Is ‘War on Obesity’ Akin to ‘Disease Mongering’?

I was linked to the following study on “disease mongering” by the Fat Nutritionist and, though it was published in 2006, it remains incredibly relevant (if not more so now than ever with our “war on obesity”).

So, what is “disease mongering”? In its most basic sense, it’s the selling of a disease, and, yes, it has a negative connotation – like peddling something unsavory; “monger” has, through history, been associated with prostitution (gotta love the Oxford English Dictionary!).  I think it’s important to understand that diseases invariably have a level of “construction” – in other words, how they are perceived (which is contingent on how they are sold via the media, your doctors, etc.), how they are treated and their general societal reception. For example compare how diseases are received by the public depending on whether they are considered “lifestyle” diseases or say, blood diseases. So, compare emphysema (which my dad – a smoker since he was 13  – has) and Leukemia.

Consider how certain things, like obesity and alcoholism, are oft considered diseases. In fact, whether obesity should be considered a disease is a hot topic these days. But, I’ll get to that in a second. First, some key quotes from the research by Moynihan R & Henry D, titled, “The Fight against Disease Mongering: Generating Knowledge for Action,” published in PLoS Med:

• “The problem of disease mongering is attracting increasing attention [1–3], though an adequate working definition remains elusive. In our view, disease mongering is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments. It is exemplified most explicitly by many pharmaceutical industry–funded disease-awareness campaigns—more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health. In this theme issue and elsewhere, observers have described different forms of disease mongering: aspects of ordinary life, such as menopause, being medicalised; mild problems portrayed as serious illnesses, as has occurred in the drug-company-sponsored promotion of irritable bowel syndrome (see pp. 156–174 in [2]; [4]) and risk factors, such as high cholesterol and osteoporosis, being framed as diseases.”
• “It can also be argued that disease mongering is the opportunistic exploitation of both a widespread anxiety about frailty and a faith in scientific advance and ‘innovation’—a powerful economic, scientific, and social norm. In many nations, government policy priority is to secure market-based economic development, while more equitable social policies, such as public health strategies, can become subordinate or redundant. Disease mongering can thrive in such a normative environment. The practical consequences are that many of the so-called disease-awareness campaigns that inform our contemporary understanding of illness—whether as citizens, journalists, health professionals, industry leaders, academics, or policymakers—are now underwritten by the marketing departments of large drug companies rather than by organizations with a primary interest in public health.“

You can get a pill for anything. Just by virtue of being a living, breathing human, there are tons of natural and HEALTHFUL occurrences that are called sicknesses, abnormalities, even diseases,  so that you may feel compelled to purchase a “remedy.”

Just walk through the “feminine care” aisle and you’ll likely walk out feeling like your vagina is a disease in and of itself – something to be stripped of all of its natural functions, something to “fix” and construct into anything other than …well…a vagina.

I’ve bolded the study’s statement above because I think what we’ve been seeing is actually not the consequence of governments prioritizing economic growth over public health & Big Pharma stepping in to do ‘its job’; what we’re seeing is government CONSTRUCTING diseases to spur economic growth. The “obesity crisis” has to be one of the most profitable “public health” campaigns there have ever been. It has gained incredible authority all over the world, with few actually publicly acknowledging that a) obesity is not a disease and b) because it is not a disease, there cannot be an “epidemic” and c) the proposed “solutions” exacerbate and create poor health.

I think understanding who and what is behind the medicalization of our lives is an incredibly important question to ask. I’ve mentioned Susan Bordo before, briefly, but her work in eating disorders has really inspired me to ask what “disorders” really mean in a larger context. This same questioning can be applied to pathologizing body size (and any medicalization of symptoms). What anxieties does our obsession with obesity reveal? what are the true risks of living with the “disease” versus taking the prescribed medication/course of action? Do we put too much faith in scientific studies without understanding their inherent biases (and funding)? Do we trust the media to correctly relay/interpret studies’ findings? Who is behind obesity ‘disease mongering’ and who is profiting?

The fact of the matter is the everyone and their mama is behind the obesity crisis and the profits are spread across a vast spectrum of private, public, non-profit and governmental entities. If you’ve ever wanted to raise funding for a company, start an anti-obesity arm and you’ll surely find your way into grants totaling hundreds of thousands of dollars.  It has become such a ubiquitous “fight” that is crosses political party lines, socioeconomic divides and unites friend and foe against a common enemy. I think this is why I, and other HAES supporters feel increasingly ostracized; the world has raised its pitch forks and we’re standing in the middle of the rabble screaming, “STOP!”

The implications of truly making obesity a disease are huge, and I’d argue are more detrimental than effective. To learn more about the stakes, this is a great recap of a debate organized by the Canadian Obesity Network Student and New Professionals with the hosts and Drs Jacqui Gingras and Arya Sharma in Ottawa.

Thoughts? Do you think obesity is a disease being sold to the public?

<3,

The Cranky One

Tags: obesity politics