The implications of defining obesity as a disease: a report from the Association for the Study of Obesity 2021 annual conference
Open accessAbstract
Unlike various countries and organisations, including the World Health Organisation and the European Parliament, the United Kingdom does not formally recognise obesity as a disease. This report presents the discussion on the potential impact of defining obesity as a disease on the patient, the healthcare system, the economy, and the wider society. A group of speakers from a wide range of disciplines came together to debate the topic bringing their knowledge and expertise from backgrounds in medicine, psychology, economics, and politics as well as the experience of people living with obesity. The aim of their debate was not to decide whether obesity should be classified as a disease but rather to explore what the implications of doing so would be, what the gaps in the available data are, as well as to provide up-to-date information on the topic from experts in the field. There were four topics where speakers presented their viewpoints, each one including a question-and-answer section for debate. The first one focused on the impact that the recognition of obesity could have on people living with obesity regarding the change in their behaviour, either positive and empowering or more stigmatising. During the second one, the impact of defining obesity as a disease on the National Health Service and the wider economy was discussed. The primary outcome was the need for more robust data as the one available does not represent the actual cost of obesity. The third topic was related to the policy implications regarding treatment provision, focusing on the public's power to influence policy. Finally, the last issue discussed, included the implications of public health actions, highlighting the importance of the government's actions and private stakeholders. The speakers agreed that no matter where they stand on this debate, the goal is common: to provide a healthcare system that supports and protects the patients, strategies that protect the economy and broader society, and policies that reduce stigma and promote health equity. Many questions are left to be answered regarding how these goals can be achieved. However, this discussion has set a good foundation providing evidence that can be used by the public, clinicians, and policymakers to make that happen.
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A blanket attribution of disease status to obesity (as currently defined and measured) poses an objective risk of overdiagnosis, resulting in unwarranted use of drugs, technologies, and surgical procedures, with staggering costs for society, and negative ramifications at clinical, economic, and political levels.
“In this context, a blanket attribution of disease status to obesity (as currently defined and measured [ie, BMI >30 kg/m2, or 27·5 kg/m2 for Asian populations]) poses an objective risk of overdiagnosis, resulting in unwarranted use of drugs, technologies, and surgical procedures, with staggering costs for society, and negative ramifications at clinical, economic, and political levels.”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [15]
Cites
Padwal, R. S., Pajewski, N. M., Allison, D. B., & Sharma, A. M. (2011) · Canadian Medical Association Journal · doi:10.1503/cmaj.110387 · Cited by 392 · see citing works
What is a disease?: Disease, disability and their definitions
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Warr, W., Aveyard, P., Albury, C., Nicholson, B., Tudor, K., Hobbs, R., Roberts, N., & Ziebland, S. (2021) · Obesity Reviews · doi:10.1111/obr.13151 · Cited by 102 · see citing works
Brosnahan, N., Leslie, W., McCombie, L., Barnes, A., Thom, G., McConnachie, A., Messow, C. M., Sattar, N., Taylor, R., & Lean, M. E. J. (2021) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12839 · Cited by 12 · see citing works
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Definition and diagnostic criteria of clinical obesity
Rubino, F., Cummings, D. E., Eckel, R. H., Cohen, R. V., Wilding, J. P. H., Brown, W. A., Stanford, F. C., Batterham, R. L., Farooqi, I. S., Farpour-Lambert, N. J., et al. (2025) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(24)00316-4 · Cited by 1,811 · see citing works
Self-citation
- Authors
- Luli, M., Yeo, G., Farrell, E., Ogden, J., Parretti, H., Frew, E., Bevan, S., Brown, A., Logue, J., Menon, V., Isack, N., Lean, M., McEwan, C., Gately, P., Williams, S., Astbury, N., Bryant, M., Clare, K., Dimitriadis, G. K., Finlayson, G., Heslehurst, N., Johnson, B., Le Brocq, S., Roberts, A., McGinley, P., Mueller, J., O'Kane, M., Batterham, R. L., Roberts, K., & Miras, A. D.
- Affiliations
- Imperial College Healthcare NHS Trust (GB)
- University of Cambridge (GB)
- University College Dublin (IE)
- University of Surrey (GB)
- University of East Anglia (GB)
- University of Birmingham (GB)
- University College London (GB)
- Lancaster University (GB)
- University Hospital Coventry (GB)
- University of Glasgow (GB)
- Leeds Beckett University (GB)
- Ipswich Hospital (GB)
- University of Oxford (GB)
- University of York (GB)
- King's College Hospital NHS Foundation Trust (GB)
- University of Leeds (GB)
- Newcastle University (GB)
- Imperial College London (GB)
- Maidstone and Tunbridge Wells NHS Trust (GB)
- University of Ulster (GB)
- Corresponding author
- Dimitriadis, Georgios K.
- ORCID
- Venue
- eClinicalMedicine
- Publisher
- Elsevier BV
- Published
- 2023-04
- Volume
- 58
- Pages
- 101962
- ISSN
- 2589-5370 (ISSN-L)
- PMC
- PMC10119881
- OpenAlex
- W4362659556
- Cited by
- 66
- References
- 4
- Citations by year
- 2026: 20 · 2025: 20 · 2024: 19 · 2023: 6
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- EClinicalMedicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Ulster University Research Portal (Ulster University) (submittedVersion, cc-by)
- University Of Wales Trinity Saint David Research Repository (University of Wales Trinity Saint David) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- European Federation of Pharmaceutical Industries and Associations
- Rosetrees Trust
- National Institute for Health and Care Research
- Novo Nordisk
- Diabetes Research and Wellness Foundation
- Innovative Medicines Initiative (875534)
- Sir Jules Thorn Charitable Trust
- NIHR Oxford Biomedical Research Centre
- Juvenile Diabetes Research Foundation United Kingdom
- European Commission
- Diabetes UK
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Keywords
- obesity, disease classification, obesity as a disease, stigma, health equity, National Health Service, economic burden of obesity, obesity policy, patient behavior, treatment provision, health data gaps
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