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Obesity as a Class Distinction

It is now more evident that obesity is a serious chronic condition that adversely affects individuals and their families and has the potential to bankrupt our health care system. The increasing rates of obesity are anticipated, along with its treatment costs, to grow to be 35% higher by 2035. However, since weight loss through lifestyle changes are seen to be ineffective solutions, and bariatric surgery is too expensive and not feasible for most patients’ anti-obesity medications are seen as an important and treatment option. For the most part the new GLP-1self injected weekly medications are accepted as safe and effective. However, some critics of these medications suggest that they promise an easy solution to a medical problem that is also a cultural problem by medicalizing weight loss. Despite the stigma, shame and biases associated with obesity, it is frequently seen as a moral crisis and one that lacks compassion towards affected individuals. But as a treating clinician, I do not see obesity as a moral crisis of “fat bodies refusing to get thin and stay thin.” There is no moral crisis of good or bad, right or wrong about eating extra calories, it is about a calorie imbalance not a social or cultural imbalance. Though weight is used as a cultural standard to judge success, acceptance and value it is often seen to be a distinction of superiority. Weight is basically a physical metric used medically to access qualities of health and risks for chronic diseases, but it is also used to distinguish an individual’s socio-cultural worth and is a form of class ranking. I believe it is easier to help change an individual’s physical metric of weight than it is to change a culture’s deeply ingrained bias against obesity I think that more effort, education and financial support should be directed toward helping individuals use the tools for weight loss than try to change a pejorative cultural bias against obesity.

Peter Vash, M.D.

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