There's been a lot of discussion about obesity. Whether or not it's a disease (as it is in the USA now). How this label would positively or negatively influence action taken by society and governments in addressing this large and growing burden.
This conversation is important, but I have noticed very often it ends with confusion. Questions around why we begin talking about obesity - and end discussing mental health, cancer, heart disease or diabetes. To make hings even more confusing, the term 'Non-Communicable Diseases' might even be mentioned.
Well the reality is that all these diseases are actually highly interrelated. Obesity, diabetes, heart disease, cancers, lung diseases and mental illness (all combined are called Non-Communicable Diseases, or NCDs) largely share the same drivers or "risk factors". Things like an unhealthy diet, using tobacco, drinking alcohol and not getting enough exercise are all related to, or direct drivers of obesity and diseases like diabetes and some cancers. What's more confusing though, is that obesity itself puts us at higher risk for diabetes and some cancers, as does diabetes for heart diseases - for example.
Taking a step back though, the overlap becomes even more apparent. Because at a time when as much as two-thirds of many countries are overweight or obese (and obesity is rapidly rising in even the poorest nations), this is not an issue that comes down to 'stupid individuals making poor choices'. The reason we have a poor diet, or smoke, or don't get enough exercise - is largely due to the built environment around us, the ubiquitous nature of junk-food and alcohol advertising, the way our cities are designed, the structuring of our food system, the subsidies that make unhealthy foods cheap, the over-focus of treatment at the expense of prevention in our health systems, the lack of integrated health education in schools and so on...
These are the structural and social determinants of health, and disease.
My point is that in a nation where 2 in 3 of us are overweight or obese, something much bigger is going on that simply 'stupid people making poor choices'.
My other point is that whilst we might think of these diseases as separated outcomes, they actually have common root causes, risk factors and social determminants. Many of them far beyond the health sector.
Some biting food for thought.
In the month of October, NCDFREE is running a campaign called The Face of NCDs. Here are some crowd-sourced reflections on the overlaps between these diseases, from people like you around the world.
For more stories, head to www.thefaceofncds.org today.
In 2013 Dr Demaio co-founded NCDFREE, a global social movement against NCDs – reaching more than 1.5 million people in its first year. His team convened two international launches and has made 4 short advocacy films; two in collaboration with the World Health Organization.
Currently, he holds a Postdoctoral Fellowship at Harvard Medical School and continues a part-time role as Assistant Professor at the Copenhagen School of Global Health. He also serves on the Advisory Board of the EAT: Stockholm Food Forum.