Abstract
Summary In June of 2013, the American Medical Association (AMA) announced a change to their nomenclature. Obesity henceforth would be considered a disease and not simply a risk factor. The decision to categorize obesity as a disease is both a scientific and a moral one, a decision that forces society not only to confront the meaning of disease itself but the implications of medicalizing mass and drawing norms based on its measurement. Cast in an historical light, medicalization of conditions has led to dramatic social and political effects on those with the given condition of interest. While there are many ways to define disease, most definitions are indefinite regarding the classification of risk factors like obesity. In such cases, the decision to classify obesity, as a disease should be pragmatic, focused on how such decisions will impact society. This paper outlines how best to determine what ought be considered a disease before concluding that in those cases where disease status is indeterminate, conditions should be categorized as disease only if such categorization will improve health outcomes for those individuals. Obesity, as a condition, exists in such an indeterminate zone of categorization. It does not fit neatly into a Wittgensteinian notion of disease nor do other methods of disease ascriptions hold weight. As such, only the outcomes matter – and if obesity is designated a disease, the health outcomes for those affected will be worse. Disease ascription will promote stigma and thus poor eating and inactivity. Disease ascription will promote individual-level interventions for a condition that requires public health and community-level interventions. Finally, disease ascription will gloss over the inaccuracy of BMI as a means by which to determine health. Ultimately, disease ascription will cause more harmful health outcomes for an already vulnerable population. In this light, the AMA should reconsider its decision in light of such outcomes.
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