The Pont de Europe (study)

Defining the Disease of Obesity in Europe

Defining the disease of obesity is quite a struggle. Everybody is certain they know what it is. Thus, many people adopt definitions that suit their purposes. Feelings about obesity run so deep that facts are mere annoyances. But on World Obesity Day, the European Commission published a definition of obesity as a chronic relapsing disease. Because it is so clear and concise, both scientists and people living with obesity are joyous about it.

Where Accuracy Is Remarkable

It might seem odd, but the accuracy of this definition was remarkable:

“Pre-obesity (overweight) and obesity are medical conditions marked by an abnormal and/or excessive accumulation of body fat that presents a risk to health ( WHO 2019 ). Obesity is a chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases, such as diabetes, cardiovascular diseases and cancer.”

It is remarkable because it leaves behind some stupid squabbles that get in the way of progress to overcome obesity. Some folks like to tie obesity solely to BMI. Then they stir endless debates about the validity of BMI and, by inference, obesity. Some even define obesity as a behavior, not a health condition.

Nathalie Farpour-Lambert is president of the European Association for the Study of Obesity (EASO).

“It is truly a milestone for Europeans either at risk of or having already developed obesity to be acknowledged as living with a chronic disease. Although primary prevention is the ideal, the sad fact is that almost 60% of the EU population already lives with pe-obesity or obesity. The publication of the European Commission’s Obesity Prevention Brief therefore represents the start of a collaborative drive to effectively address obesity as a chronic relapsing disease that embraces policy interventions that can go beyond primary prevention.”

The Imperative to Address NCDs

For the health of the world, addressing non-communicable diseases (NCDs) has become a huge priority. For one thing, NCDs are now the most common cause of death and disability worldwide. This was true even before the COVID-19 pandemic. But now, with the pandemic, NCDs are are clearly a key factor in the risk of death from infectious diseases. In fact, a recent study linked severe obesity and five other NCDs to a greater risk of infection deaths.

A stumbling block remains with how we define obesity. Just as the European Commission has done, more and more experts are coming to the view that obesity is an important NCD. A few others still prefer to treat it as a risk factor or a behavior instead. But the tide is running against that view because the real, lived experience with obesity tells a different story.

Obesity is a complex chronic disease with environmental, physiological, and behavioral dimensions. Embracing this reality is the first step toward overcoming it.

Click here and here for more on the European Commission’s recent policy publication on obesity. For more on the importance of NCDs in the response to COVID-19, click here.

The Pont de Europe (study), painting by Gustave Caillebotte / WikiArt

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March 14, 2021

3 Responses to “Defining the Disease of Obesity in Europe”

  1. March 14, 2021 at 10:31 am, Michael Mantell, Ph.D. said:

    “Obesity is a complex chronic disease with environmental, physiological, and behavioral dimensions. Embracing this reality is the ‘first step’ toward overcoming it.”
    We’ve heard and been singing this “chronic disease” song for many, many years.
    “First step”? “Overcoming it”?
    Seems, then, that the obesity industrial complex merry-go-round continues to be spinning on that same “first step” with little real progress – if any – in turning down the numbers of the pandemic of this raging disease.
    Now it’s an “NCD,” an “environmental” or “physiological” based complex disease, not a “risk factor,” or a “behavior” (but does have these dimensions).
    It’s all of the above, and more, with many points of entry, no one of which has brought much other than another opportunity to create a new definition juggling words around, create more graphics, a new column chance to criticize another approach, while the world continues to grow heavier.
    Let’s embrace and be curious about that. 😊

  2. March 14, 2021 at 12:06 pm, David Brown said:

    In my view, obesity is best characterized as a symptom, not a disease. Like obesity, chronic cough, sore throat, and post nasal drip are symptoms that can arise from various causes. And like obesity, if the cause cannot be determined, the symptom gets treated.

    In this era of industrial food, most obesity seems to stem from imbalanced and or excessive omega-6 polyunsaturated fatty acid intake. The field of nutrition continues to ignore arachidonic acid research. Perhaps that the reason no country on Earth has been able to reverse the trend toward more and more obesity.

  3. March 14, 2021 at 12:30 pm, Ted said:

    Thanks, David. I have my doubts that omega-6 polyunsaturated fatty acids explains most of our problems with obesity.