Obesity: social choice or a disease?

Obesity is defined as someone who is overweight with a high proportion of body fat; the body mass index of an obese person would be between 30 and40 and above 40 would be classified as morbidly obese. A disease is a disorder of structure or function and produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

Therefore the symptoms of obesity are weigh gain, with combined increase risk of other illnesses such as type 2 diabetes, colon cancer and heart disease, as well as further social issues such as depression. These symptoms can arise due to an underactive thyroid gland, also known as hypothyroidism, where a lack of thyroxine means the patient has a lower metabolic rate, therefore more food is stored as fat. Furthermore weight gain can be a secondary impact of reduces physical exercise due to fatigue which is also a symptom of hypothyroidism. Another example of obesity not being a social choice is due to excess levels of cortisol secreted from the adrenal cortex, diagnosed as Cushing’s syndrome. There is a build-up of fat stores on the abdomen, face, neck and upper back, because the excess cortisol does not increase the metabolism of protein and carbohydrates. Instead it slows down or disables metabolic reactions inside the body.

However on the other hand, the majority of the obese patients, have a high proportion of fat, and a high BMI due to eating more calories than are burnt, and the excess is stored as fat. This would be described as a social choice, although there are many influencing factors such as access to cheap, high energy foods, the increased use of cars or public transport and also less active jobs. Nevertheless it is a social choice on the food consumed, and the lack of exercise and individual does.
Although obesity is considered a social choice, on the other end of the spectrum, anorexia nervosa is a condition when someone is severely underweight with a BMI of less than 17.5. Unlike obesity anorexia is a mental health condition, and therefore not defined as a social choice. This gives the perception that obesity is easily curable through change in lifestyle, whereas anorexia is harder to cure and needs medical intervention. However should obesity not need medical intervention when it causes increased health risks?

Finally recently on the news, was a story of a five year old girl who was ten stone and taken in to care. Although this is due to excessive consumption of food and lack of physical exercise, it cannot be considered a social choice. Parents have primary control on raising a child, therefore the type and amount of food consumption is provided by parents or guardians and at a young age there is vulnerable knowledge to the need of exercise. There are many social and medical problems associated especially with childhood obesity. The medical condition consists of type 2 diabetes; high blood pressure, high cholesterol and asthma, but the more concerning are the social impacts of depression, teasing, discrimination and low self-esteem. For both the medical and social reasons lowering the quality of life for the child, it can be defined as a type of child abuse.

References:

http://www.nhs.uk/conditions/Obesity/Pages/Introduction.aspx
http://www.nhs.uk/conditions/Anorexia-nervosa/Pages/Introduction.aspx
http://www.medscape.com/viewarticle/778000_1