End Fattism

We need to treat obesity as a real disease, not as a ‘bad habit.’

One of the last socially acceptable prejudices is that against the obese. Fed by a steady stream of diet books, TV shows, and even documentaries, the stereotypes are constantly reinforced; overweight people are heavy simply because they eat too many Big Macs and french fries; they’re desperately lonely and gorge themselves out of despair; they’re couch potatoes who just refuse to exercise. These are, of course, caricatures of a complex problem that affects millions of people.

As Rockefeller University molecular geneticist and obesity researcher Jeffrey Friedman argues in “Wired to Eat,” obesity is a disorder that is largely caused by genetic factors. For more than a decade, Friedman has visited the remote Micronesian island of Kosrae in an attempt to pinpoint the specific genetic and molecular reasons why the population, descended from a mix of Micronesian and European ancestors, exhibits such a high rate of obesity. He and his colleagues at Rockefeller collected medical information on the entire adult population of some 2,500 islanders and now have begun detailed analysis of the DNA to identify specific genetic variations that are associated with obesity. If Friedman succeeds in finding genetic causes for the island’s obesity and health problem, it will have immense implications for how we view overweight people. “We have to realize that obesity is a disease, like cancer, that people have less control over than most of us think,” maintains Friedman.

Writer David Ewing Duncan, who traveled to Kosrae earlier this year to report the story, notes that Friedman’s position is controversial among those who treat obesity. Indeed, even health workers on Kosrae are confident they can decrease the island’s obesity rate by working with communities to improve their eating and exercise habits. And the people of Kosrae, still stinging from being tagged “Macronesians,” appear to be responding. The controversy won’t be easily settled – after all, in many ways it is the familiar debate about nature and nurture. Obesity is likely caused by a complex mixture of genetic, environmental, and lifestyle factors. But Friedman deserves credit for attempting to elevate obesity from a “bad habit” caused by slothful behavior to a treatable disease.

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