Should Europe follow the US and declare obesity a disease?: a discussion of the so-called utilitarian argument

Abstract

In 2013, the American Medical Association (AMA) decided to recognize obesity as a disease. One of the main arguments presented in favor of this was broadly 'utilitarian': the disease label would, it was claimed, provide more benefits than harms and thereby serve the general good. Several individuals and groups have argued that this reasoning is just as powerful in the European context. Drawing mainly on a review of relevant social science research, we discuss the validity of this argument. Our conclusion is that in a Western European welfare state, defining obesity as a disease will not on balance serve the general good, and that it is therefore more appropriate to continue to treat obesity as a risk factor. The main reasons presented in favor of this conclusion are: It is debatable whether a disease label would lead to better access to care and preventive measures and provide better legal protection in Europe. Medicalization and overtreatment are possible negative effects of a disease label. There is no evidence to support the claim that declaring obesity a disease would reduce discrimination or stigmatization. In fact, the contrary is more likely, since a disease label would categorically define the obese body as deviant.

Obesity as a Disease: The Obesity Society 2018 Position Statement

“…TOS ascribes to the position that the benefits of defining obesity as a disease outweigh the commonly advanced counterarguments, such as that excess adiposity should be viewed as an intermediate risk factor rather than as a disease per se or that medicalizing obesity would increase rather than decrease some of the adverse social and psychological consequences for those afflicted .…”

Are we close to defining a metabolomic signature of human obesity? A systematic review of metabolomics studies

“…Substantial controversy exists regarding whether obesity should be considered a disease (Vallgårda et al 2017 ). Within the obese population, clinicians can distinguish between metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) subjects.…”

Anti-Fat Attitude in Society and Healthcare: The Need to Reduce a Big Issue

“…Obesity has been declared a disease by the American Medical Association, and Europe may follow [29,30]. From being virtually nonexistent about 10000 years ago, obesity prevalence has increased substantially in the past three decades and is expected to rise further [31,32].…”