We no longer perceive ourselves to be free people making good or bad personal choices from which we will either benefit or suffer. Instead, our personal problems are being medicalized—almost to the point that whenever we hurt ourselves, we are told it is actually a symptom of illness.
Obesity is the latest example. The American Medical Association has now declared obesity—not just the maladies it can cause, such as type 2 diabetes—a “disease.” Not only that, but the AMA makes it clear that those (like me) who think overweight people (like me) made ourselves that way are worse than silly:
The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.
That has it backwards. All smokers don’t get lung cancer, and all overweight people don’t suffer health consequences from their girth. Following the AMA’s reasoning, cigarettes should be considered a disease—or at the very least, smoking. (I hope I haven’t given them any ideas.)
Be that as it may, redefining obesity into a “disease” illustrates how the powers-that-be believe we lack capacity to keep ourselves well. We need “the experts” to do it for us.
That is certainly the AMA’s approach. The body urges “federal support of research” to determine “the causes and mechanisms” of becoming overweight, including “biological, social, and epidemiological influences on weight gain, weight loss, and weight maintenance.”
Federal agencies and their “stake holder” partners are also to “determine the long-term safety and efficacy of voluntary weight maintenance and weight-loss practices and therapies.” And of course, where would the solution to a nationwide epidemic caused by behavior be without the creation of a “multi-disciplinary task force”—already as ubiquitous as ants—“to review the public health impact of obesity and recommend measures to better recognize and treat obesity as a chronic disease”? Coming soon: The National Obesity Awareness Month, to be created “in collaboration and coordination with programs and activities of appropriate agencies,” of course.
New York’s nanny Mayor Michael Bloomberg must have gotten tears in his eyes at the AMA’s call to:
Develop a school health advocacy agenda that includes funding for school health programs, physical education and physical activity with limits on declining participation, alternative policies for vending machines that promote healthier diets, and standards for healthy à la carte meal offerings.
Yes, the AMA supports sugar taxes. And, coming from the other direction, the group wants studies funded to investigate “potentially adverse effects of long-term consumption of non-caloric sweeteners.” Damned if you do; damned if you don’t.
Perhaps the most important point, from the AMA’s perspective, is to ensure that doctors get paid. Thus, the group urges “the appropriate federal agencies to work with organized medicine and the health insurance industry to develop coding and payment mechanisms for the evaluation and management of obesity.”
The AMA’s embrace of obesity as a “disease” should be seen as part of a far larger international effort to link the problem to other imperatives supposedly requiring bureaucratic solutions, like global warming. For example, a proposal—funded by grants from the National Institutes of Health and the Robert Wood Johnson Foundation—was published in the medical journal The Lancet (August 2011)offering technocratic policy remedies in the U.N. to prevent obesity that were nearly identical to policy agendas to combat climate change.
Consistent with the AMA’s prescription, the stated goal of international fat fighters is to fashion “integrated interventions throughout society—individuals, families, local, national, and international,” as well as “interventions across the life course for all demographic groups to reinforce and sustain long-term behavioral change.”
The authors make the connection explicit. “Obesity,” they write, “should be considered alongside other major issues that confront societies ... [including] reduction of poverty in all countries, a sustainable food supply, and action against climate change, because they all have strong links with obesity prevention, including common causes and solutions.” (My emphasis.)
So what we see here is a large helping of politics, not just science. This is why the technocracy—which threatens to smother society like the old movie monster The Blob did Steve McQueen—never stops growing.
Medicalizing our social problems isn’t healthy. It undermines personal responsibility and renders important character-building virtues such as self-restraint and discipline hopelessly passé. Lowering expectations for individual behavior is the real “disease” afflicting the modern age, and well-intentioned “experts” are the vectors.
Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. He also consults for the Patients Rights Council and the Center for Bioethics and Culture.