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Obesity: take a pill, or take the stairs?

Sorry boss, I'm having an acute obesity attack and can't come in today.

Sorry boss, I'm having an acute obesity attack and can't come in today. Photo: iStock

With a change of leadership in Canberra, the news is filled with Labor versus Liberal arguments: the boats, the carbon tax, Work Choices, Gonski, etcetera.

Yet the elephant in the room that costs Australians $120 billion per year, or about 8 per cent of Australia's annual output, still receives little attention – obesity.

The American Medical Association released a statement two weeks ago officially concluding that obesity is, in fact, a disease. Given the US's obesity statistics mirror our own, how the US is tackling the issue may inform Australia's response.

If the Australian medical community considers making the same statement, I hope they will consider the following:


Pharmaceutical companies make billions from individuals leading unhealthy lives. Is the classification of obesity as a disease an easy way for big business to make bigger profits? When something is called a disease, it's the green light for more laboratory research that results in more surgeries, more pills, powders, and potions … and more profits.

Emotional weight gain

I'm in touch with numerous readers of this blog, many of whom tell their personal stories. One told me of their physical abuse as a child. It made me realise the 'eat less, move more' approach doesn't always apply. Once physically healthy and fit, abuse lead to this person to over-eat in order to make themselves unattractive. Is a GP's office the place to start discussing and treating such emotional issues? Running, healthy eating, or weight loss pills and surgeries aren't the cure for emotional weight cases. Doctors would need to be retrained to treat such patients … or maybe the doctor's office isn't the right place to start.

'I have a disease'

What does that mean to an individual? After the American Medical Association made its obesity declaration, one-third of adult Americans suddenly had a disease. What might be the psychological implications of such a statement to millions of Australians? In the US, only time will tell.

Common sense

Imagine an overweight Australian going to a country where people go hungry every day, where children are malnourished and underfed most days, and claiming 'I have a disease.' Sometimes some common sense has to kick in – calling gluttony a disease might be insensitive to people who don't know where their next meal is coming from.

The prescription

Will doctors prescribe weight loss pills? Or dish out “20 per cent off” coupons for a new pair of Nikes with a healthy eating plan? The former is putting a Band Aid on a gunshot wound; the latter are the tools for patients to cure themselves. I wonder which option doctors will prescribe with recurring revenue (ie. refilling medicine prescriptions) at stake? Pharmageddon lurks again.

Work issues

Imagine this SMS sent by thousands, with a doctor's note to verify it: “Boss. Too much pizza last night. Disease flared up; I'm bloated. Staying home. See you tomorrow.”

The kick in the bum

I've been that lazy, chubby chap, and I made a lifestyle change. I had done the pills and potions, but once I confessed to myself that my gut was due to way too much booze, fizzy drinks, and eating fast food meals while lounging all day … I turned it around by booting myself in the arse and changing my lifestyle.

Do it yourself

The lazy majority don't need a doctor. They don't need pills, and they don't need surgery. Just a pass to the local gym and a healthy eating plan – a simple solution that many men and women can take on without a doctor's visit.

Yep, you can probably read between the lines to sense my opinion. Yet, I definitely consider cancer a disease. Every family has been affected by it, and cancer sucks. But when an individual smokes three packs a day and contracts cancer, might that be the same situation as somebody overeating and 'contracting' obesity and its related ailments? That question alone makes my opinion waver.

Some folks think we are too liberal in calling addictive behaviours a disease – sex, gambling, and even internet and video game playing. So I'll take the stance: Obesity is not a disease.

I contacted a reader to get his 'professional' opinion. Andre is a father and husband who first got in touch with me because he wanted to eat healthier so he could spend a few more months with his family … because he has a disease more terminal than cancer called pulmonary fibrosis.

Andre says: “I think they are very, very wrong. Obesity in a person without a genetic disposition cannot be considered a disease. By definition the 'habit' can be the reason, however a conscience decision or 'habit' to me that is wrong, and can be controlled – is a choice. A choice the Western world makes numerous times incorrectly.”

Meanwhile, emeritus professor Paul O'Brien from Monash University's Faculty of Medicine states: “Yes. Obesity is a disease. First, the obese person will accumulate multiple health problems because of their obesity and can be predicted to die younger. Second, obese people are not well. They suffer numerous physical and psychosocial deprivations due to their obesity.”

Dr Andrew Rochford from Channel Ten's The Living Room program adds: “The AMA officially adopting the definition of obesity as a disease is all well and good, and I agree that it is a serious enough issue that ticks all the clinical boxes to warrant such a definition. But it is only worth changing the definition if it leads to a significant change in the nation's obesity plan of action ... at all levels, from government down. It has long been referred to as the 'obesity epidemic' so it's not a huge step to officially call it a 'disease'; I can appreciate the classification, but the fact is, action is truly what's needed.”

Opinions vary. It's an interesting discussion, a difficult one, and of enormous medical and social importance in affluent, developed societies worldwide.

I'm just not sure the doctor's office is where this discussion progresses. Joan Welsh said it best: “A man's health can be judged by which he takes two at a time - pills or stairs.”

If in the next 10 years obesity is set to cost us in excess of one trillion dollars, who should we count on to solve the problem – government, doctors, or corporate wellness programs?

One simple and inexpensive answer is staring right back at you in the mirror.

Should obesity be classified as a disease in Australia?

Email Michael here; follow him on Twitter here.


  • This generation of fatties is doomed. We need to concentrate on the children with early intervention to prevent them from becoming overweight. Before the age of 18 fat cells multiply as a child puts on weight, making it harder to lose weight as an adult. However after the age of 18 any weight gain means that the cells only get larger, they don't multiply.

    Obesity is not being taken seriously by governments which are kowtowing to multinational junk food conglomerates, advertising business and the grocery lobbyists.

    The cheapest way to "cure" the "disease" these fatties have would be a one-way ticket to a refugee camp in Sudan.

    Date and time
    July 03, 2013, 12:42PM
    • You're wrong. People in refugee camps overseen by the United Nations are often overweight, reason being the food they're provided with is high calorie, low nutrition, shelf stable. Flour, pasta, beans, sugar, oil etc.. When they arrive here their blood tests often show the sorts of deficiencies rarely seen here. One refugee family I welcomed at the airport a couple of years ago showed both parents overweight, and they've since lost weight being able to eat a much healthier diet including much more fruit and veggies.

      Date and time
      July 03, 2013, 1:54PM
  • Part of the problem is that there is so little consensus as to specific causes of and fixes to obesity, and this may result in legislation to tackle obesity that is wrong headed and may entrench incorrect assumptions, causing more harm than good.
    For example traditional wisdom is that eating fat is bad for weight loss and jogging long distances is good for weight loss, whereas a growing body of evidence suggests that basing your plan on such simplistic assumptions can be counter-productive.

    Date and time
    July 03, 2013, 12:48PM
    • That is true, Al, but more relevant to people of more typical girth who are trying to lose weight or merely stay in shape.

      I have never met an obese person who did not overeat. Indeed, most obese people seem to act towards food in a similar way that a junkie does towards drugs or an alcoholic towards booze. That is, they are clearly unable to control their eating and are normally in complete denial about the amount they eat. Therefore, in my view, obesity and overeating should be treated more like an addiction than anything else.

      Date and time
      July 03, 2013, 1:37PM
  • Food Addicts in Recovery Anonymous (FA) is a free Twelve Step recovery program offering a solution for anyone suffering from any form of food addiction including overeating, bulimia, under-eating, or food obsession.

    FA has meetings throughout Australia.

    If you would like more information about FA, please visit our website:

    FA Sydney
    Date and time
    July 03, 2013, 12:53PM
    • So lazy is a disease now? Idiocracy here we come.

      Date and time
      July 03, 2013, 12:54PM
      • Plenty of obese people are not lazy in other areas of their life. Plenty of non obese people are chain smokers and can't give up. Plenty of non obese people are unable to finish uni courses etc. Plenty of people have willpower for some things and not others, something that's virtually NEVER mentioned in posts where people accuse the obese of being lazy.

        Date and time
        July 03, 2013, 1:56PM
      • Why do people assume obesity = lazy? I've met ALOT of workaholics in my life who are obese. guess why they are obese? cos they are workaholics and are married to their job that hey do not have time to look after their health or eat properly.

        I've noticed alot of these workaholics tend to binge eat too. Alot of them are so busy they forget to eat that when they become so hungry. they eat 3 big macs in a row to quench their hunger.

        Must be great for you to have alot of spare time to cook nice meals and have spare time to be able to go to the gym daily

        Date and time
        July 03, 2013, 2:23PM
      • My view on this is that it shouldn't be called a disease, because by doing so it will provide an excuse to those that are obese by choice. It would seem that the majority of cases are derived from apathy, whereas there are others that have genuine reasons for being overweight, such as genetics, depression or the taking of medication that decreases metabolism.

        I have been bordering on obese myself in the past (now i'm a healthy BMI of 23.8). Then I got a corporate job in Sydney and after looking at some of my colleagues, I started to feel ashamed about the fact I was overweight. The reasons for obesity are complex, however for me it was because the people in my environment changed and they influenced me to lose weight and take pride in my appearance. Had obesity been classified as a disease I may have had an excuse not to lose the weight.

        Let's Make Sandwiches
        Date and time
        July 03, 2013, 2:32PM
      • @ZZZzzz

        Sorry, but no. I work long hours, but have found ways of healthier living. Instead of taking a lunch break, I go for a run and then eat at my desk. When it's warmer, instead of driving/commuting home I run. Given the traffic in CBD areas, it doesn't take much longer.

        Workaholics being too busy to eat? I have never met anyone so busy that they couldn't work while eating an apple; I make sure I always have some sitting on my desk.

        As to not having time to prepare food; been there. Know what? You can cook a week's worth of meals in a couple of hours on the weekend, and chuck them in the freezer. Just takes a bit of planning.

        Don't get me wrong, until quite recently I was in the 'I don't have enough time to get fit' camp. I am still overweight, but I have realized that it was me, and not my job, that was the reason.

        Date and time
        July 03, 2013, 3:25PM

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