AMA declares obesity a disease

Fat and Poor? Time to get to work


A friend of mine shared this article regarding the AMA’s decision to declare and classify obesity as a disease. You can read it here. The article mentioned two things that struck me. The first was that the pharmaceutical companies would be pleased because of the associated increase in production and sales of weight loss drugs, because reclassification as a disease means insurance companies will likely have to start covering weight-loss medications. Then there was this:

Some hope that designating obesity as a disease will remove the stigma associated with it, and obese people will no longer be blamed for their condition. Yet already it is being called the “fork to mouth” disease, and the disease categorization may reinforce blame by raising the stakes. If obesity is a disease, parents of fat children may not merely be silently judged as bad parents but also accused of neglect and child endangerment.

For those families living in poverty – a significant number of them headed by women – some of the same root causes and correlations of poverty are the same as those for obesity.

According to Donna Beegle, PhD:

Food stamp values amount to $3 per person a day today, she said. “People say there’s no hunger in America, there’s obesity,” she said. “Well, that shows our ignorance about what you can buy for $3 a day. You buy what fills you up. You can’t buy health food.”

This statement is supported by this 2004 article from The American Journal of Clinical Nutrition: Poverty and obesity: the role of energy density and energy costs1,2

Among women, higher obesity rates tend to be associated with low incomes and low education levels . . . Although obesity rates have continued to increase steadily in both sexes, at all ages, in all races, and at all educational levels (26), the highest rates occur among the most disadvantaged groups.

Food insecurity and obesity also appear to be linked . . . food insecurity was defined as “limited or uncertain availability of nutritionally acceptable or safe foods . . . Households with children were twice as likely to report food insecurity (35). Among low-income families, food insufficiency was associated with single-parent families, not having health insurance, and having a family head with < 12 y of education.

I am a medically obese woman, living in poverty, with untreated physical and mental health conditions. I do have some college education, however, I haven’t yet been able to obtain a degree and have massive amounts of educational debt.

I live in a subsidized housing property with a tiny kitchen, little storage, and less food preparation space. I have recipes and knowledge about how to plan menus and prepare healthy meals. I don’t have some of the basic equipment and tools to prepare homemade meals. Some of the equipment I do have is cheaply made and damaged to the point it probably shouldn’t be used. I can’t afford to purchase things like mixing bowls, casserole dishes, food processors, and juicers. Because of the fatigue, sciatic/back pain, and neuropathy in my hands the time and effort required to prepare a healthy meal means, I am not able to do the prep and clean-up and have the capacity – mentally, emotionally, and physically to constructively interact with and keep up with my four year old. My story is not unique.

I make the healthiest choices I can afford to – financially and in other ways. I am making changes in my activities and working hard to prioritize my values over both my physical and emotional feelings. There is a lot I had given up on in terms of myself and the goals and dreams I once had. I am fighting hard to forge a new path and create a new future for myself and for my family within the context of illness and poverty.

I’m overcoming overwhelming feelings and attitudes of guilt and shame, which have been informed and exacerbated by prejudices, myths, and stigmas associated with things like mental illness, obesity, race, gender, and poverty.

What are some of your beliefs and assumptions about poverty and obesity? How do these things affect how you look at and think about the people in your community based on their physical attributes and external behaviors? Do you know where those assumptions, beliefs, and attitudes come from and if they are based in actual reality or based on sound-bites and extreme examples?