Opinion

Obesity is clearly a disease and not a reflection of "individual failure"

LETTER — Posted April 10, 2006

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Regarding "Is obesity a disease? Clinicians disagree" (Article, Feb. 6): To deny that obesity is a chronic, relapsing, neurobiological disease is tantamount to ignoring the last 50 years of medical progress. Far from being the disgusting, volitional disorder reflecting individual failure, a view shared by most Americans through their mass-media tainted eyes, it is now known to be associated with significant hypothalamic, neuroendocrine and physiologic dysregulation. Once the obese state is established, the body vigorously defends against negative energy balance via persistent changes in appetite, resting and active energy expenditures, muscle energy efficiency and nutrient partitioning, among others. These changes are well-documented in published, peer-reviewed studies.

Like virtually every other chronic medical condition, treatment termination is associated with return of the underlying condition or, as in this case, the recidivism that is commonly associated with weight management. This result, however, does not equate to personal failure and does not negate the fact that obesity, once established, is a disease state, currently with limited, long-term medical treatment modalities and long-term treatment results.

Michael D. Myers, MD, Los Alamitos, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/04/10/edlt0410.htm.

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