Professor Emerita of Clinical Medicine at Columbia University College of Physicians and Surgeons
Not Clearly Pro or Con to the question "Is Obesity a Disease?"
"Obesity is a complex entity that can have many causes; some are endocrine (like thyroid malfunction or hyperfunctioning of the adrenal gland-Cushing's syndrome [sic]) but often the condition is from a combination of inactivity and overeating. For others, there are genetic factors that produce a tendency to overweight even with the consumption of what would be for most people an appropriate number of calories.
There is, to be sure, an important emotional component to overeating; often patients do it for comfort, out of habit, from boredom or for combating anxiety. Some use being obese as a defense against rejection: 'It's just because I am fat that I am not promoted/have no significant other/have few intimate friendships.' Overeating for some patients is a lifelong compulsion which is profoundly ingrained into their behavior. Many children are served inappropriate foods in much-too-large portions.
Counseling patients about their weight thus becomes very complex, because establishing the reasons for obesity and then helping patients cope with changing their lifestyle or correcting the illnesses that may be causing their overweight are not easy things for the practicing physician to do. To add to the difficulties, family members, believe it or not, may have an investment in keeping the patient overweight: the husband who becomes uneasy about the improvement in his wife's appearance, for example. Those family members may actually sabotage or neutralize the patient's effort to control and correct weight. Society's idea of what body size is acceptable may also be an important factor: watch British television—many of the female actresses would be classified as overweight by an American physician!
It really doesn't matter how the AMA or any other organization characterizes 'obesity'—sorting out the causes and dealing with the incredibly complex task of leading a patient to a healthier and more functional state is not a trivial task. In short, it's a heterogeneous entity and all too often one of the hardest to correct. Whether the causes are hormonal, genetic or reside in the brain (its reward system or the circuitry that underlies habit, perception of portion size, the choice of food, etc.) is often difficult to sort out."
Statement to Prevention Magazine, "Is Obesity a Disease? Prevention Experts Weigh In," www.prevention.com, June 2013
Experts Individuals with MDs; individuals with PhDs or equivalent advanced degrees in fields relevant to obesity and health; top-level federal government officials with significant involvement in obesity-related health issues. [Note: Experts definition varies by site.]
Involvement and Affiliations:
Professor Emerita of Clinical Medicine, Columbia University College of Physicians and Surgeons
Adjunct Professor of Medicine, Johns Hopkins Medical School
Fellow, American College of Physicians
Editorial Board Member, Women's Health in Orthopedics, 2008-present
Director, Foundation for Gender-Specific Medicine, 2006-present
Editor-in-Chief and founder, Gender Medicine, 2004-present
Editorial Board Member, JMHG & International Society for Men's Health and Gender Collaboration, 2004-2006
Attending Physician, Lenox Hill Hospital, 2004-present
Editorial Board Member, Medicine and Behavior, 1998-present
Health Advisor, MORE Magazine, 1998-present
Attending Physician, Presbyterian Hospital in the City of New York, 1998-present