As global approvals of new anti-obesity medicines accelerate, drugmakers have a public service announcement for the world: “Obesity is a disease.” Eli Lilly launched a website asserting that obesity is not merely a risk factor for medical complications but a chronic and complex medical entity in its own right. Novo Nordisk, more circumspectly, appeals to institutional authority on its website: “Recognised as a disease by the World Health Organization, obesity is serious, progressive and chronic.”
It is no surprise that the new wave of obesity pharmacotherapy has leaned heavily on disease framing. A medical solution requires a medical problem, and a chronic medical problem provides a rationale for long-term medical treatment.
Designating something as a disease is compelling, precisely because the term itself implies a concrete and coherent pathology. But medicine has never reached consensus on what the term “disease” precisely refers to. As such, disease framing is almost always controversial, particularly for prevalent public health problems like obesity.
Epidemiological evidence shows that obesity, particularly at higher BMI thresholds, is associated with substantially elevated risks of cardiovascular disease, type 2 diabetes, stroke, and premature mortality. Basic and translational research has identified numerous biological mechanisms — genetic susceptibility, appetite-regulation pathways, neuroendocrine processes, metabolic adaptation — that contribute to weight gain and impede its loss.
