# Should obesity be accepted, or should it be viewed as a disease? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [July 5, 2012, 11:30pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362 "2012-07-05T23:30:19Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 6, 2012, 4:19am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/21 "2012-07-06T04:19:51Z")
What a strange dichotomy to set up. “Accepting” or “discouraging” as somehow related to thinking of something as or as not a disease. Do we discuss accepting or discouraging diabetes, Parkinson’s, hypertension, or depression? Odd thought that. Obesity is a risk marker _for_ disease states and contributes to them. Someone who is obese is statistically a greater mortality risk … as is someone who is underweight to the same degree. But an obese individual with healthy habits is not necessarily unhealthy and is not per se diseased. On an _individual level_ obesity is not a disease, in and of itself. On a societal level, OTOH, the increased prevalence of obesity, and in particular of morbid obesity, is a societal disease. An underweight individual may be at the same degree of health risk as an obese individual is, but there are many fewer of them. Obesity has increased because our modern world is obesiogenic and those with a genetic predisposition will be triggered by that environment without intervention. The response to the individual is to address the behaviors and to develop behavior patterns that significantly decease health risks, changing their personal environment. Modest weight loss (5-10%) and adoption of those behaviors may leave an individual obese but will have them at not appreciable increased risks for disease. If that be “accepting” obesity then yes accepting obesity it is. The response to the societal disease of increased obesity prevalence is at _the systems level_, diminishing those aspects of the environment that are obesiogenic using multiple levels of tools. Disapproval of individuals or “discouraging” them is not part of the effective toolbox. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [July 6, 2012, 5:14am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/22 "2012-07-06T05:14:27Z")
> [@TriPolar](#): > > Do you have some evidence that obesity is a debilitating medical condition? If that were the case, and the statistics about the incidence of obesity are correct, then I don’t see how this country to continues to operate with so many people so severely crippled by their weight. We do it in part by massive expenditure of resources. The average American takes 5,117 a day (as compared to the Swiss at 9,650). Many of us have lost the ability to walk mid-range distances. I have “healthy” friends who feel winded and sore after walking a mile- barely 15 minutes of light effort. We make up for this deficiency by strapping ourselves into in average of two tons of steel and using fire to propel us these distances. Lots of people use their cars like absurdly large wheelchairs. ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [July 6, 2012, 5:31am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/23 "2012-07-06T05:31:08Z")
> [@even\_sven](#): > > We do it in part by massive expenditure of resources. The average American takes 5,117 a day (as compared to the Swiss at 9,650). Many of us have lost the ability to walk mid-range distances. I have “healthy” friends who feel winded and sore after walking a mile- barely 15 minutes of light effort. > > We make up for this deficiency by strapping ourselves into in average of two tons of steel and using fire to propel us these distances. Lots of people use their cars like absurdly large wheelchairs. Wow, that’s amazing. I can’t believe the Swiss take 9,650 a day. That’s incredible. I’m surprised Amercans are only at 5,117. But that’s still really good right? Because we want more of that, but we have a lot of … what are we talking about here? ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [July 6, 2012, 5:32am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/24 "2012-07-06T05:32:16Z")
> [@Wesley\_Clark](#): > > I could go on on how the health effects can be exaggerated, the health benefits of weight loss can be exaggerated, and how more benign behaviors ( **lack of moderate drinking** , etc) are just as bad if not worse for your health. (my bold) Surely you jest? Lack of moderate drinking is just as much of a health risk, _if not moreso,_ as obesity? :dubious: ---
**Author:** ![Eonwe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eonwe/32/240_2.png) [@Eonwe](https://boards.straightdope.com/u/Eonwe)\ **Post date:** [July 6, 2012, 10:27am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/25 "2012-07-06T10:27:26Z")
> [@TriPolar](#): > > Wow, that’s amazing. I can’t believe the Swiss take 9,650 a day. That’s incredible. I’m surprised Amercans are only at 5,117. But that’s still really good right? Because we want more of that, but we have a lot of … what are we talking about here? Steps, I assume from context. ---
**Author:** ![Omar\_Little](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/omar_little/32/269_2.png) [@Omar\_Little](https://boards.straightdope.com/u/Omar_Little)\ **Post date:** [July 6, 2012, 10:42am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/26 "2012-07-06T10:42:51Z")
Some time in the future, 2 liter bottles of soda and boxes of twinkies will carry warning labels and pictures of constricted blood vessels and rolls of neck fat. Much of the personal liberty arguments in this thread have been used for decades against regulation and taxation of tobacco products. They haven’t worked that well. ---
**Author:** ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)\ **Post date:** [July 6, 2012, 11:49am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/27 "2012-07-06T11:49:57Z")
> [@Wesley\_Clark](#): > > Anyone who thinks teenage girls want to lose 20 pounds because they don’t want a 40% higher risk of a heart attack in 2050 is lying to themselves. Teenage girls aren’t exactly a reliable barometer of \*anything \*- I don’t know why you’d even bother mentioning this, unless there are indeed people out there telling this lie to themselves (I’ve never met 'em). ---
**Author:** ![scareyfaerie](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/scareyfaerie/32/3135_2.png) [@scareyfaerie](https://boards.straightdope.com/u/scareyfaerie)\ **Post date:** [July 6, 2012, 11:53am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/28 "2012-07-06T11:53:54Z")
I voted for “disease” because there wasn’t a “both” option. ---
**Author:** ![Imago](https://avatars.discourse-cdn.com/v4/letter/i/85e7bf/32.png) [@Imago](https://boards.straightdope.com/u/Imago)\ **Post date:** [July 6, 2012, 12:06pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/29 "2012-07-06T12:06:38Z")
From all my experiences as a smallish and now muscular chick who’s dated her share of overweight/obese girls, I cannot emphasize enough that making them feel shitty about being overweight is _not_ going to up the chances of them making healthier lifestyle choices. Who cares why its ineffective? The fact is it’s ineffective. I believe a stressed-out person with a fit body will get sicker and likely die sooner than a chubby person with less stress. A lot of the health problems apparently related to obseity are also related to stress- heart disease, certain cancers, stroke, etc. We just stress out all our fat people so much that it isn’t obvious enough to be studied yet. If there’s a serious health risk, then there’s no reason to pretend otherwise. But before we can actually address any of the health questions related to obesity we need to get to a point where fat people are treated like adults, not like walking bags of fat. Society is nowhere near that point right now. I did have one girlfriend who lost about 30 pounds while she was with me because she started coming with me to the gym. Why? Definitely not because she was filled with envy or wanted to look better. It was because she knew that if anyone said anything obtuse I was going to tell them off. 80% or so of the fat folks I have known didn’t avoid exercise out of pure laziness or overeat due to some primitive lack of impulse control. They avoided exercise because it made them feel like failures and overate because people treated them differently. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [July 6, 2012, 12:44pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/30 "2012-07-06T12:44:26Z")
I wonder how much we can affect what we find attractive by societal education and pressure. I for one find it hard to believe that any number of images in the media will convince me that morbid obesity is just another way of being beautiful. The “1:1.3 waist to hip ratio” standard of female beauty seems to be cross-cultural. One of the many issues in dealing with obesity is that the urge to over-eat seems to be in our genes. The standard for female beauty that says a woman whose belly is bigger than her hips is not attractive may be the same. Even pushing an opposite standard of near-anorexia, as Hollywood and the magazines seem to be doing now, doesn’t “work” all that well, IMO. The subset of people who find extreme thinness attractive seems to be much smaller than those who find a better-nourished figure to be more attractive. I suspect if Hollywood or society in general pushed the idea that real obesity can be just as beautiful as anything else may run into the same resistance, and for the same reasons. Maybe I’m projecting. But maybe not. Regards, Shodan ---
**Author:** ![Drain\_Bead](https://avatars.discourse-cdn.com/v4/letter/d/e47774/32.png) [@Drain\_Bead](https://boards.straightdope.com/u/Drain_Bead)\ **Post date:** [July 6, 2012, 12:59pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/31 "2012-07-06T12:59:19Z")
The standard American diet causes obesity, and it’s all anyone really knows. The state of nutritional information and education in this country is abysmal. People are biologically hardwired to eat crap, and crap is readily available. There’s no moral issue regarding obesity–most people who are obese (and I used to be one of them, and am still overweight but heading downward) are not obese because they are weak or lazy. They’re obese because they don’t realize what eating highly-processed foods does to their bodies. That doesn’t mean that this shouldn’t be fixed, though. It’s a major public health issue (probably THE major public health issue). Goodness knows how, though–getting everyone on a real food diet is damn near impossible. ---
**Author:** ![Nunzio\_Tavulari](https://avatars.discourse-cdn.com/v4/letter/n/b9bd4f/32.png) [@Nunzio\_Tavulari](https://boards.straightdope.com/u/Nunzio_Tavulari)\ **Post date:** [July 6, 2012, 1:59pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/32 "2012-07-06T13:59:10Z")
Screw 'em. They’re as big a load on the health care industry as smokers. Treat them the same way. No assistance, just refuse to sell food to anyone who’s overweight. Make them eat at home. Lock up all the high-fat foods at the grocery and make the cashier call for someone with a key. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 6, 2012, 4:21pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/33 "2012-07-06T16:21:57Z")
**Shodan** , your post illustrates how the op is a bit of a mishmosh: it conflates standards of beauty with disease. People are entitled to their opinions about what and is not attractive (does “beauty comes in all shapes and sizes”?) and I am with you in the belief that those opinions are to no small extent based on evolutionarily selected brain responses. We can insist that the obese are treated _with respect_ but no one can mandate that someone find someone else to be a standard of beauty. (I do find it odd however that as the average American has become fatter the typical image of beauty presented to them has become thinner, often likely clinically underweight. Even beefcake albeit to a lesser degree than female images.) The op does a disservice to the discussion by presenting the choices as either obesity is attractive or obesity is disease. They are very different issues. **Nunzio** is I presume, less than serious … or maybe not … but the attitude satirized there (even if unintentionally satirized) is the ignorance that is rife in our society where oddly enough people who are usually at least overweight themselves often mock those who are heavier yet. ([Over 2/3s](http://www.cdc.gov/nchs/fastats/overwt.htm/) of adult Americans are either overweight or obese, using current definitions. **Nunzio** , if serious, would impose those discriminiations on the vast majority of those in this country, likely him or herself inclusive.) ---
**Author:** ![thelurkinghorror](https://avatars.discourse-cdn.com/v4/letter/t/7c8e57/32.png) [@thelurkinghorror](https://boards.straightdope.com/u/thelurkinghorror)\ **Post date:** [July 6, 2012, 4:27pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/34 "2012-07-06T16:27:27Z")
> [@Nunzio\_Tavulari](#): > > Screw 'em. They’re as big a load on the health care industry as smokers. Treat them the same way. No assistance, just refuse to sell food to anyone who’s overweight. Make them eat at home. Lock up all the high-fat foods at the grocery and make the cashier call for someone with a key. Uh huh. And you’d give the keys to the grocery store workers, who are always perfectly fit and therefore have the moral superiority to tell people off? Seen a Walmart employee recently? :dubious: ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 6, 2012, 5:23pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/35 "2012-07-06T17:23:17Z")
> [@DSeid](#): > > …I do find it odd however that as the average American has become fatter the typical image of beauty presented to them has become thinner… I had a little time to kill and found some actual [support](http://www.tandfonline.com/doi/abs/10.1300/J013v41n02_02) for that contention. > [@](#): > > Overall, all anthropometric measures differed significantly over time. Body mass index (BMI) for all women in the idealized groups tended to decline significantly over time, while the BMI for Young Women increased significantly. Models tended to have the smallest bust and hips, Playmates the largest bust, and Young Women in general the largest waist and hips … Idealized women have a body size unlike that of Young Women and the chasm between the media-defined ideal and reality is continuing to diverge. In male models I see it reflected in the fairly modern obsession with “washboard abs” which only pop out at absurdly low levels of body fat. BMI may still be reasonable since these models are well muscled as well but beefcake of years past did not have such extremely low levels of body fat. Images may not impact what we find attractive in others all that much, but I do think it impacts self-satisfaction with our own body images. Anyone with an explanation for the psychology behind the increasing chasm? Why does the media hold up more extreme low adiposity as the ideal almost in lock step as more and more average people go farther to the other pole? Is the media imaging exclusively a response to increased adiposity, or does it, by way of increasing body image anxiety, paradoxically increase contribute to the problem? ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [July 6, 2012, 6:04pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/36 "2012-07-06T18:04:27Z")
Public health interventions DO work. We have, for example, dramatically reduced smoking through public health methods. China is realizing that with prosperity comes new risks, and it’s interesting how they have anticipated these problems. Everyone is strongly encouraged to participate in two different physical activities a day, and there is a strong push to normalize daily activity. And it seems to work- after school, my college campus swarmed with kids playing badminton, elderly ladies line dancing, and little kids playing tag. People had strongly internalized “You get off work and you go do something with your body” as a normal thing. They’ve built in spaces for recreation in their cities, with special care taken to provide recreational activities for the elderly. There are ample public parks, and every housing development has a nearby outdoor exercise course, which are especially popular among older people- they will watch the kids play on the jungle gyms while they work out. It’s customary to walk after dinner, so in the evening you will see thousands of families on the streets taking an evening stroll. I’m not sure if it is a government thing, but they’ve made it extremely easy to run fruit stands, such that the nearest source of food to any given person is probably a fruit stand. It becomes much easier to pick up apples and watermelon wedges than chips and soda. If we are smart, we’ll start looking toward how we can structure our communities to encourage health. Urban planning and transit options have a direct correlation with obesity rates. We can build fat cities, or healthy ones. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 6, 2012, 7:02pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/37 "2012-07-06T19:02:12Z")
[Not so sure](http://www.sciencedirect.com/science/article/pii/S0167527308007420) if China really makes your point so well, as much as I agree with it. > [@](#): > > China now joins the world epidemic of childhood obesity … In 2005, the prevalence of combined childhood overweight and obesity in China reached 32.5% for males and 17.6% for females in the northern coastal big cities, suggesting that the obesity prevalence in some urban Chinese populations has approached that of the developed countries … ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [July 6, 2012, 7:19pm UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/38 "2012-07-06T19:19:23Z")
> [@DSeid](#): > > In male models I see it reflected in the fairly modern obsession with “washboard abs” which only pop out at absurdly low levels of body fat. BMI may still be reasonable since these models are well muscled as well but beefcake of years past did not have such extremely low levels of body fat. ISTM that “abs” are not necessarily a modern ideal - witness various Greek statuary such as [this](http://www.google.com/imgres?hl=en&sa=X&biw=1225&bih=821&tbm=isch&prmd=imvns&tbnid=NuG6AOledkoS9M:&imgrefurl=http://boards.straightdope.com/sdmb/showthread.php%3Ft%3D624512&docid=yBAWVVVMW4jRgM&imgurl=http://4.bp.blogspot.com/-1389OQA16ic/TfO5pVmvoMI/AAAAAAAABZg/DyAa4FvtXkY/s1600/Six-pack%252Bwashboard%252Babs%252B%252525282%25252529.jpg&w=1050&h=1050&ei=STj3T-W4As6jqwH_wNCLCQ&zoom=1&iact=hc&vpx=348&vpy=297&dur=2659&hovh=225&hovw=225&tx=139&ty=134&sig=108350199768779564117&page=3&tbnh=146&tbnw=149&start=61&ndsp=30&ved=1t:429,r:13,s:61,i:312) and [this](http://www.google.com/imgres?start=127&hl=en&sa=X&biw=1225&bih=821&tbm=isch&prmd=imvns&tbnid=XuGl64F4hkD9MM:&imgrefurl=http://www.pheromonetalk.com/lounge/ladies-non-pheromone-questions-54059-4.html&docid=M3zEOIL7-NeMaM&imgurl=http://1.bp.blogspot.com/_ZKwi2HpR3M8/S9IvaznpITI/AAAAAAAAMSs/eb1Cuy7Qhm0/s1600/Riace%25252BBronzes%25252B%282%29.jpg&w=924&h=1172&ei=rjj3T8LVJYWqrQGJ09GLCQ&zoom=1&iact=hc&vpx=733&vpy=434&dur=2041&hovh=253&hovw=199&tx=137&ty=131&sig=108350199768779564117&page=5&tbnh=141&tbnw=111&ndsp=36&ved=1t:429,r:4,s:127,i:132). ISTM that washboard abs are much more naturally seen as part of the idealized male physique. Not so with women so much, of course. > [@](#): > > Images may not impact what we find attractive in others all that much, but I do think it impacts self-satisfaction with our own body images. Anyone with an explanation for the psychology behind the increasing chasm? In many instances, I would expect that the presenters of the image are trying to raise anxiety levels in their audience in order to sell them diet books or high fashion clothes. Some who is anxious about their self-image is someone with less sales resistance. No hard figures to back that up - sorry. > [@](#): > > Why does the media hold up more extreme low adiposity as the ideal almost in lock step as more and more average people go farther to the other pole? Is the media imaging exclusively a response to increased adiposity, or does it, by way of increasing body image anxiety, paradoxically increase contribute to the problem? Some of it might be a status display, like pale skin was in cultures where the lower classes spent their time working in the sun, or extremely long fingernails to show that the woman did not work with her hands. Regards, Shodan ---
**Author:** ![Arabella\_Flynn](https://avatars.discourse-cdn.com/v4/letter/a/8491ac/32.png) [@Arabella\_Flynn](https://boards.straightdope.com/u/Arabella_Flynn)\ **Post date:** [July 7, 2012, 8:18am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/39 "2012-07-07T08:18:57Z")
You are asking two entirely different things here. Should obese people be “accepted”? Yes. This is like asking whether diabetic people should be accepted, or tall people, or Presbyterian people. Sometimes you can choose the characteristics you have, sometimes you can’t. I personally believe that no one ever has the right to treat you like anything less than a human being, for any reason. Should obesity be considered a “disease”? Slightly trickier. I certainly think that if your own body mass is preventing you from walking then this constitutes a medical issue; I would like to point out that having a severed spinal cord preventing you from walking is also a medical issue, and that neither of them says anything about your moral fiber. The only thing the social and medical viewpoints have in common is that the outright demonization of obese people is probably not a helpful thing. Moral panics have happened before, and generally do more harm than good, particularly when there is hard research involved. Nobody ever scienced any better by being hell-bent on proving a particular agenda. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [July 7, 2012, 10:51am UTC](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362/40 "2012-07-07T10:51:14Z")
> [@DSeid](#): > > Anyone with an explanation for the psychology behind the increasing chasm? Because something being hard to achieve makes it useful as a status symbol; if everyone can look a particular way then you can’t feel better than other people for it. Like how being fat used to be considered a status symbol because only the wealthy could afford that much food. The harder it is to be really thin and the fewer people who are really thin, the more of a status symbol it becomes. If you invented a magic drug that let everyone set their weight to any desired point, being thin or fat would have little relevance to status anymore. [Previous page](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362.md?page=1) [Next page](https://boards.straightdope.com/t/should-obesity-be-accepted-or-should-it-be-viewed-as-a-disease/627362.md?page=3)