Luli Migena, Yeo Giles, Farrell Emma, Ogden Jane, Parretti Helen, Frew Emma, Bevan Stephen, Brown Adrian, Logue Jennifer, Menon Vinod, Isack Nadya, Lean Michael, McEwan Chris, Gately Paul, Williams Simon, Astbury Nerys, Bryant Maria, Clare Kenneth, Dimitriadis Georgios K, Finlayson Graham, Heslehurst Nicola, Johnson Brett, Le Brocq Sarah, Roberts Audrey, McGinley Patrick, Mueller Julia, O'Kane Mary, Batterham Rachel L, Miras Alexander Dimitri
Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, United Kingdom.
Department of Clinical Biochemistry, Institute of Metabolic Science, Cambridge University, Cambridge, United Kingdom.
EClinicalMedicine. 2023 Apr 6;58:101962. doi: 10.1016/j.eclinm.2023.101962. eCollection 2023 Apr.
Unlike various countries and organisations, including the World Health Organisation and the European Parliament, the United Kingdom does not formally recognise obesity as a disease. This report presents the discussion on the potential impact of defining obesity as a disease on the patient, the healthcare system, the economy, and the wider society. A group of speakers from a wide range of disciplines came together to debate the topic bringing their knowledge and expertise from backgrounds in medicine, psychology, economics, and politics as well as the experience of people living with obesity. The aim of their debate was not to decide whether obesity should be classified as a disease but rather to explore what the implications of doing so would be, what the gaps in the available data are, as well as to provide up-to-date information on the topic from experts in the field. There were four topics where speakers presented their viewpoints, each one including a question-and-answer section for debate. The first one focused on the impact that the recognition of obesity could have on people living with obesity regarding the change in their behaviour, either positive and empowering or more stigmatising. During the second one, the impact of defining obesity as a disease on the National Health Service and the wider economy was discussed. The primary outcome was the need for more robust data as the one available does not represent the actual cost of obesity. The third topic was related to the policy implications regarding treatment provision, focusing on the public's power to influence policy. Finally, the last issue discussed, included the implications of public health actions, highlighting the importance of the government's actions and private stakeholders. The speakers agreed that no matter where they stand on this debate, the goal is common: to provide a healthcare system that supports and protects the patients, strategies that protect the economy and broader society, and policies that reduce stigma and promote health equity. Many questions are left to be answered regarding how these goals can be achieved. However, this discussion has set a good foundation providing evidence that can be used by the public, clinicians, and policymakers to make that happen.
与包括世界卫生组织和欧洲议会在内的不同国家及组织不同,英国并未正式将肥胖认定为一种疾病。本报告呈现了关于将肥胖定义为疾病对患者、医疗系统、经济及更广泛社会的潜在影响的讨论。一群来自广泛学科领域的发言者齐聚一堂,就该话题展开辩论,他们带来了医学、心理学、经济学、政治学背景的知识与专业技能,以及肥胖症患者的经验。他们辩论的目的并非决定肥胖是否应被归类为一种疾病,而是探讨这样做会有哪些影响、现有数据存在哪些差距,以及提供该领域专家关于这一话题的最新信息。发言者们就四个话题阐述了各自的观点,每个话题都设有问答环节以供辩论。第一个话题聚焦于将肥胖认定为疾病对肥胖症患者行为的影响,这种影响可能是积极且赋予力量的,也可能更具污名化。在第二个话题中,讨论了将肥胖定义为疾病对国民医疗服务体系及更广泛经济的影响。主要结果是需要更有力的数据,因为现有数据无法代表肥胖的实际成本。第三个话题涉及治疗提供方面的政策影响,重点是公众影响政策的能力。最后,所讨论的最后一个问题包括公共卫生行动的影响,强调了政府行动和私人利益相关者的重要性。发言者们一致认为,无论他们在这场辩论中的立场如何,目标都是共同的:提供一个支持和保护患者的医疗系统、保护经济和更广泛社会的策略,以及减少污名化和促进健康公平的政策。关于如何实现这些目标,仍有许多问题有待解答。然而,这次讨论奠定了良好基础,提供了可供公众、临床医生和政策制定者用以实现这些目标的证据。