Is obesity a disease?

For years there has been a push to recognise obesity as a disease in its own right, and therefore something that needs to be treated in and of itself, rather than just as a risk factor for other things, such as diabetes, heart disease, strokes, and some cancers. And there is indeed much evidence that being obese can result in exceptionally poor health. But many who are obese are not unwell in the slightest. This argues that obesity per se should not be treated as an illness.

Until two years ago, such discussion was of little practical relevance, since there were few treatments for obesity between the extremes of bariatric surgery and the old-fashioned approach of eating less and exercising more. However, the

arrival in 2023 of GLP-1 weight-loss drugs

in the form of semaglutide (known commercially as Wegovy) changed that. If these drugs are to be prescribed sensibly and fairly, then who among the fat is sick and who is not becomes an important question.