Should Europe follow the US and declare obesity a disease?: a discussion of the so-called utilitarian argument

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In 2013, the American Medical Association (AMA) decided to recognize obesity as a disease. One of the main arguments presented in favor of this was broadly ‘utilitarian’: the disease label would, it was claimed, provide more benefits than harms and thereby serve the general good. Several individuals and groups have argued that this reasoning is just as powerful in the European context. Drawing mainly on a review of relevant social science research, we discuss the validity of this argument. Our conclusion is that in a Western European welfare state, defining obesity as a disease will not on balance serve the general good, and that it is therefore more appropriate to continue to treat obesity as a risk factor. The main reasons presented in favor of this conclusion are: It is debatable whether a disease label would lead to better access to care and preventive measures and provide better legal protection in Europe. Medicalization and overtreatment are possible negative effects of a disease label. There is no evidence to support the claim that declaring obesity a disease would reduce discrimination or stigmatization. In fact, the contrary is more likely, since a disease label would categorically define the obese body as deviant.

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We thank Kim Fleischer Michaelsen for useful inputs to the article. Also, we thank Paul Robinson for help in improving our English writing and Sara V Kondrup for help in searching literature and editing the paper. The work was carried out as a part of the research programme ‘Governing Obesity’, a part of the University of Copenhagen Excellence Programme for Interdisciplinary Research (

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Correspondence to S Vallgårda.

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Vallgårda, S., Nielsen, M., Hansen, A. et al. Should Europe follow the US and declare obesity a disease?: a discussion of the so-called utilitarian argument. Eur J Clin Nutr 71, 1263–1267 (2017) doi:10.1038/ejcn.2017.103

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