by Terry O'Neal-Cox MD

Created on: March 31, 2009

Obesity: Is it a disease or a choice?

This question is one that has brought about a significant number of debates. The question lends itself to more answers than the choices given. To answer the question, one must first choose "disease" or "choice", and defend that position. But this is clearly a multiple choice question that, intentionally or unintentionally, left out two additional choices. Those choices are "both" (disease and choice) and "neither" (disease or choice).

In answering the question fully, I am assuming that the question is directed at humans with an intact cognitive ability and not at lower animals. It is also important to assume that the answer to the question is independent of emotional or egotistical involvement, and can be proven by facts. To do this, it is necessary to understand the lexical definition of the words: obesity, fat, disease, and choice.

First, what is obesity? Defined, obesity is "an excessive accumulation of body fat or adipose tissue". The degree of excess is measured by a formula called the "Body Mass Index" (BMI). The formula uses weight and height to determine habitus; if one is of normal weight, overweight, or the extreme which is called obese. The BMI is a function of weight divided by height. Normal (BMI) weight is given a value of less than 25; being "overweight" has a BMI between 25 and 30, and "obesity" has a BMI greater than 30. In other words, for example, take any given height, and you can now manipulate the formula by changing the weight (100/5=20; 150/5=30; 200/5=40). It is much easier to change one's weight than to change one's height. Weight changes as the amount of fat increases or decreases.

Ignoring the complexities of structure and composition of fat, it suffices to define human fat as an accumulation of tissue that is used for the purpose of storing extra energy (Calories). A calorie is a unit of energy the body uses to perform any given function, like the energy required to breath while reading this article. A Calorie from food eaten at a "fast food joint" is the same as one from "organic" food or from French Cuisine. Fat is essential to human life. Without fat humans would not be able to use a lot of the essential vitamins, and the structure of our cells would be unstable. We would have no means to store the excess energy (Calories) for use during a period when we are ingesting (eating) less than our daily requirements. In a simple form, let's think of our body's function similar to that of a car. In order

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