Five Stages of Accepting Obesity as a Disease

More than a month has passed since the AMA decision accepting obesity as a disease, and the media is still full of reports on the subject. Folks seem to be going through a grieving process as they let go of beliefs about obesity that must have given them comfort.

Every stage of the classic grief process is evident in comments about the decision that continue to surface.

Denial. We’ve been doing this since 1998 when NIH, the Obesity Society, and a host of other organizations issued guidelines for diagnosis and treatment, declaring that obesity is a complex, chronic disease. The classic attitude of denial was summed up beautifully by Bradley Fox, a family physician invited to participate in a roundtable published by Medscape:

Do I agree with the change? Do I think that obesity should be considered a disease? Not really. I don’t think that smoking is a disease. I don’t think that laziness is a disease. I don’t think that poor hygiene is a disease, so I need to be consistent and say that obesity is not a disease.

Anger. A lot of anger surfaces from fat acceptance activists who are justifiably ticked by the pervasive bigotry of weight bias. Here’s a sampling of that anger from a petition posted on by Marilyn Wann, author of Fat!So?:

Fat hatred in the medical community is already rampant and we do not need another reason to be treated like piles of [expletive].

Bargaining. Health insurance plans are the real pros when it comes to bargaining. Susan Pisano, a spokesperson for America’s Health Insurance Plans, was quick to say the AMA’s ruling won’t change anything:

What prompts changes in coverage are information, science, and evidence that something works and is safe. Whether you call something a risk factor, a condition, or a disease, that’s not what leads to coverage.

Depression. This sentiment is largely voiced on behalf of people with obesity by other people who usually don’t seem all that concerned about them. They predict that calling obesity a disease will be devastating. For example, the Center for Consumer Freedom, an organization funded by restaurant and food companies to fight health-related food regulations, put it this way:

Declaring obesity a “disease” will cause people who need to lose weight — and are making efforts to do so — to give up.

Acceptance. Let’s get on with the research, prevention, and treatment that will be necessary to finally get a grip on this chronic disease. It’s been hiding in plain sight for far too long. And it’s been extracting a growing toll on America’s health while we’ve been in denial about it.

Click here and here to read more.

Grief, photograph © debaird / flickr

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