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The ongoing discussion of whether obesity should be categorized as a disease - with all the legal and social implications such a move would carry - continues to generate interest.

One MNB user wrote:

I was intrigued by all the responses you received regarding your views on obesity, manufacturers, disease classification and personal responsibility.

"If people think that obesity is really a disease and it should be treated
that way, just wait until we get the newest rate increases in health
I've never known an insurer to cover an eating disorder. We'll all pay for it anyway as obese people use the medical industry more and more.

"People do not have to helplessly die of obesity as they would die of a real
disease such as cancer."
Isn't Bulimia a "real" disease? How about Anorexia? These diseases revolve around bad food choices or lack thereof and distortions of self image. Both of these factors seem to be very involved with obesity. People die from Anorexia, from Bulimia AND Obesity - often helplessly. They are just as "real" as cancer. Ask anyone who's had a relative or friend die from an eating disorder.

Let's face it, there are people out there who need help, personal responsibility or no. And there are those who just need a shove in the right direction.

Here's a thought - we've created a pretty miserable environment for a lot of people when it comes to food (from "ideal" body images to super sized meals to "convenience" foods loaded with fat, sugar and preservatives), why can't we take some responsibility for that while helping those who've gotten caught in the middle of it?

MNB user Katherine Johnston disagreed:

This is definitely a topic that is heated! My view is that obesity is a symptom, not a disease. People get fat for many reasons. For some, there is a legitimate medical reason. Glandular problems, metabolic problems, etc., are the diseases, and obesity is a symptom of that. “Emotional” eaters and other overeaters may be depressed or have an addiction. Those are mental health diseases or conditions. Most of us (myself included, now slimmed down thanks to getting off my behind and giving up sugar and fast food) are not sick. We know that Quarter Pounders with Cheese aren’t healthy, and we don’t care enough to change. Maybe that’s a mental condition or laziness. Obesity is not a disease by itself. We just need to realize that we are creating bad health and it will catch up with us, not medicate it or throw money at it.

Another MNB user wrote:

I can't control my spending. Why don't we make that a disease and the government or and insurance company can pay off my credit card.

You might be able to run for office on that platform…

MNB user Susan Kemp wrote:

If obesity is classified as a disease, will it also qualify for disability] coverage? (Hmmm, seems to me that the "Simpsons" aired an episode about this.) If so, we will pay increasing health insurance costs and increased Social Security contributions at a time when the pool of employees paying into SS is shrinking and the pool of people collecting benefits is increasing.

With all these deductions from our salary, who will be able to afford food?

Yet another MNB user wrote:

It seems a little insensitive for those of us who have not struggled with obesity to determine that those who are obese have become that way solely as a result of their own choices, particularly if we aren't experts on the medical and hereditary causes of obesity.

I am not an expert, but having studied a little physiology, I do know that the number of fat cells in a person's body is fixed by age 2 and that each fat cell sends a message to the brain when it becomes depleted. That means that those who have more fat cells (through no fault of their own, unless you want to blame babies) are constantly hungry if they eat the same amount as the average person. It's not just a matter of self-discipline; they are actually having hunger pangs! How long can any of us--fat or thin--can stand feeling hungry?

For those who don't actually have more fat cells but just eat compulsively, why shouldn't that be considered a disease? Many insurance plans cover psychological treatment, and eating disorders would certainly fall under that classification. And as for the insurance rates going up, my guess is that it would be cheaper to give overweight people some preventative treatment early on than to let them treat themselves with fad diets and then shell out the money later for the diabetes treatment and triple bypass surgeries! I don't believe food manufacturers are responsible for anything more than accurate labeling, but there's no reason health plans shouldn't help obese people become healthier.

And finally, this MNB user offered a unique perspective:

I am both a recovering alcoholic and a smoker, yet my BMI is a 24.5. Simply meaning I have a disease, a weakness and a desire to stay fit.( yeah, I
know, can't fix stupid!) The point of my message is simply this: Obesity, alcoholism and smoking are all health concerns that carry additional health cost, yet the only one that the insurance companies single out are the smokers. I am not complaining about my surcharge for smoking yet I find it curious that it is the ONLY behavior that is surcharged.

I have been helped tremendously by the medical community in relationship to my alcoholism. I could not deal with my daily struggle without them so I can identify with the obesity issue. How about a simple solution, Let's add physical fitness and lifestyle to the guidelines of the various insurance programs. You yourself have been working to shed pounds and not only do you feel better, but I am willing to bet your health risk have been reduced. Therefore, you should be awarded by reduced insurance cost. They have reduced car insurance for safe drivers!

By the way, I do enjoy your wine reviews. I read them with a bit of envy once in a while, but it is nice to be reminded that there are people who can enjoy a nice Cabernet( my personnel choice) without having to drink 6 bottles.


Is it too naïve to frame this discussion as a matter of compassion, as opposed to what might be fiscally prudent in the short run?
KC's View: