Philosophical determinants of obesity as a disease

Kilov, Daniel; Kilov, Gary

doi:10.1111/obr.12597

Cited by 18 publications

(20 citation statements)

References 55 publications

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“…We chose to include obesity as a chronic condition because it is known to develop over time, be associated with poor health outcomes and functional limitations, and there are existing strategies for its prevention and treatment. [17][18][19][20] We chose the CDC recommendations because we were interested in the prevalence of activity limitations among those with individual chronic conditions and by number of chronic conditions, without specifying one condition as the index condition (i.e., clinically dominant or most important) and without weighting conditions based on risk prediction models.…”

Section: Chronic Conditions and Multimorbiditymentioning

confidence: 99%

Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old

et al. 2019

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BACKGROUND: Functional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64 years old. OBJECTIVE: To describe the prevalence of activity limitations and the association with multimorbidity in middleaged adults. DESIGN: Cross-sectional analysis of US populationbased National Health and Nutrition Examination Survey (NHANES) 2011-2016. PARTICIPANTS: The total number of communitydwelling NHANES participants aged 50-64 years old is 4217. MAIN MEASURES: Chronic conditions included hypertension, high cholesterol, diabetes mellitus, obesity, chronic kidney disease, cancer, stroke, coronary heart disease, heart failure, chronic obstructive pulmonary disease/asthma, arthritis, and depression. Activity limitations were defined as any difficulty within each of four International Classification of Functioning (ICF) domains: functional limitations (kneeling, carrying, standing, sitting, reaching, grasping, pulling), mobility (walking ¼ mile, climbing 10 steps), basic activities of daily living (BADLs; walking, transferring, eating, dressing), and instrumental activities of daily living (IADLs; finances, chores, cooking). We calculated prevalence ratios for activity limitations using generalized estimating equations. KEY RESULTS: The prevalence of functional limitations, mobility limitations, BADL difficulty, and IADL difficulty was 34%, 11%, 15%, and 17%, respectively. Seventy-two percent of participants had two or more chronic conditions; 23% had two, 18% had three, 15% had four, and 16% had five or more. Multivariable adjusted prevalence ratios (95% CI) for functional limitations among those with 2, 3, 4, and 5 or more chronic conditions, compared with 0-1 conditions, were 1.94 (1.43-2.63), 2.50 (1.93-3.23), 3.26 (2.48-4.27), and 4.54 (3.48-5.93), respectively (p trend < 0.001). Larger prevalence ratios at a higher number of chronic conditions were present for mobility limitations, BADL difficulty, and IADL difficulty. CONCLUSIONS: Problems with function are not limited to older adults and multimorbidity may be helpful for identifying middle-aged adults with a high prevalence of activity limitations.

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Section: Chronic Conditions and Multimorbiditymentioning

confidence: 99%

Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old

et al. 2019

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“…According to the philosophy of medicine, disease when viewed through the naturalist lens is characterized by biological dysfunction. 53 Thus, for an individual with common obesity, the disease state can be viewed as an emergent phenomenon whereas in those with monogenic obesity, an inherent one. Collectively, this poses a challenge to the societal assumption an individual's ability to freely choose how much to weigh.…”

Section: Obesity As a Disease: Vulnerability To Weight Gainmentioning

confidence: 99%

Obesity and responsibility: Is it time to rethink agency?

Grannell

Fallon²,

Al‐Najim

et al. 2021

Obesity Reviews

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Despite obesity declared a disease, there still exists considerable weight stigma in both popular culture and health care, which negatively impacts policy making regarding prevention and treatment. While viewed as a choice or a failure of willpower by many, evidence exists to challenge the argument that both weight gain and failure to achieve weight loss maintenance are the individuals' fault due to personal failure or lack of responsibility. In this article, we draw upon literature from obesity treatment, neuroscience, philosophy of mind, and weight stigma to challenge the commonly held beliefs that individuals are free to choose how much they can weigh, and achievement of long-term weight loss maintenance is completely subject to conscious choice. In reality, the regulation of hunger, satiety, energy balance, and body weight takes place in subcortical regions of the brain. Thus, hunger and satiety signals are generated in regions of the brain, which are not associated with conscious experience. This points towards biological determinism of weight and challenges ideas of willpower and resultant moralization regarding body weight regulation. In this article, we will thus argue that in the context of dysregulation of hunger and

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“…4 There may be people who are more concerned about waist circumference, or waist-hip ratio, rather than overall weight or BMI. 2 It is imperative, therefore, to develop more accurate means of diagnosing obesity. Until this is done, multiple anthropometric and non-invasive markers, including waist circumference and body fat percentage, may be used to ensure person-centric diagnosis.…”

Section: Techniquesmentioning

confidence: 99%