The question of whether an obese person is always sick is at the heart of a controversial debate in modern medicine. According to a study published in the Lancet Diabetes & Endocrinology, experts propose a new definition of obesity, emphasizing that the body mass index (BMI) is insufficient to assess it.
“The idea that obesity is a disease is at the root of one of the most controversial and divisive debates in modern medicine,” summarizes the work published Wednesday in the Lancet Diabetes & Endocrinology.
The long article is signed by several dozen obesity specialists. They agreed to redefine the way in which this condition is characterized, as well as the problems it represents on a medical level. The subject is very delicate, because it regularly provokes bitter debates which go beyond the medical community alone.
We know that obesity is associated with a wide range of pathologies such as diabetes or cardiovascular diseases. But for some observers, an obese person can sometimes live in good health and their excess weight should therefore not only be considered as a risk factor.
WHO recognizes obesity as a disease
For others, obesity is necessarily a health problem, which must be considered as a disease in itself. This is the view of the World Health Organization (WHO).
The new recommendations from global doctors, notably from the University Hospitals of Geneva, seek to qualify the definition of obesity: in summary, obesity can be considered as a disease, but not systematically.
However, this recognition from the WHO will make it possible to “improve management and also patient care”, explains Wednesday in the 12:30 p.m. of RTS Farpour-Lambert, pediatrician, associate doctor at HUG and consultant for the WHO .
She specifies that this should make it possible to adapt the healthcare system and improve access to treatments. Currently, the criteria for access to drug treatments are too strict.
In Switzerland, people affected by obesity are not yet sufficiently supported. “Around 700,000 adults, 50,000 children and adolescents are affected by obesity in Switzerland, but less than 10% of adults and less than 1% of children receive adequate treatment,” underlines Nathalie Farpour-Lambert.
Obesity redefined beyond BMI
In their report, the experts emphasize a now consensus point: the body mass index (BMI), which measures the ratio between weight and height, is insufficient to correctly assess obesity.
It would need to be supplemented by other examinations to decide whether a patient is obese: measuring their waist circumference for example, or, using radiology techniques, estimating the quantity of fat in the body.
But even if a patient is declared obese, experts do not necessarily judge that this should be seen as an illness. According to them, it is only if organs show signs of dysfunction that obesity becomes “clinical”.
Without this, they call for talking about “pre-clinical” obesity. It would then not be a disease, but a condition which essentially requires preventive measures, and not necessarily medicinal or surgical treatments, in order to avoid “overmedicalization”.
Radio subject: Pauline Rappaz
Web adaptation: agencies/Miroslav Mares
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