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Obesity as a disease

RCP calls for obesity to be recognised as a disease

The RCP wants to see obesity recognised as an ongoing chronic disease to allow the creation of formal healthcare policies to improve care both in doctors’ surgeries and hospitals

The Royal College of Physicians is calling for obesity to urgently be recognised as a disease by government and the broader health sector, and warning that until this happens its prevalence is unlikely to be reduced. According to Public Health England, in 2015 63% of adults were classed as being overweight or obese. In 2015 to 2016, 19.8% of children aged 10 to 11 were obese and a further 14.3% were overweight.

The RCP wants to see obesity recognised as an ongoing chronic disease to allow the creation of formal healthcare policies to improve care both in doctors’ surgeries and hospitals, and so that significant and far-reaching preventative measures can be put in place.

“Obesity is not a lifestyle choice caused by individual greed but a disease caused by health inequalities, genetic influences and social factors,” said Professor Andrew Goddard, RCP president. “As well as encouraging prevention, treatment and greater empathy with patients, the RCP wants to see a change to public discourse about obesity, so that those with the condition are no longer blamed for it. It is important to the health of the nation that we remove the stigma associated with obesity.  It is governments, not individuals, which can have an impact on the food environment through regulation and taxation, and by controlling availability and affordability. Governments can also promote physical activity by ensuring that facilities are available to local communities, and through legislation and public health initiatives.”

However, some experts disagree including David Buck from the health think tank, The Kings Fund, who said the classification is not necessary and risks over-medicalising what is a lifestyle choice for many: “II do think this could have dangerous consequences. Obesity isn't a disease, it's a condition, an outcome. I am slightly overweight, according to government statistics, but I don't see myself as suffering with a disease. It's because of the environment I live in, the choices I make. It's a condition not a disease, I don't buy that at all."

Professor Rachel Batterham, University College London, UK, believes that obesity is a chronic, progressive disease and classing it as such is the only way to treat the cause rather than the consequences of the obesity crisis in the UK.

Rachel Batterham

"We know the biology now and there are over 100 DNA that have been identified showing how some people will develop obesity and others will be protected. We also know that once a person has developed obesity it's almost impossible to lose that weight and keep it off. The body will do all it can to go back to the highest weight you've ever reached."

The decision to recognise obesity as a disease would require a radical overhaul of the NHS, a national strategy, more funding and the use of long-term medication to treat patients.

"The idea of obesity as a disease has got some advantages in terms of treatment and taking the issue more seriously but it can be problematic for those who aren't heavily obese as it can medicalise what is actually a normal experience for most of us and being physically active is something we all would want to do as part of daily life,” said Dr Fiona Gillison, from the University of Bath. “It can also be off-putting, particularly to parents when we are saying children have a disease if they are overweight or obese."

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