Aliosha Bielenberg Pittaka

DISEASE OR NUTRITIONAL CHOICE?

Obesity is a growing problem around the world, particularly among children: in 2010, more than one third of children and adolescents were overweight or obese. It is particularly prevalent in the United Arab Emirates, with it recently becoming the fifth most obese country in the world. However, all responsibility can be placed on every person for their decisions; in other words, obesity is a nutritional choice, not a disease. This conclusion, reached after extensive research, is based on the facts that: obesity is mainly caused by excessive calorific intake, which, ethically, is completely voluntary; obesity's social stigma, though significant, does not eliminate the onus on the obese person; and any hereditary factors that may be claimed to cause obesity play no significant role in the development of obesity. Obesity's main cause is an excessive and unhealthy diet. A diet that is outof-balance and contains too much of one food group or nutrient is one cause of many health problems, from heart disease to scurvy to diabetes. One of the key symptoms of this diet is obesity, officially defined as a Body Mass Index greater than 30. Obesity is usually obvious through certain visual cues, such as a large waistline and excess fat pockets, such as a double chin and a protruding belly. All of these symptoms can be directly linked back to an excessive and unhealthy diet, which is clearly a nutritional choice. Some may argue that even though it is a choice, people may not have healthier food available, or they may simply not know any better. Although at first dietary guidelines were unclear or difficult to access, awareness has increased dramatically in recent years. This has been achieved through initiatives like the USDA's Food Pyramid and popular documentaries like Morgan Spurlock's Super Size Me. By 2011, BMC Pediatrics was able to report that [m]ost adolescents (92.4%) [are] aware of the Food Guide Pyramid. Therefore, any further consumption (or over-consumption) of foods, particularly unhealthy ones, is completely voluntary and has nothing to do with misinformation or the lack thereof. Modern government is based on the principle that educated, intelligent people have the ability and responsibility to protect themselves from harm: nobody wants a nanny state. Because people are fully educated about the risks of an unhealthy, healthier food is readily available (at least in developed countries like the USA and the UAE), any choice to consume food or drinks that have an obvious deleterious effect is completely voluntary. Ethically, at least, there is

OBESITY

Aliosha Bielenberg Pittaka no longer any justification for people not to make the right choices and to avoid unhealthy food. Socially, the issue of obesity is more complicated, though any effects do not play a large role in a person developing obesity. First of all, there is now a large stigma attached to obese people. Critics attack this stigma as discrimination, merely redirected to easy targets. This is particularly evident with regards to bullying in schools, as many students are bullied because of their weight: a study by the University of Michigan C.S. Mott Children's Hospital found that 34% of obese children had been bullied. On the other hand, a stereotype of an obese bully, venting his lack of self-esteem on others, has entered popular culture. Both of these unfortunate situations, however, can be eliminated completely simply by reducing your weight. As described above and below, there is no reason why somebody who has made a commitment to losing weight can not achieve his or her goal. Therefore, social factors such as bullying, though they play a role in the development and retention of obesity, do not affect a personto such an extent that they cannot, through a healthy diet and exercise, eliminate obesity. Many obese people try to excuse or explain their obesity through having a slow metabolism or being big-boned. However, these causes do not play a significant part in determining a person being obese or not. One study by PLOS Medicine surveyed over 20 000 people who were obese, many of whom claimed that their obesity was genetic. It found that their genetic predisposition to obesity can be reduced by approximately 40% by having a physically active lifestyle. This, along with a cohort of other studies, have conclusively found that genetic predispositions play no significant role in the development of obesity. Therefore, any genetic predispositions or family history play no part in obesity. Once genetic predispositions have been shown to play no significant effect in obesity, and social concerns have been eliminated as a cause, the fact remains that obesity is not disease. After also seeing that most people are thoroughly informed and educated about obesity and a healthy diet, the only conclusion that can be drawn is that it is every person's right and responsibility to prevent themselves from falling into the trap of obesity. Obesity is therefore not a disease: rather, it is a clear nutritional choice.

Aliosha Bielenberg Pittaka

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Aliosha Bielenberg Pittaka Puhl, R. M., & Heuer, C. A. (2009). The Stigma of Obesity: A Review and Update. Obesity, 17(5), 941964. doi:10.1038/oby.2008.636 Wojcicki, J. M., & Heyman, M. B. (2012). Adolescent nutritional awareness and use of food labels: Results from the national nutrition health and examination survey. BMC Pediatrics, 12(1), 55. doi:10.1186/1471-2431-12-55 World Health Organization. (2000). Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: World Health Organization. Yaqoob, T. (n.d.). New survey highlights extent of obesity crisis - The National. Retrieved March 27, 2013, from http://www.thenational.ae/news/uae-news/health/new-survey-highlightsextent-of-obesity-crisis