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.

I think my reason for eating has changed recently. I’m always after a dopamine hit. I’ve been told the first bite gives the best hit and I keep chasing that. I’m always ‘rewarding’ myself with food. Unfortunately not healthy food. I have made associations with foods to try to make me feel happier. Chocolate, cakes, takeaways all scream treats to me. Treats = happiness but obviously long term they do the opposite. I’m never hungry.

Sorry but it depends on what has caused it or adds to it. That’s not to say for everyone. But if for example there is an eating disorder, this comes under mental health. Binge eating disorder is a recognised condition by the way.

As you've identified, It's a learned behaviour, a way of 'being' that you accepted as normal – aka a habit.

Sometimes it's the type of food, sometimes it's the quantity of food; often it's both.

@agel what did you learn about food when you were growing up?

The WHO describes obesity as a “chronic disease”
https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

i think it is because it has so much impact on the body. Fat is not just a passive lump, it is an active tissue that produces hormones and inflammatory signalling molecules, all of which can have damaging effects throughout the body.

We all have biological drives to varying levels to seek out energy dense food and that food is now so accessible. And yet we evolved when those types of food were scarce. So our biology and environment are out of sync.

watched a programme about two sisters. one fat one thin.

they gave some of the fat one’s gut bacteria to the thin one and she got fat. they said our gut biome is very important.

i cannot remember the ins and outs of it, i do think that things like that can affect our health. thats nothing to do with over eating as it was the thin healthy eating sister. so it follows that some of us comfort eat it whatever but others do not and still get fat.

so i’d say yes it’s a disease. but also an illness and addiction.

I am helping on a scientific study where we had to decide if obesity was a "disease" or a "risk factor". We quickly decided to treat it as a RF.

Whether it's a disease or a risk Factor, you still want to feel empowered to get into recovery. And you are responsible to do what you can within your power to try to get better. That is how alcoholism & addiction should be viewed, too.

If people want to think less of you they will find any excuse, that's in them not on you.

Do you agree that it’s different with a food addiction because you simply cannot abstain from eating?

@MedSchoolRat do you think that classifying obesity as a disease is ever a correct step, or like your study it should always be considered as a “risk factor” whatever that might mean in the context of real life rather than a study?

Not in itself, no. But being obese can lead to illness and mental health problems can cause obesity.

In our study context we were studying another intervention, certain diet patterns, and whether those diet options resulted in a bad health status (like high cholesterol or hypertension), and whether certain risk factors were relevant (moderators, mediators) like being obese at baseline.

I don't need to have an opinion about whether obesity is ever a "disease".

Do you agree that it’s different with a food addiction because you simply cannot abstain from eating?

what the eating disorder groups say is that eating is normal but compulsive behaviour around food and compuslive over- or under-eating is not normal. People can get addictive (compulsive) around washing hands or how they organise their kitchen, and other ordinary actions. I perceive that it's very contentious on MN to call obesity an eating disorder. Some people want to embrace that idea and others are outraged by it, including especially some MNers who themselves are obese. They can be very offended if you imply they have a mental illness.

Below is a Wikipedia definition of "disease". Using below definition, obesity is often but not Always a disease.

A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury.

The part of this thread that now intrigues me is WHY do people want to call obesity a disease. OP thinks (?) that the definition is important for being able to get sympathy over her lack of control. Yet people with schizophrenia or hypertension are expected to be responsible and manage their lives to reduce risks from their illness and even recover. The Schizophrenics sure don't get a lot of sympathy and the person with hypertension won't get sympathy if they make no effort. The catch with having a mental illness is that the illness itself stops you from doing the things you need to do to get better. If obesity is basically a mental illness, then I guess it's not surprising it attracts lots of skepticism about having "disease" status, similar to other mental illnesses.

Thank you for replying. As a person with mild OCD, I fully understand compulsions and obsessive thoughts. I can tell you that for me, my thoughts of food are not obsessive nor is eating a compulsion. I know the difference because I’ve spent a lifetime with intrusive thoughts and fears and compulsions. But not with food. It’s simple - I feel hungry, my appetite is not satisfied by eating, I never feel full. I honestly believe this is because of some sort of hormone imbalance that would be cured by WLIs. This started around menopause. I’ve read accounts from too many users who say that they now know how people who can leave food on a plate because they feel full feel.

You also refer to severe mental illness as a comparable thing which I found troubling :

“Yet people with schizophrenia or hypertension are expected to be responsible and manage their lives to reduce risks from their illness and even recover. The Schizophrenics sure don't get a lot of sympathy and the person with hypertension won't get sympathy if they make no effort. The catch with having a mental illness is that the illness itself stops you from doing the things you need to do to get better.”

Are you saying that someone with schizophrenia could become and, importantly, remain well by secondary methods but without drugs? So like a person like me who is obese, trying hard to eat the right amount of calories via good whole foods, high protein, etc. should be able to do but also without medical intervention? I find the comparison you make about schizophrenia worrying but can’t quite find the words to articulate it.

Are you saying that someone with schizophrenia could become and, importantly, remain well by ...

I'm saying that often people with mental illness make bad choices that perpetuate the worst symptoms of their illness. If obesity is ever manifestation of a mental illness then it could be like many other mental illnesses where the illness itself interferes with making good decisions in managing the illness. Seems like it's hard for humans to find sympathy if they feel you didn't try hard enough to make good choices, and that's why OP is struggling to get what she called "understanding". All mental illnesses attract a stigma like that.

I did wonder if OP is projecting. I do have an opinion that most people only care about their own lived experience, only really think about themselves, they don't have energy to have much opinion about others, & certainly not opinions (about OP's body) that OP should care about.

Do you think COPD is an illness?
Do you think alcoholic liver disease is an illness?
Do you think a spinal injury in a rugby player is an illness/ medical condition?

All are consequences of lifestyle choices, some are just judge with more pity than others.

@agel Can I ask what sort of therapy are you having?
Do you have an inner critic?

@MedSchoolRat do you also consider the hormonal link to obesity? Why do some people find it easy to eat “normally” and feel satiated, when others dont?

I found the radio series Hunger Game (Prof Giles Yeo) excellent on the subject. If you haven’t listened I really recommend it to everyone.

The point for me is that I don’t think it’s a mental illness, but I do think something is off kilter thus making it necessary for me to have a daily battle with myself (yep I try very hard and it’s exhausting).

I would say no. Being obese is the outcome or symptom of potentially different circumstances. Perhaps it's because you have an underactive thyroid, in which case the disease is the attack on your thyroid, very often autoimmune in nature, which is slowing your metabolism to the point you accumulate weight (along with many other signs of this disease). Or the obese condition may be due to a pathogenic desire to overeat. I don't see the actual excess weight as the disease, but the symptom of it, if that makes sense.

That makes sense @GentleSheep (i love your username by the way).

I’m obese but no, I don’t think it’s a disease for the majority. It’s greed in my case! I think for some people it is though, like an addiction. Thing is you have to eat, so exercising moderation can be very difficult.

No.
It causes them though.
And thats what matters. Recognising it and prioritising helping people over judging them.

the hormonal link to obesity?

Ffiohna, it sound like you are describing an illness (hormone imbalance) that is causing a symptom (obesity). In that situation, obesity is a symptom.

Simple definitions can't tell a full story, probably. There are feedback loops between something like obesity and other health outcomes. BodyFat itself is considered it's own organ sometimes, that affects other health outcomes, especially if there is too much total bodyFat or fat in the internal organs.

Yeah obesity is a chronic disease. I wouldn't call it an illness as such, but that might be semantics.

No, it's a lifestyle choice.
It's a symptom of unresolved trauma or numbing

I think what you have touched on here is that different people are overweight for different reasons. I do, what you do, but with wine. I don't look ill (I am a healthy weight) and I am not sure I would consider myself to have a disease but I am certainly less healthy because I drink too much wine. I guess our 'afflictions' are very similar but yours is more visible. Also food is socially acceptable at any time whereas drinking wine for breakfast is not!

Other people on this thread talk about being hungry all the time, so they obviously have a very different 'problem' to you (and me).

I find all this very interesting albeit I don't have any good advice I am afraid.

I agree, the reasons for becoming obese vary so much and can be complex. I don’t necessarily comfort eat, but feeling hungry or not satisfied after eating what any ‘normal’ person would eat, certainly makes me feel - not sure how to say it but - deprived. Like I am hungry my brain is telling me so. But I can’t be. I’ve just eaten a good balanced very tasty plate of food. So why is that for me but not my companion who says they are full.

(when i use the word normal, to me that is describing someone whose brain actually gives them a full signal, nothing more in my case).

I think for some people it's an illness, for others it is just lifestyle choices.

And I include myself in the latter category. I eat too much high calorie food because I enjoy it a lot and lack willpower.

Not saying that is the case for everyone as I believe some people do have physical or mental reasons that have led to their obesity. But to pretend it is an illness in every case is just not true, in my opinion.