Is obesity a disease or not?

Is obesity a disease or not?
August 24, 2017 Carl-Magnus Broden
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Every sixth Swede has passed the BMI limit for obesity. In spite of this, the number of bariatric surgery procedures performed in Sweden per year is declining, and national guidelines are lacking. This summer, the medical newspaper Dagens Medicin Agenda, in collaboration with Medtronic, had a symposium in Almedalen (Sweden’s big annual summer meeting place for politics, industry and public organizations, including the health care sector) with the theme “Should we treat obesity as a disease?”. The fact that this is highlighted in Almedalen is both talkative and a little disappointing: overweight is and remains something society has very hard to deal with in an objective and prejudice-free way.

Current science indicates that established obesity is a hormonally controlled, chronic disease that shortens people’s lives and causes a large number of complications. Obesity is a product of our western society and rarely an effect of “bad character”. The health effects of permanent weight loss would certainly have been awarded the Nobel Prize in Medicine -had it been due to a drug. Now instead, the method is a surgical procedure. Obesity surgery has complications -like all surgery (just as all medicines have side effects).

In general, society thinks that if an operation should be “worth” performing despite the risk of complications, the indication must be strong. It must therefore be a dangerous disease you are treating. As obesity has not been accepted as such yet, the focus remains to instead blame the obese themselves for their condition, often offering “upbringing” treatment attempts such as “be more physically active and eat a little less”. These are our collective prejudices that shine through (“fat, lazy and stupid”).

Established chronic obesity currently only has one effective treatment; gastric bypass/sleeve gastrectomy. Those who choose this make a scientifically evidence based choice. You as a bariatric surgery patient will need to change a lot in your daily life habits, but your clinic, and if you want our iPhone app BariBuddy will help you along the way.

In the future, we hope that society will raise awareness of how obesity works, so that more people have access to effective treatment (and receive a non prejudiced evaluation in their contacts with the health care system).

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