David B. Allison, PhD, Professor of Biostatistics and Head of the Section on Statistical Genetics at the University of Alabama at Birmingham, Morgan Downey, JD, former Executive Director of the American Obesity Association (AOA), et al., in their Apr. 24, 2008 Obesity journal online article "Obesity as a Disease: A White Paper on Evidence and Arguments Commissioned by the Council of The Obesity Society," wrote:
"The scientific approach would be well suited to answering the question 'is obesity a disease?' rather than 'should we consider obesity a disease?,' were the former question answerable.
However... the former question is ill posed and does not admit an answer. This is not because of a lack of agreement or understanding about obesity but rather because of a lack of a clear, specific, widely accepted, and scientifically applicable definition of 'disease' that allows one to objectively and empirically determine whether specific conditions are diseases."
The Centers for Medicare and Medicaid Services (CMS), in a statement made by its Administrator Mark McClellan, MD, PhD, quoted in the July 15, 2004 US Department of Health and Human Services (HHS) press release "HHS Announces Revised Medicare Obesity Coverage Policy," stated:
"From the standpoint of Medicare coverage and the health of our beneficiaries, the question isn't whether obesity is a disease or a risk factor. What matters is whether there's scientific evidence that an obesity-related medical treatment improves health."
"Obesity is a chronic disease, prevalent in both developed and developing countries, and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concerns, including undernutrition and infectious disease, as one of the most significant contributors to ill health."
Arthur Frank, MD, Founder and Co-Director of George Washington University Weight Management Program (GWUWMP), stated in the Nov. 10, 2003 Washington Post article "Is Obesity a Disease?":
"There's no question that obesity is a disease... Obesity is a disease where there's a disregulation of eating - just like diabetes is a disease where the system of controlling blood sugar is not functioning properly."
"Obesity is a complex, multifactorial disease that develops from the interaction between genotype and the environment. Our understanding of how and why obesity occurs is incomplete; however, it involves the integration of social, behavioral, cultural, and physiological, metabolic, and genetic factors."
The American Obesity Association (AOA), now known as The Obesity Society (TOS), provided on the page "Obesity Is a Chronic Disease" of AOA's website (accessed Jan. 8, 2010):
"The American Obesity Association (AOA) believes that obesity is a disease. We want obesity understood by the health care community and patients as a serious disease of epidemic proportions.
First, let's define our terms. Dictionaries agree: obesity is excess body fat. It is not defined as a behavior. However, many people use the term obesity as short-hand for overeating or lack of exercise. But that is not its definition.
Consider this: most people can distinguish between smoking and lung cancer. One is a behavior and one is a disease. Or problem drinking of alcohol and liver disease. One is a behavior and one is a disease. Sunbathing without protection is a behavior; skin cancer is a disease.
Second, obesity - the excess accumulation of body fat - fits all the definitions of 'disease.' How is 'disease' defined? Most dictionaries, general as well as medical, define a disease as an interruption, cessation or disorder of a bodily function, organ or system. Obesity certainly fits this definition."
José F. Caro, MD, Vice President of Global Diabetes Care at Eli Lilly, wrote in his McGraw-Hill's AccessScience Encyclopedia of Science & Technology article "Obesity Pathophysiology" (accessed Jan. 13, 2010):
"...[O]besity is one of the most frequent and serious metabolic diseases. Furthermore, strategies for long-term reduction of body weight are largely ineffective. More than 90% of people who lose weight eventually regain it...
[H]uman obesity belongs to a large group called complex diseases. Included in this group are type II diabetes, hypertension, and ischemic heart diseases (characterized by deficient supply of blood to cardiac muscle). The inheritance of these diseases is different from the classic mendelian mode of transmission of monogenic diseases (related to or controlled by one gene). The phenotype of complex diseases reflects the multifactorial effect of all contributing genes (polygenic) and all environmental factors."
Louis J. Aronne, MD, Clinical Professor of Medicine at Weill Cornell Medical College, Donald S. Nelinson, PhD, President of InterQuest Medical & Scientific Communications, and Joseph L. Lillo, DO, Assistant Professor of Family Medicine at Arizona College of Osteopathic Medicine (AZCOM) at Midwestern University, in their 2009 Clinical Cornerstone article "Obesity as a Disease State: A New Paradigm for Diagnosis and Treatment," wrote:
"Obesity meets all accepted criteria of a medical disease, including a known etiology, recognized signs and symptoms, and a range of structural and functional changes that culminate in pathologic consequences. Excess adipose tissue acts as an endocrine organ to produce excess free fatty acids, as well as tumor necrosis factor-á, interleukin-6, leptin, and plasminogen activator inhibitor-1. These bioactive molecules are associated with hyperinsulinemia, hyperglycemia, insulin resistance, development of diabetes, endothelial damage, and the onset and progression of atherosclerotic lesions."
Antonio Rene, PhD, Associate Professor of Epidemiology and Biostatistics at Texas A&M Health Science Center, and Baqiyyah Conway, PhD, Research Fellow in Epidemiology at Vanderbilt University, wrote in their May 2004 Obesity Reviews article "Obesity as a Disease: No Lightweight Matter":
"Contrary to just being a medical condition or risk factor for other diseases, obesity is a complex disease of multifaceted aetiology, with its own disabling capacities, pathophysiologies and comorbidities. It meets the medical definition of disease in that it is a physiological dysfunction of the human organism with environmental, genetic and endocrinological aetiologies. It is a response to environmental stimuli, genetic predisposition and abnormalities, and has a characteristic set of signs and symptoms with consistent anatomical alterations. Excess adipose tissue increases the work of the heart and leads to anatomical changes in this organ. It alters pulmonary, endocrine and immunological functions, all with adverse effects on health. Some of the complications of obesity include cardiovascular disease, non-insulin-dependent diabetes mellitus, obstructive pulmonary disease, arthritis and cancer. Given the excess mortality, substantial morbidity and the economic toll of obesity, this is a disease that warrants serious attention by the medical community."
Richard Berman, JD, Executive Director of the Center for Consumer Freedom (CCF), in the July 16, 2004 article "Obesity Is Not a Disease" posted on CCF's website, stated:
"The pharmaceutical and weight loss industry have manufactured an 'epidemic' to have the cost of their weight loss drugs and treatments underwritten by taxpayers... Obesity is not a 'disease' if it can be cured by taking regular walks and eating less... We need to be careful not to dumb down the definition of the term disease at the expense of taxpayers."
South Carolina's Department of Health and Human Services (DHHS), in its Jan. 1, 2010 Hospital Services Provider Manual(371 KB) provided on www.dhhs.state.sc.us, stated:
"Obesity itself cannot be considered an illness. The most common cause is caloric intake that is persistently higher than caloric output. Reimbursement may not be made for treatment of obesity alone since this treatment cannot be considered reasonable and necessary for the diagnosis or treatment of an illness or injury. However, although obesity is not in itself an illness, it may be caused by illnesses such as hypothyroidism, Cushing’s disease, and hypothalamic lesions. In addition, obesity can aggravate many cardiac and respiratory diseases as well as diabetes and hypertension. Therefore, services related to the treatment of obesity could be covered services when such services are an integral and necessary part of a course of treatment for one of these illnesses."
Stanley Heshka, PhD, Associate Research Scientist at the Institute of Human Nutrition of Columbia University, and David B. Allison, PhD, Professor of Biostatistics and Head of the Section on Statistical Genetics at the University of Alabama at Birmingham, wrote in their Oct. 2001 International Journal of Obesity article "Is Obesity a Disease?":
"Obesity, defined as a body mass index (BMI, kg/m2) or percentage body fat in excess of some cut-off value, though clearly a threat to health and longevity, lacks a universal concomitant group of symptoms or signs and the impairment of function which characterize disease according to traditional definitions. While it might nevertheless be possible to achieve a social consensus that it is a disease despite its failure to fit traditional models of disease, the merits of such a goal are questionable. Labeling obesity a disease may be expedient but it is not a necessary step in a campaign to combat obesity and it may be interpreted as self-serving advocacy without a sound scientific basis."
Allen Steadham, Founder and Director of the International Size Acceptance Association (ISAA), in the Oct. 2004 DOC News article "Obesity Is Not a Disease," wrote:
"The term 'obesity' has metamorphosed over the years from simply describing a state of fatness to now being synonymous with disease and death. A thorough and unbiased closer look, however, reveals that obesity is, in fact, not a disease at all.
First of all, many of the medical conditions, including mortality, associated with obesity are actually a result of sedentary lifestyle and poor food choices...
Second, a significant source of decreased health on the body is cyclical weight-loss dieting and fad diets... In contrast, increased mobility through mild but maintainable activity, in combination with improved food choices, decreases stress and increases health and energy, whether or not actual weight is lost."
Paul F. Campos, JD, Professor of Law at the University of Colorado at Boulder, wrote in his 2004 book The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health:
"From the perspective of a profit-maximizing medical and pharmaceutical industry... the ideal disease would be one that never killed those who suffered from it, that could not be treated effectively, and that doctors and their patients would nevertheless insist on treating anyway. Luckily for it, the American health-care industry has discovered (or rather invented) just such a disease. It is called 'obesity.'
The reasons why the disease of obesity doesn't kill those who suffer from it and why it remains impossible to cure are one and the same: Because it doesn't exist.
...Most groups of people categorized as 'overweight' and 'obese' do not suffer from poorer health or higher mortality than 'ideal weight' individuals. In many of the largest-scale studies, groups of people currently categorized as overweight have better mortality statistics than anyone else...
The absurd notion that something as complex as an individual human being's health can be adequately gauged, or even generalized about, by determining where he or she fits on something as crude as a body mass index scale is a remnant of a level of medical knowledge (or rather ignorance) that had very little to do with science...
In fact, as we have seen, there is no valid medical reason why two women of the same height cannot weigh 100 and 200 pounds respectively, while both maintain optimum cardiovascular and metabolic fitness, and excellent overall health."
Mike Adams, Editor of NaturalNews.com, wrote in the July 18, 2004 article "Medicare Declares Obesity to Be a Disease, Stripping Away Patient Responsibility and Power" on NaturalNews.com:
"Is obesity really a disease?... I argue that it's not a disease at all but rather the natural result of a person making extremely poor decisions about food choice and physical exercise. It's something that can be entirely reversed in virtually 100% of the cases by changing these two simple things. As a result, it rests firmly under the control of the patient, especially if they are educated about healthy nutrition and how to make intelligent choices about what foods and groceries they consume.
To call obesity a disease is a 'dumbing down' of the very idea of what a disease is. And unfortunately, it implies that the patient is helpless to do anything about it."
J. Eric Oliver, PhD, Professor of Political Science at the University of Chicago, wrote in his 2006 book Fat Politics: The Real Story behind America's Obesity Epidemic:
"[A]s a disease, obesity is a flawed construct. Consider, for a moment, some of the awkward questions that arise when you call obesity a disease: is someone who is slightly overweight, only slightly diseased? Can someone catch or 'come down' with obesity? Can obesity really be 'cured'? If these questions seem ludicrous, it is because obesity does not readily meet the criteria of disease. According to Stedman's Medical Dictionary, a disease is 'an interruption, cessation, or disorder of body function, system, or organ.' By this definition, if obesity is a disease, then we must assume that, at some level, body fat is pathological. Yet... there is no clear evidence about what level or even how, exactly, adipose tissue is harmful to our health. For some extremely heavy people, their body fat may disrupt their ability to function, particularly their ability to exercise, but for most people their fatness is not a disorder. Indeed, body fat on some parts of the body, such as the thighs, can actually be helpful to sustaining our health. Even Stedman's Medical Dictionary does not call obesity a disease; it is simply known as 'excess subcutaneous fat in proportion to lean body mass' or, at worst, 'a public health problem.'
...Despite the plethora of apocalytpic warnings, there is no clear evidence that, for most Americans, their weight is putting them at any health risk... In truth, we could end the obesity epidemic right now if we desired—all we would need to do is to redefine obesity according to the real criterion of a disease. If we simply classified obesity at a level where body fat is incontrovertibly pathological, only a fraction of Americans would qualify and this 'epidemic' would vanish."
Portion Sizes: How Big or Small Should They Be?
provided on www.who.int, wrote: