Obesity is now akin to liver disease and heart attack where all the focus is on how the poor victim will cope with the new onset of the disease and how we as social animals can help them cope with this terrible affliction that God (atheists read Nature) has cursed them with. There are clearly similarities with heart and liver disease that cannot be ignored. A chronic smoker smoking 3 packs a day for the past 20 years gets a heart attack at 45 years of age. Any sympathisers? Oh yes, Other smokers! An alcohol abuser gets cirrhotic liver disease at 35 years of age. Are you empathising with a can of beer in one hand and the mouse in the other? This heart attack and cirrhosis are very similar to those caused by other illnesses as well to a significant degree. Would you treat them like any other heart attack and cirrhosis or would you distinguish between heart-attack-despite-health-lifestyle and heart-attack-of-smoking? Unfortunately No. Is it purely because we cannot tease out the contribution of smoking from other factors causing heart attack in that smoker? Or is it because you are someone who has lived your entire adult life fearing about accusations of discrimination?
So how is obesity different you ask. Please see my blog on secondary obesity. Will the AMA distinguish between genetic and lifestyle obesity? Or between obesity due to hypogonadism or that due to emotional overeating? If not, they are doing humanity a grave injustice by legalising food-related highs. Columbians will be clamouring to legalise cocaine next. They may even argue that if food is legal why is cocaine not? Both are addictive and food is even worse in that it probably kills more people worldwide than cocaine. (no reference available, just my suspicion).
Currently in the UK, viagra is available for free on the NHS only if the erectile dysfunction is secondary to a disease process like hypogonadism or vascular damage. It has to be paid for if you merely need it to keep your family together. In a similar vein, if the recognition of obesity as a disease crosses the atlantic, would there be patients who would have to pay for obesity treatments versus those who wouldn't have to? I can already hear the shouts of "double standards" and "two-tier system" from the "free-at-the-point-of-care-with-no-questions-asked" brigade. Why is healthcare in Africa poor at diagnosing this disease? Do we need a better and sensitive diagnostic test that can detect this disease in blacks? We have supplied many countries with food and weapons. Suddenly it seems like neither was a good idea after all....
At the end of the day, it is a victory for the obese. They have been absolved of their sins as well as their responsibilities. Millions of poor things have been struck down by the hand of god in their youth. Born with great potential they were stopped from achieving their dreams and aspirations by this deadly life-changing disease that has destroyed their lives and their families' lives. And despite all this suffering, the government has failed them. Lawyers' field day. New nightmare for insurers. But all I am worried about really is what is the obesity SHMI (summary hospital level mortality Indicator) for my hospital going to be next year?