Opinion: Obesity should be viewed as a disease – Canada.com


Posted: March 6, 2020 at 5:41 am

"Many people think that those with obesity simply need to lose weight to be 'cured.' Is it really that simple? With obesity, there are a number of changes that occur in our bodies that make it difficult to lose weight," Sylvia Santosa and David Secko write.

By Sylvia Santosa Special to Montreal Gazette

On World Obesity Day, March 4, organizers hope people will reflect on how obesity and being overweight affects more than 1.9 billion adults and 380 million children. According to the World Health Organization, deaths worldwide from obesity and being overweight are more common than deaths from being underweight. Though there are still many questions to be answered about obesity and obesity treatment, one thing seems clear: obesity is a disease that parallels aging.

Children with obesity can develop hypertension, high cholesterol and Type 2 diabetes. These are conditions usually only seen in adults.

People with obesity, on average, die about seven years earlier than those of normal weight. We also know having obesity puts you at risk for many conditions and diseases, including Type 2 diabetes, impaired mobility, hypertension, sarcopenia, cardiovascular disease, cancer and Alzheimers disease, all of which are also linked to aging.

Hit the molecular level and the linkage looks even more intimate. In both aging and obesity, there is greater free radical formation, energy-producing mitochondria in our muscles start to fail and inflammation becomes chronic. The immune cells in our body that fight infections also weaken with both obesity and aging. Even our DNA is affected with obesity. The telomeres that protect our DNA have been found to be shorter with obesity to a degree that aging is accelerated by eight years.

But obesity is not just a condition that accelerates aging: obesity should be viewed as a disease that accelerates aging. Obesity clearly changes the function of body systems resulting in adverse health outcomes, but there still is a debate over whether obesity is, in fact, a disease. If you look at the definition of a disease, part of the controversy may surround the term normal functioning. What is normal? One could argue that weight gain and the eventual classification of obesity is a normal adaptation to energy surplus. Here, some view obesity as arising from an unhealthy lifestyle, one that is fraught with too much food and too little exercise.

Yet, there is no question as to whether other diseases associated with lifestyle are in fact diseases. There is no debate over whether cardiovascular disease, cancer or Type 2 diabetes are diseases, even though they have significant lifestyle components. One might respond that these diseases do not only result from lifestyle choices, but our genes as well. But genes have also been linked with the development of obesity. After all, dont we all have that friend that can eat twice the amount of food than we do and stay thin as a toothpick?

Many people think that those with obesity simply need to lose weight to be cured. Is it really that simple? With obesity, there are a number of changes that occur in our bodies that make it difficult to lose weight. It is estimated that weight-loss treatment of obesity through lifestyle is successful in only 20 per cent of people. Most who have kept off the weight will tell you that it is a lifelong struggle.

We would argue that aging and obesity are actually two sides of the same coin. The fact that so many people are affected means we need to act faster to address obesity. Understanding obesity as a disease of premature aging might be the spark we need, for example, by applying abundant research in aging to obesity in order to generate new solutions. Accepting obesity as a disease that accelerates aging will allow us to shift our approach to understanding obesity and its treatment. And that new framing might bring a new awareness of the urgency to act on such a serious health threat.

Sylvia Santosa is an associate professor in the Department of Health, Kinesiology and Applied Physiology at Concordia University and a Canada Research Chair in Clinical Nutrition. David Secko is a professor in, and chair of, Concordias Department of Journalism.

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