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.

It is definitely an illness/disease. Being a bit fat isn’t, but obesity is. Kind of the same as being a bit slim or underweight isn’t an illness but anorexia is.
I’ve lost over 6 stone on GLP-1s and used to think my obesity was a moral failure almost, but the WLIs have made me realise it was an illness the whole time and not a failure of willpower/or a choice on my part.

May I ask you, were you like me, no hunger off switch, before WLI and the WLI simply enabled that to work, so you do now feel satisfied and not constantly hungry?

I am pleased they worked for you!

Imho it's a symptom rather than disease itself.

I'm not sure if it's helpful to think of it in thos terms or not. Maybe for reducing the stigma and guilt a bit?

I self-fund Mounjaro because I was morbidly obese. My overall health has improved significantly after losing 25kg, which is the important thing.

But the most shocking thing for me was to suddenly not feel hungry all the time. I didn't know that was a state of being you could have.

So I am rethinking my endless self-flagellation about how weak willed and undisciplined I am to have ended up so fat.

If other people aren't genuinely feeling hungry 90% of the time, no wonder they aren't huge. I had a massive handicap in that area.

More like an eating disorder, if caused by overeating.

Yes, I felt hungry all the time and I was so shocked that I wasn’t when I started jabs. I don’t think about food any more because I get ‘normal’ hungry cues and I get full now, where I didn’t before.

I relate to this so much. It was a shock to me starting the jabs and being like ‘this is what normal hungry is, this is what full feels like’

Come on. You are dismissing how dangerous anorexia is by comparing it to obesity.

Around 30% of adults aged 16 and over in the UK have a body mass index (BMI) of 30 or higher. They are technically obese like me. I do not in any way compare the problems I have as an overweight woman with someone suffering from anorexia.

Any type of addiction involves lack of accountability and emotional immaturity
( I dont mean silliness, I mean difficulty coping with difficult emotions)
Calling obesity a disease with the inferance that its not in the control of the individual is problematic because it avoids accountability

It takes self reflection to get to the root of the issue and thats not always possible
Trauma and DV for example
Undiagnosed ND
Burnout
Using substances to cope with difficult emotions is at the root of the issue
We all do it sometimes
Ah fuck it!
But our environment now encourages it, we live in an obesogenic environment yet obese people are treated appallingly which makes it a spiral

Its not always safe to examine trauma and DV if you are still in the relationship/ dependant on the person
Toxic families thrive on secrecy
ND individuals blame themselves

WLI tackle the effects not the cause

It’s an eating disorder, the same as anorexia. I think if we started treating it with more support and moved away from drugs & surgery we’d be more likely to fix the root cause of why some people (including me) are effectively self-harming with food. It’s not as simple as many people think. I struggle with my weight, I’m not obese but I have excess body fat and I know that when I’m eating badly it impacts my health, both with weight gain high cholesterol, as well as digestive problems, but I definitely go through phases of cognitive dissonance where I don’t eat mindfully and then get frustrated and annoyed with myself at the consequences.

They’re like 2 ends of a spectrum IMO. Obesity is as dangerous as anorexia. Costs the NHS more, both are killer illnesses. They’re not the exact same but I don’t think they’re that different, you don’t agree that’s fine but many people are naive about the impact of obesity (BMI 30-35 milder risk, BMI 35+ the risks and mortality are huge)

In some people it's an eating disorder, in others it's a choice.

I would never have allowed myself to become fat/obese as a younger person, as I was too vain and cared about how I looked more.

I care less now and have allowed myself to think "fuck it" re eating things I know are bad for me. Actually I'm losing weight now - this is for health reasons. I can do this without drugs because in my case my weight was a choice not an illness. I do appreciate for other people it may be different but it's too simplistic to think that everyone who is obese has become so because they are mentally ill.

Something is wrong in my body and always has been. I was so hungry as a child, fed the same way as my slim sisters and totally unable to stop eating in secret. My mum and siblings have always been slim, my dad and I always fat and always hungry. Something about our signals, our bodies, has never functioned like theirs. It isn't a question of willpower or lack of understanding; we have both spent our whole lives trying to tackle it and have both achieved significant success professionally and personally except for this one thing. We have both dedicated money and time and effort into fighting a battle we couldn't win, have read so many books and consulted doctors and paid for personal trainers and therapists and tried every possible diet and intervention and both spent most of our lives obese, yoyoing in weight but steadily getting fatter. Then along comes Mounjaro and everything is transformed. It fixes something in the body - it is not simply an appetite suppressant. It corrects a dysfunction. I don't believe either one of us will ever come off it in some form because there is no other way for us of achieving and maintaining a healthy weight. I believe it's a complex combination of factors and most certainly there has been a profound psychological effect over the decades of being in battle with my body and disordered eating has been at play but I think that was triggered - for me at least - by my mental distress caused by the hormonal imbalance that GLP-1s address. As in, my eating got disordered because I was fat and ashamed and couldn't find a way to make my body function properly so turned to damaging behaviours. Rather than my disordered eating causing my obesity (though obviously I entered a vicious circle and doom spiral of making it worse through a binge-starve loop). So I do regard it as a disease or bodily dysfunction that is corrected by medication, but is greatly exacerbated by psychological and social factors too.

Cmon it is not an eating disorder for every obese person, it wasn’t for me, there was physical health issues behind it but I was not mentally unwell,

No, being obese is a result of persistently eating too many calories for the amount of energy output.

Being obese can cause illnesses ranging from joint problems to cancer, but it is not an illness in itself.

Yes obesity is now considered a chronic disease. The word illness just refers to a persons lived experience of their disease. So I suppose obesity could be an illness to some and not others (ie some people are obese and strong and fit and so their obesity doesn’t impede their life. others are obese and as a result have mobility issues/breathing difficulties/poor mental health etc and so yes their obesity is an illness and disease).

I view it as a complex, chronic disease.

When I was at uni I was fascinated by the microbiome studies involving mice. Very, very broadly obese mice was given the gut microbiome of a skinny mouse. They lost weight. The inverse happened when the skinny mice's gut microbiome was replaced by one of an obese mouse.

I also found the epigenetic studies on populations that had previously experienced starvation interesting. The one I remember off the top of my head looked at the descendants of people who faced prolonged starvation during the Holocaust. The epigenetic changes in DNA were still seen by their descendants. So what/how much you eat was linked to how your DNA get's expressed, (so how you produce proteins - hormones etc) and more importantly how the DNA is expressed of future children, born after the period of starvation.

I think the issue is so complex that we are still discovering the internal mechanics of what contributes to obesity. But in my mind it is likely that there are many diverse contributory factors (environmental, emotional, social, genetic etc) that can all result in the same diseased phenotype of obesity.

Obesity overall is not as dangerous as anorexia.

Maybe morbid obesity could be, though I haven't seen any data on that - have you?

I would be more in agreement that morbid obesity is a mental illness but with 30% of UK adults being classified as obese, are you really claiming that so many people in the UK are mentally ill with their eating habits?

I see it as an eating disorder and addiction.

Some obese people want it to be a physical disease but it’s not. It does have serious physical consequences though.

Same. For most of human history,
widespread obesity was virtually non existent.

Why does that mean it can’t be a disease? A lot of things were virtually non-existent for most of human history, doesn’t mean they’re not a thing now. Can you explain your rationale in more detail?

This and it frequently has a genetic element too. Often while families are affected.

I think it's a disease/disorder very much like diabetes, or any other imbalance/deficiency.

Possibly not for everyone, but for many.

I say this because I've been taking Mounjaro, and it's very easy to be slim when your body tells you to "stop eating, you're full now" and very easy to over-eat when it doesn't.

I've also been learning a lot about how the food industry has been working to addict us to poor food (although I'm GenX - and so grew up eating home-cooked and still do - just too much of it without Mounjaro)

The mental effort that losing weight without Mounjaro takes is unsustainable - I have to count every macro, weigh all food, because my body doesn't give me the feedback. People who have that feedback just don't understand what it's like.

And if you have no trauma and all the other things you mention, but just always hungry and when you eat, you are never full, what’s that then? I’m not doubting that trauma and self medication via food is real, just that I (and many others I’m sure) don’t recognise this. Self loathing perhaps yes through the fact I don’t seem to be able to be full.

Thank you. I don’t qualify for nhs WLI nor can I afford to pay, but I am convinced that WLI would work for me and at least I wouldn’t constantly feel deprived and hungry. I do eat balanced diet, just portion control is the battle.