With obesity now affecting 29% of the population in England, and expected to rise to 35% by 2030, should we now recognise it as a disease? Obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets the dictionary definition of disease, argues Professor John Wilding. He points out that more than 200 genes influence weight. “Thus body weight is strongly influenced by biology—it is not an individual's fault if they develop obesity.” Yet the widespread view is that obesity is self-induced and that it is entirely the individual's responsibility to do something about it. Recognising obesity as a chronic disease with severe complications rather than a lifestyle choice “should help reduce the stigma（耻辱）and discrimination experienced by many people with obesity,” he adds. Professor Wilding disagrees that labelling a high proportion of the population as having a disease removes personal responsibility or may overwhelm health services, pointing out that other common diseases, such as high blood pressure and diabetes, require people to take action to manage their condition. He suggests that most people with obesity will eventually develop complications. “But unless we accept that obesity is a disease, we are not going to be able to tackle it,” he concludes. But Dr. Richard Pile, a physician with a special interest in diabetes, argues that adopting this approach “could actually result in worse outcomes for individuals and society.” He believes that the dictionary definition of disease “is so vague that we can classify almost anything as a disease” and says the question is not whether we can, but whether we should, and to what end. If labelling obesity as a disease was harmless then it wouldn't really matter, he writes. But labelling obesity as a disease “risks reducing autonomy, disempowering and robbing people of the intrinsic（内在的）motivation that is such an important enabler of change.” What's more, making obesity a disease “may not benefit patients, but it will benefit healthcare providers and the pharmaceutical（制药的）industry when health insurance and clinical guidelines promote treatment with drugs and surgery,” he warns.

目前，肥胖影响了英国29%的人口，预计到2030年这一比例将增长到35%，我们现在应该将它视为一种疾病吗？约翰·怀尔丁教授认为，肥胖是指体内多余的脂肪积累到对健康造成不利影响的程度，符合字典上对于疾病的定义。[46] 他指出，有200多种基因能够影响体重。“因此，体重在很大程度上受到生理的影响——如果人们得了肥胖症，这并不是他们个人的错。”[47] 然而，普遍的观点是肥胖是由自身引起的，对此采取什么措施完全是个人的责任。他补充说，认识到肥胖是一种伴有严重并发症的慢性疾病，而不是一种生活方式的选择，“应该有助于减少很多肥胖症患者遭受的耻辱和歧视”。 [48] 对于将高比例的肥胖人口视为患者就会免除肥胖者的个人责任，或者可能使医疗服务不堪重负的观点，怀尔丁教授表示不赞同。他指出，其他常见疾病，比如高血压和糖尿病，要求人们采取行动来控制自己的病情。他表示，大多数肥胖症患者最终都会出现并发症。“但是除非我们承认肥胖是一种疾病，否则我们将无法解决它。”他总结道。 但是对糖尿病特别感兴趣的内科医生理查德·派尔认为，采取这种方式“实际上可能会对个人和社会造成更糟糕的结果”。[49] 他认为，字典上对于疾病的定义“太模糊了，以至于我们几乎可以将任何事情都归类为疾病”，他说问题不在于我们是否能将肥胖定义为疾病，而在于我们是否应该这样做，以及要达到什么目的。 他写道，如果把肥胖列为一种疾病不会产生什么坏处，那就没什么要紧的了。[50] 但是将肥胖列为一种疾病“存在降低自主性、剥夺人们的权利和内在动力的风险，而内在动力是改变的重要推动力”。此外，他警告说，将肥胖定义为一种疾病“可能不会给病人带来好处，但是当医疗保险和临床指南提倡使用药物和手术来治疗肥胖症时，它将使医疗保健机构和制药业受益。”