“Disease” or Not?

As we’ve noted in the past here at Diabetes Flashpoints, what we call a medical condition can have an impact on how we think of it. For example, in a post last year[1], we mentioned an effort to rename Type 2 diabetes[2] “insulin-resistant diabetes” and Type 1 diabetes[3] “autoimmune beta cell apoptosis”; proponents of such a change claim that these more descriptive terms would help the public distinguish between the two conditions and understand that Type 2 isn’t just the result of bad lifestyle choices. A new study on obesity, however, shows that what matters may be not just the name of a disease, but whether people think of it as a disease at all.

Published late last month by the journal Psychological Science, the study[4] sought to find out whether the American Medical Association’s June 2013 decision to label obesity a disease, rather than simply a condition that can lead to disease, might affect the behavior of obese individuals. According to a press release on the study[5] from the Association for Psychological Science, researchers recruited over 700 participants to take an online survey that came in three different forms. First, participants read one of three randomly selected articles about obesity. One article was about how obesity is a disease, another discussed the importance of weight control without saying whether obesity was a disease or not, and a third article emphasized that obesity was not a disease but rather a condition affected by choices. Participants then completed a survey that asked them about their attitude towards their weight, health, and diet, and asked them about personal data such as their height and weight.


The researchers found that among participants who were determined to be obese, those who read the “obesity is a disease” article were less likely to indicate being concerned about their weight and health than obese participants who read the two other articles. They reported greater satisfaction with their bodies, and when prompted at the end of the study to select a sandwich from a menu, they tended to choose a higher-calorie item than participants who read the other articles. The researchers concluded that labeling obesity as a disease may lead people to conclude it’s not their fault or responsibility, resulting in less healthy choices and less resolve to lose weight. They did note, however, that the “disease” label could also have positive effects, such as reducing the social stigma associated with higher body weight that may prevent some obese people from joining a gym or fitness program, or otherwise pursuing health- and weight-related goals.

While both Type 1 and Type 2 diabetes are clearly defined as diseases, there may be parallels between Type 2 diabetes and obesity when it comes to how labels affect behavior. Some people with prediabetes[6] or Type 2 diabetes are reluctant, upon diagnosis, to make any lifestyle or dietary changes, viewing their blood glucose levels as largely out of their control (except, perhaps, when it comes to taking a drug they’ve been prescribed). It is possible that if more people viewed their blood glucose levels as dependent on many factors — not just as the result of a disease or condition — that they would feel more in control and be more likely to follow a healthier diet and get more exercise. Many people with diabetes, both Type 1 and Type 2, also dislike the term “disease” because, they feel, it implies that they are sick — when, in fact, they can be healthy if they manage their diabetes effectively. This attitude seems to suggest that a self-rejection of the “disease” label may also make a person more likely to actively manage his or her condition.

What does the term “disease” imply, in your mind? Do you think of your diabetes as a disease? Does calling diabetes a disease make people less likely to make lifestyle changes, or could it make some people more engaged in managing their blood glucose levels? Should health professionals make a greater effort to explain — in cases of obesity, Type 2 diabetes, and other conditions — that having a “disease” doesn’t mean it’s completely out of your control? Leave a comment below!

  1. post last year: https://www.diabetesselfmanagement.com/Blog/Flashpoints/rename-diabetes/
  2. Type 2 diabetes: https://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/type-2-diabetes/
  3. Type 1 diabetes: https://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/type-1-diabetes/
  4. the study: http://pss.sagepub.com/content/early/2014/01/24/0956797613516981.abstract
  5. press release on the study: http://www.psychologicalscience.org/index.php/news/releases/labeling-obesity-as-a-disease-may-have-psychological-costs.html
  6. prediabetes: https://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/prediabetes/

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