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Great topic! One of the questions to ask when considering obesity as a disease is epidemic. If obesity is classified as a disease, has it reached epidemic proportions yet? Does the government consider it an epidemic? If so, it might be a good idea to see how the authorities handle other "epidemics." Why should the "epidemic of obesity" be treated any differently than any other disease of epidemic proportions?

Ron asked for an opinion so here is mine.  But first the short answer, yes Obesity is a desease but the patient also has an obilgation to participate in their own recovery.

There has been a lot of talk about the bariatric process being impeded by the government, VIHA, and the bigotry of obese persons at the hands of family physicians and society in general.  And this in my view is true.  But what I don’t see on the forums is the level of commitment and desire to change their lives from the people weight loss surgery effects most.  Speaking for myself only, I sometimes question the relationship between obese people and the prejudice pressed upon them.  I wonder what do I do to perpetuate the image and what about those who are of my size who are also obese and have no interest in altering their body size or their lifestyle.

By committing to WLS surgery it is my understanding that I have an obligation to the surgeon, healthcare system, and myself to do my part.  I have heard repeatedly that surgery is not the cure it is only the tool.  To extend the metaphor I have many tools in my basket.  The surgeon’s and their medical team, health care workers, dieticians as well as exercise facilities, family, supporters, and even the internet act as a tools for me to use.  The remaining piece on the bench is myself.  But if I do not use my tools to actively get better, I will perpetuate the myth of the obese man.

I look at large people like myself and wonder “how did they get that way?” or “why don’t they change”?  Other smaller size people are probably thinking “It doesn’t take much – few hours of exercise each week and backing up from the table”.  I think that people not like me would not understand the emotional attachment to food or even the process of eating.  Still I know that reducing my caloric intake is one of the primary tools in my belt. 

Another one of the most efficient tools on my belt is exercise.  If obesity is a disease of solidarity, then exercise must be the hardest thing in the world for a large person to do.  The simple matter of putting yourself out there in the world to move, sweat and minimally stretch.  I don’t have to do much to sweat profusely which makes it a really good thing because then I really do look like I am working out.  I know that people in the gym are looking at me wondering “what in the world am I doing there?”  Most have been supportive, some have giggled, many just don’t give a damn.  All the trainers I have met in the gym; however have been awesomely supportive.  They don’t understand large people’s issues but they have been helpful when asked. 

But the one thing I do recognize is that I do not exercise enough.  Fitness experts say that to maintain weight, people need to exercise three to four one hour active exercise sessions – “Active” means to increase your heart and breathing rate to a point beyond the ability to hold a casual conversation.  To lose weight – participants must exercise five times a week.  In his information sheet Dr. Amson recommends a minimum of five hours of exercise per week.   I considered this thought “you’ve got to be kidding” I can’t do everything in my life and still exercise five hours a week”.  I think that is the point – my life will not be the same now that I am committing to WLS.

But getting back to my point of obesity, image and commitment, I think if we are to genuinely get public support for the cause, we are going have to be more evident in our efforts.  The public needs to have an image of the large guy in the gym not McDonalds, or the woman buying exercise clothes not doughnuts.  Inthe big scheme of things WLS members are in the minority of large people.  Many people will not even entertain the idea of surgical intervention and budgetary restraint will ensure that even fewer people will have the opportunity.  Of those who opt for surgery, very few of us will actually make the efforts to make themselves visible.  But in my view, visibility is the only way we will see a change in the way obese people are treated in society.

Ron said:Author Ron Merk This question is the heart of all the problems associated with the lack or support and treatment for people with obesity. Almost all Governments consider obesity a life style choice. Life style choice equals "your fault" and "fix it" yourself. If you've read my articles before, you know that I urge people to be advocates for Weight Loss Surgery reform. Certainly in Canada we have a long journey to go before we get Provincial Governments and Health Authorities to view Weight Loss Surgery as required treatment for a disease called Obesity. I'm afraid that many of us have targeted the wrong issue when it comes to weight loss surgery. The obvious and most visible result of bigotry against obesity is the reduction of budgets by Health Authorities to fund surgery. Classifying Weight Loss surgery as "elective" insures that it comes last after all other surgeries are funded. Frankly you can get a hang-nail dealt with easier and way quicker than you could ever get weight loss surgery. All of us have asked why funding has been cut for WLS and demanding that funding be re-established, but I beleive that we're asking the wrong questions. What we really need to ask is why are our Governments and Heath Authorities minimizing Public health measures and preventive medicine for Obesity that other conditions often receive generous funding for?(eg Heart Disease/healthy diet, annual physical examinations, immunization programs, smoking cessation campaigns, promotion of exercise and active lifestyles). Whether and how our institutions and organizations pay for obesity treatment should ultimately depend on what health outcomes we value, how much we value them, and the cost of achieving them.

I Need Re-Education!

Right now our Health Authorities and Government consider Obesity to be a "self inflected" condition or situation which is not a diseases but does represent serious risk factors to health. These attitudes are driven by the professional consultants and team members of the Provincial Ministries Of Health, Health Authorities and College of Physicians. (in other words – Doctors) – yes, I said Doctors! I beleive we will not see any major gains in funding for WLS until we see a shift in the way the medical profession views Obesity and consequently policy makers in our Health System. In future articles we'll examine the specifics of why Obesity should be considered a disease. Until then consider expanding your advocacy to not only ask for funding but to also begin to "educate" our medical professionals and political policy makers on Obesity. Here are some suggestions:

• Write a letter to you Provincial College of Physicians explaining why you beleive Morbid Obesity is not just a life style choice, but is a disease.
• Write the same letter to your MOH – Policy Makers
• Write more letters to all those politicians again, but this time , don ask for funding – rather explain Obesity as a disease that is treatable via weight loss surgery.
• Share this article everywhere!
• Comment here on this article
• Stay tuned for future coming articles which will provide facts that Obesity IS a treatable disease.

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