Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How obesity is like alcoholism

Arya M. Sharma, MD
Conditions
March 21, 2011
Share
Tweet
Share

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease with genetic, psycho-social and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with the drug alcohol despite adverse consequences and distortions of thinking, mostly denial.

Let us look at this definition of alcoholism and see what aspects of it (if any) apply to obesity.

No doubt, as readers of these pages know, obesity is most definitely a chronic condition, whose development and manifestations are influenced by genetic, psycho-social and envrionmental factors. In some cases obesity may be more genetic, in others more psycho-social and sometimes purely environmental, but certainly, obesity would fit the bill as far as this statement goes.

And yes, obesity is often progressive and fatal. Most people, let alone those struggling with obesity, experience progressive weight gain over time. Sometimes periods of rapid weight gain are followed by periods of weight stability or even weight loss, but in the long term, no one with obesity would carry their excess weight had they not progressively gained it over time (and often continue to do so).

And yes, obesity is no doubt fatal. This may not seem as obvious as in the case of the alcoholic who dies of liver cirrhosis or totals his car (and himself) whilst DIU, but when you start looking at the many ways in which obesity can kill you, from heart attacks to cancer, there is no doubt that obesity is fatal (often after ruining most of your life first – another similarity to alcoholism).

Many of my patients would also be the first to admit that their weight problems stem directly from their continuous or periodic impaired control over their eating (or drinking of caloric beverages – including alcohol). This is not a moral judgement – whether their loss of control is genetic, psycho-social or simply a consequence of our obesogenic environment, it is still a loss of control. Were they able to control their intake of excess calories, they would obviously not have the problem.

And of course many people who struggle with excess weight are preoccupied with their drug (food). Whether they are thinking about their next meal, trying to suppress their cravings, planning their diet, feeling guilty about their last binge, hoping to find the strength to say no to that dessert or second helping, or simply giving in and longing for the comfort and satisfaction that they get from eating – no doubt food is on their mind – one way or another.

And all the obvious adverse consequences don’t seem to deter. I have yet to meet a patient who wants to be obese (even the patients, who admit that their excess weight protects them from unwanted attention). Even those, who do not relate their many health problems to their excess weight, cannot but help thinking how much easier life would be, would they not have to carry around their excess weight for the world to see, every single step and moment of their waking day (and interestingly, not just the waking day – given the profound effects of excess weight on sleep).

Finally, is it not the profound distortion in thinking that keeps the commercial weight loss industry in business? The idea that obesity can be “cured” with some magical potion or herb that will burn fat or rev up metabolism or suppress appetite. The idea that, “If I can only kick-start my weight loss and lose the first 10 lbs, the next 100 will surely follow”. The illusion that the next diet will be the last for sure. The fantasy that if I only lost some weight, my brain would readjust its “setpoint” and I could return to the weight I had as a 21 year old. The unrealistic expectation, that an hour in the gym each day will help melt away the lbs, or skipping meals will help cut calories.

ADVERTISEMENT

But most of all I see denial – denial to see excess weight as a problem, even when it clearly affects your health, your well-being, your appearance, your self-image, your sex life, your relationship, your happiness. Perhaps, in an ideal world, excess weight should have none of those negative consequences, but in reality it does. The options are to either wait till the world changes (and becomes fairer to people with excess weight) or to step out of denial and seek the help you need to conquer those lbs (and I am not talking about signing up for the next commercial weight-loss program).

Many, if not all of us have accepted that alcoholism is a disease. Does obesity, not often meet the very same criteria?

Unfortunately, however, one important difference remains – in obesity, food abstinence is not an option (even if some of my patients have done just fine by completely giving up certain foods).

Arya M. Sharma is a Professor of Medicine at the University of Alberta who blogs at Dr. Sharma’s Obesity Notes.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

What makes a great surgeon or doctor?

March 21, 2011 Kevin 5
…
Next

Family physicians who care for underserved patients

March 21, 2011 Kevin 46
…

Tagged as: Patients, Specialist

Post navigation

< Previous Post
What makes a great surgeon or doctor?
Next Post >
Family physicians who care for underserved patients

ADVERTISEMENT

More by Arya M. Sharma, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Simply knowing about health risks does not change behavior

    Arya M. Sharma, MD
  • Charging passengers by the pound is unfair

    Arya M. Sharma, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Why weight loss advice may be unethical

    Arya M. Sharma, MD

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How obesity is like alcoholism
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...