Obesity should be renamed to remove stigma and reflect that it is an inherited disease, researchers say.
Measures such as BMI has left the public ‘confused’ over what obesity is with most believing it simply means ‘being too fat’.
Instead, the illness should be rebranded as ‘Chronic Appetite Dysregulation’ to encourage those with symptoms to get treatment.
Scientists have identified hundreds of genes that increase the risk of obesity, fuelling the argument it should be classed as a disease.
It is thought mutations in these genes lead to changes in the parts of the brain that regulate appetite, leading some to overeat and gain weight.
Researchers want you to say they’ve got ‘chronic appetite dysregulation’ instead of obese
By reclassifying obesity to reflect this, researchers suggest it would pave the way for those most in need to access treatments such as appetite-suppressing weight-loss jabs.
Dr Margaret Steele, of the School of Public Health, University College Cork, studied the philosophical considerations about how obesity should be classified.
She said efforts should be made to ‘disentangle’ public health and medical meanings of obesity and ‘acknowledge the fact that we’re really talking about two different things.’
While the public health message focuses on BMI, medical professionals tend to look at a person’s physiological processes, they found – such as their ability to store excess energy as fat, to deal with insulin and dietary sugar and how well someone is able to function metabolically – to diagnose obesity.
‘Our environment throws so much food at us but some people seem to be able to resist the temptation and to stop eating when they’ve had enough to maintain their weight,’ she said.
WHAT SHOULD A BALANCED DIET LOOK LIKE?
Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain, according to the NHS
• Eat at least 5 portions of a variety of fruit and vegetables every day. All fresh, frozen, dried and canned fruit and vegetables count
• Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain
• 30 grams of fibre a day: This is the same as eating all of the following: 5 portions of fruit and vegetables, 2 whole-wheat cereal biscuits, 2 thick slices of wholemeal bread and large baked potato with the skin on
• Have some dairy or dairy alternatives (such as soya drinks) choosing lower fat and lower sugar options
• Eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily)
• Choose unsaturated oils and spreads and consuming in small amounts
• Drink 6-8 cups/glasses of water a day
• Adults should have less than 6g of salt and 20g of saturated fat for women or 30g for men a day
Source: NHS Eatwell Guide
‘Yet for other people that just doesn’t seem to work – there’s something going on in the brain, something in the level of hormones. It’s not a question of willpower, it’s not a question of making decisions. It’s at a much, much deeper level that we don’t really have full control over.
‘They’re constantly getting signals that they’re hungry and they feel physical hunger all the time. They’re constantly being sent signals to eat and so they might respond by overeating.
‘These are the people that need to get some kind of medical help to not do that and these are the people with the disease.’
Working alongside the University of Galway, they conclude excess adiposity – or fat – alone was not enough to be considered a disease.
Instead, those with physiological issues which mean they cannot regulate appetite, should be diagnosed with an illness but it should be given an alternative name to obesity.
This would encourage those who need it to seek help, according to the findings presented at the European Congress on Obesity in Dublin.
She added: ‘We need to think of the disease as being separate to the BMI category because there’s a relationship between them but they’re not the same thing.
‘Not everyone who’s fat has the disease – it might just be that your setpoint weight is higher but there’s nothing pathological going on. Equally, you can be thin and have the disease as well.’
The debate over whether obesity should be classed as a disease has raged on for decades, with the World Health Organisation classing it as such since 1936 while the NHS still refers to it as a term used to ‘describe a person who has excess body fat.’
Critics say medicalising obesity by framing it as a disease rather than a consequence of behaviour, can be counterproductive.
Dr Max Pemberton, psychiatrist and Daily Mail columnist, said it ‘takes away personal responsibility and places it with doctors’.
Comparing it to alcoholism and smoking, he said it is part of a wider trend to medicalise aspects of our life — to turn behaviours or choices into a disease.
But just as smoking is not considered a disease, obesity must be viewed similarly, he urged.
He said: ‘People who are overweight and want to lose weight should be met with compassion and support. But we can be kind and caring to people who are struggling without claiming they have a disease.
‘Disease suggests there is an inevitability when it does not have to be that way.
‘There are generic components, just like there are genes that predispose people to be much more likely to become addicted to smoking than other people.
‘But we would not classify smoking as a disease – it causes disease but we understand it as a behaviour that we have a choice in.
‘Even those who have genetic predisposition to become fat are not slaves to their DNA.
‘If we pathologize obesity, we fail to look at the complicated social factors that are involved and we almost stop considering the legislation and policy changes that are and can be made to address obesity.’
A weight loss drug helps patients lose nearly a quarter of their body weight, according to new analysis.
Tirzepatide, which is taken as a weekly injection, was tested 2,539 adults who were overweight or obese and had at least one weight-related complication, excluding diabetes. Over a 72-week trial period, those on the highest dose lost 23 per cent of their body weight.
Some 96 per cent of people taking 15mg lost 5 per cent or more of their body weight.
Some 63 per cent in the 15mg group lost a fifth or more of their body weight compared with 1 per cent on placebo. The drug’s manufacturers, Eli Lilly and Co, are seek approval from UK medical regulators for the use of tirzepatide in obese patients with at least one weight-related condition, such as diabetes or heart disease.
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