jabs regain the weight after stopping them. So that's another hurdle.

Unfortunately I think it is like blood pressure medication..you need to be on it long term
I think the weight will pile back on the moment i come of the GLP1

@DeliaPith321 I think I’d be mad to stop taking Mounjaro or another suitable GLP1 if it’s successfully helping me to keep the weight off. I’ve been obese for decades. I think I’d need a very long period of adjustment before I’d be so confident as to stop taking this medication.

Sure. My view would be if it works, keep taking it. I'm wondering about the expense though, on a global scale of keeping that many people on them! It'll be interesting to see how things pan out.

From the folks in the trials, data in the USA shows real life users faring much better, they think it’s to do with the investment required,

but there are so many options,

you can stay on forever, I am. A low maintence dose,

stay in for two years or howver long you need to settle into your new routine,

if you regain weight any within a year, you can go back on, so you don’t need to reach overweight, so you can buy a couple of pens, knock the few pounds off, and then Stop again,

it’s up to the individual. But it’s not like thr 80 percent who regain when they didn’t use the meds, solutions exist to fit people’s pockets and preference,

What do you mean by the last paragraph?

I find this totally predictable. I think that for many people the drugs should be seen as keeping things as they should be and not stopped when the goal is reached.

No different to me taking statins and anti anxiety meds. Can you imagine - after a year taking statins- hurray my cholesterol is now fine, the statins have worked. Gp- That’s you done. No more statins. 6 months later cholesterol is back up - ah what have you been doing to cause this you irresponsible person, here’s another prescription. And do the yoyo begins

I’m not in WLI but I would find it wrong to take them, be able to eat “normally”, then have it withdrawn. I probably wouldn’t start in the first place as the disappointment and having to hear the hunger noise once again would be unbearable, having experienced what the WLI delivers. Probably just as well I don’t qualify on the nhs!

The difference is - statins, high blood pressure tablets, etc are all free on the NHS and you get annual checks in the case of blood pressure tablets, also free on the NHS.

WLIs are not free on the NHS (well only to a small minority of people). Maybe they will be more widely available in future I don't know. But I can't really imagine people of normal weight being prescribed them on the NHS so it's hard to see how a lifetime of taking them won't prove to be expensive even with micro dosing. The cost may feel worth it for the benefits but it's a hard one if you think about having to keep paying for it over and over again.

The financial aspect will be a worry for lots of people. However in the longer term, these new medications will lose their patents in the UK and cheaper generics will become available. Newer GLP1s may mean that the price falls for what will become the older less effective versions. Generic semaglutide is now legally available in India, and it is about 80% cheaper than Wegovy.

Plenty of people pay for gym membership, exercise classes, meal delivery boxes and a whole host of other fitness/wellness type products that they consider to be important for their wellbeing. I would think that a lot of people would view continuing to pay for GLP1s for maintenance to be in that same sort of category and well worth it for the host of other health benefits they provide alongside the weight loss.

Yeah so my point about the 2/3 regaining weight after stopping the GLP1s was a concern about the fact that it is a potentially large expense to keep people on them for life. I'm not negating that staying on them would be best for the individual. If we look at Mental Health for example, the government are stingy with how they fund this area of the NHS as it is. Obesity is another area of health that disproportionately effects those in households with lower incomes so receiving this medication from the NHS is going to be the only option for many. It also makes me think of all the discussion there has been around potential privatisation of healthcare in this country.

They're certainly worth it but a lot of people aren't able to afford gym memberships etc.

@DeliaPith321 they won’t be the people that start taking GLP1s privately if they don’t have the disposable income to start with.

Whether or not the NHS will continue to fund it for people who qualify for it long term is clearly going to be an issue. I would think that given the limited budget you’d be told up front that it’s for a limited time frame and I suppose you would decide then if you’re prepared to start knowing you couldn’t afford to continue with a private prescription if the NHS one stops. Although, if I were in that position I’d still take the NHS prescription and worry about maintaining any weight loss once it had happened. That’s still a better position to be in than morbidly obese with several weight related health conditions.

This is copy-pasted but along the lines of what I was already thinking:

"Could this become a major public health inequality?
Yes, and UK researchers are already documenting evidence consistent with that concern.
The Health Foundation published an analysis in 2026 finding that, after accounting for obesity prevalence, people living in the least deprived areas were more than twice as likely to access privately prescribed GLP-1 treatment as those in the most deprived areas.

The Health Foundation

This creates a potentially troubling situation: people living with obesity in disadvantaged communities may have the greatest clinical need but the least financial access to ongoing treatment.
There is also an emerging debate about whether pharmaceutical treatment can sustainably address obesity without substantial changes to the wider food environment.
The Food Foundation has raised concerns that people discontinuing GLP-1 treatment return to an environment in which inexpensive, highly palatable, energy-dense foods remain widely available.

Food Foundation

One question I find particularly important is whether we are creating a new form of financial dependence on obesity medication: not addiction in the pharmacological sense, but a situation in which maintaining the benefits of treatment becomes contingent on the ability to keep paying for it.
There is an important distinction between needing ongoing medication to manage a chronic condition and being unable to afford that medication. The first is common throughout medicine; the second raises substantial questions about healthcare access, affordability and equity.
And unlike medications for many other chronic conditions, obesity treatments are currently being accessed predominantly through private payment in the UK."

@DeliaPith321 I was about to say something about health inequality as your post went up. Absolutely it is. Right now there’s no way I could afford to pay privately. Well maybe I could but the trade off would be to buy cheap crap food - I prioritise good food which isn’t cheap - which would help slim unhealthily. People have said to me ohhh but you’d spend less on food as you’d eat less, but I fight myself every day to eat in a deficit already, so that’s not an option, I would likely eat the same on WLI but without the misery.

@SilenceInside I wouldn’t accept WLI on the nhs unless it was potentially forever because if it worked, I know stopping would make me revert, and I couldn’t pay privately to maintain. I don’t need to learn what to eat, to balance food, to eat satiating food, etc etc with WLI to help me. If they worked and flicked a switch in me, I would find it horrific to have the switch flicked back on. Thats just my personal take.

I honestly don't know what could be done to reverse the situation and stop these medications being widely available privately. It was inevitable and very very predictable that once an effective treatment for obesity was available that it would be extremely popular with anyone who could afford it. It was also very predictable that long term use would be necessary, as weight regain is an issue for any weight loss method including via medicated approaches.

I would love to be able to get Mounjaro for the £9.90 prescription charge and to be able to expect to have it long term just as I do with my high BP medication. I am not sure there is a solution now that the cat is out of the bag and so many people are accessing these medications privately.

I've never heard of health practitioners giving patients the heads up about future potential cuts to funding of their treatment - not to say it doesn't happen. I have a problem with the idea that people in need of the jabs cannot access them in the first place in many instances - it's not only the idea of not being able to sustain treatment. There's something very dystopian about class differences slowly but surely becoming even more physically apparent than ever. The psychological impacts that will have on a demographic already disproportionately predisposed to higher rates of poorer mental health and also, given the cruelty of so many people the potential for hostility / aggression of having both of these things going against you in a society where it feels like everyone is not just more privileged but physically healthier and more comfortable. It was already the case but it'll become even more pronounced and it's really quite dispiriting.

Yes that's very true, but there is nothing that I as an individual user of a GLP1 privately can do about that. If I stopped taking it, it would make no difference.