In opposition to the beliefs of the majority of Americans, obesity is not always a choice. There are various components that quite possibly could contribute to obesity that people are born with. There are many factors that correlate with obesity, that are not chosen by any individual, such as: gestational weight gains within mothers, illness of mothers, drug use of mothers, unhealthy habits in parents, psychological factors, one’s genetics, one’s environment and socio-cultural factors. These are all variables that play a role in leading one down a long and dangerous path. Once someone suffers from obesity, it is indeed possible, but very difficult for them to overcome. The American Medical Association (AMA) found evidence to identify obesity as a disease. That being said, factors that contribute to this disease prove that obesity, in many cases, is not always chosen and can cause some seriously unfortunate consequences. Therefore, Americans should encourage those who suffer from it and fight hard to put an end to this terrible disease that effects so many!

The American Medical Association declared that obesity was a disease sometime in the year 2013. According to the American Medical Association’s House of Delegates, the AMA can declare any condition to be medically defined as a disease, if it fits all of the following criteria: the condition is associated with morbidity or illness, there is evidence of deficiency of normal bodily functions, and symptoms and signs that can define the condition. The American Medical Association stated that the amount of fat in an individual can be associated with the following conditions that can then be considered illness or a factor in morbidity: polycystic ovary syndrome, type 2 diabetes, some cancers, osteoporosis, and even cardiovascular disease. Obesity can also be associated with the following deficiencies in body functions: hormonal malfunction, multi-metabolic malfunction, appetite dysregulation, dysregulated adipokine signaling, endocrine dysfunction, abnormal energy balance, nonalcoholic fatty liver disease, dyslipidemia, elevated leptin levels, resistance to insulin, increase in infertility, abnormal endothelial function, adipose tissue inflammation and hypertension. Some of the signs that helped to define obesity as a disease were increased body fat, accumulation of body fat, low self-esteem, joint pain, sleep apnea and immobility. Therefore, the American Medical Association had evidence and reason to decide and announce obesity as a disease. 

Obesity is a rapidly rising problem in today’s world and it does not discriminate against age. Within children, obesity is so extremely prevalent that an article from opposing viewpoints in context states, “one in every three children (31.7%) ages 2-19 is overweight or obese” (“Childhood Obesity Is an Urgent Health Problem”). Although this statistic in itself is extremely high, more recent studies show that in the last few years the obesity rate in children has been increasing at an even more rapid pace. Mgutshini mentions a study that showed an 11% increase in the number of obese children in the United States, ages 6 to 11 from 1980 to 2010 from the National Health and Nutrition Examination Survey (NHANES). During the same time period, there was a 13% increase in the number of obese children between the ages of 12 and 19 (Mgutshini, 2014).  The disease is not only a huge public health problem for children, but adults as well. Two thirds of the American population are overweight, while one third of all Americans can be described as obese. Findlay mentions that 45% of adults in the United States were obese in 1980 and this percentage rose a total of ten percent over just ten years (Findlay, 2003). One can see from this statistic, that the disease is just as frequent in adults as it is in children and it is increasingly becoming a more common problem for those in the United States. It is evident that the disease is becoming quite significant and is effecting many more people than one assumes. Obesity can be caused by various factors that in most cases are uncontrollable; one being gestational weight gain in mothers. 

 Gestational weight gain in mothers can cause their offspring to be overweight and in some cases, obese. Obviously, this is completely and totally out of the child’s control, as it is something that happens before they are even born. Evidence shows that the amount of weight a mother gains during pregnancy could play a vital role in the future genes of their offspring. Mgutshini touches on a case study that exemplifies that a mother’s over-nutrition during her pregnancy can cause modifications in the appetite centers in the brain of her child, increased fat mass, and also modified genes in fat tissue within the child. That being said, it is assumed that this “over-nutrition” in mothers can later lead to various problems such as issues with controlling one’s appetite and/or suffering from a low functioning metabolism (Mgutshini, 2014). Issues with gestational weight gain in mothers and the effects that this has on the child is just one of the many examples as to why obesity is a disease, rather than a choice. Other decisions made by mothers can lead to their children being overweight or obese. Such factors are illnesses in mothers and/or drug use by mothers while pregnant with their child. 

Another factor that could cause obesity in young children is having neglectful, lazy parents who fail to possess healthy eating habits themselves. A child is helpless when he or she is born, therefore looks to his or her parent for help in every way. Children learn from their parent’s actions and behaviors. A parent’s poor eating habits and weak willpower could later in life have a horrible effect on their child. John Donvan’s case study following two young children shows exactly that situation. When the children and parents in the study were asked what an average dinner for their family was, the mother of little Nick responded, "It's usually a meat and two vegetables, and then we fix him macaroni and cheese every night because that's the only thing he'll eat” (Donvan, 2010). The response of young Nick’s mother shows the poor eating habits were an extremely common thing in their household. The bad habits of this family were more than likely taught early on in the child’s life when the parents were too lazy to prepare something healthy, and macaroni and cheese was the easiest, fastest way to feed their hungry child. It is significant for parents to understand the importance of health eating habits and for them to model those habits to their children. The author of “Childhood Obesity: Causes and Consequences”, Krushnapriya Sahoo explains that children learn through mimicking and modeling from their parents. They also learn through their peer’s preferences, willingness and intake to trying new foods. When parents make healthy food available repeatedly it can help children overcome their preference towards unhealthy food or foods they may dislike (Sahoo, 2015). Sahoo’s point proves that it is vital for parents to step in and enforce to their children the right foods to eat in order to maintain a healthy lifestyle. Also, it is vital of the parents to make healthy snacks available such as ones that incorporate fruits and vegetables available rather than simply what is convenient. It is best that parents enforce healthy eating habits because if not the child may not learn them until it is far too late. 

There are a number of psychological factors associated with eating habits that many obese people unfortunately formed as children. Touching on the last topic, children learn habits and pick up on behavioral skills from their parent’s actions and behaviors. Many people associate stress and boredom, both psychological factors, with over-eating. This can lead to becoming overweight and over time, become obese. Children are often rewarded with treats such as candy or cookies. The associations people make with food, such as a treating it as a reward, can be hard to unlearn or ignore as they become older. This leads to indulging in sweets and fattening food too often which can lead to obesity. Being depressed is another factor that can also lead to the consumption of more food (Novitt-Morena, 1998). 

One’s genetics can cause obesity. Specific diseases such as Prader- Willi Syndrome and Bardet Biedel syndrome are present due to genetics and have side effects including excessive weight gain or obesity (“Other Factors in Weight Gain”). Polycystic ovary syndrome and Cushing’s disease can also both cause weight gain and possibly obesity; which are obviously not self-inflicted diseases (“Other Factors in Weight Gain”). It is unfortunate, but evident that in today’s society, obesity is likely a problem that is centralized within a family. An article from the Research Chair in Obesity states, “Obesity risk is two to eight times higher for a person with a family history as opposed to a person with no family history of obesity, and an even higher risk is observed in cases of severe obesity” (“Genetics Play a Role in Obesity”). Although this statistic is unfortunate, it is true and again proves that some people don’t suffer from obesity simply by making bad choices, it is something they have been doomed with sense before their birth. Another study that proves obesity is likely linked with genetics shows the examination of two identical twins. In the study, it was proved that twins who both ate the same number of calories throughout the whole year ended up gaining the same amount of weight. The researchers concluded by stating that genes account for around 25 percent to 40 percent of one’s likelihood to be overweight. (Novitt-Morena). According to Tim Ehrlich, there are 32 genes from each parent, a total of 64 genes, that can contribute to causing obesity in the offspring (Ehrlichbariatrics, 2013). Novitt-Morena also touches on how there was a fat gene found in rats. The gene, Ob gene, was recently found in humans too. The gene contains leptin which is a protein that when released into the blood stream, signals the brain to stop eating because the stomach is full. If the gene is missing or defective, the signal to stop eating cannot be sent to someone’s brain (Novitt-Morena, 1998). These statistics and studies once again prove that obesity is not always a choice, these poor people suffering from the disease certainly cannot control their genetics and family history. 

A person’s weight can also be influenced by the environment in which they live. According to the Centers for Disease Control and Prevention, people make decisions about their community and the environment that they live in. It is not always someone’s choice to have a store close to their home or be able to walk to work or school. They may not have the option to live in a safe neighborhood where they feel like they can go for walks or work out outside. It is not someone’s choice to have the ability and access to parks or trails, and sometimes even sidewalks for them to be able to walk on. It may be more convenient, less time consuming, and more inexpensive to eat at a fast food restaurant than go to the grocery store and prepare a healthy meal (“Other Factors in Weight Gain”). According to a survey done by the University of Pennsylvania, the increased amount of fast food restaurants in an area, the higher rate of obesity is displayed (Holliday, 2008). Although one’s environment, along with the various other reasons I have touched on above prove that obesity indeed is a disease, many Americans argue otherwise and think obesity is simply a choice of bad habits and laziness of the individual. 

Regardless of the evidence presented about obesity not being the choice of the specific individual, there is still an incredible amount of discrimination against people with obesity. People on the opposing side of the argument associate being overweight and obese as lifestyle choices made by the individual that suffers from them. Those in opposition, such as Dr. Keith Ablow believe such things as this, he writes, “It is largely caused by poor decisions—like binging on food or eating lots of candy, ice cream or Cheetos” (Ablow, 2013). While in some cases this indeed could be true, Ablow is describing just one of the more unlikely reasons behind the disease of obesity. In Ablow’s article for Fox news he even compares the disease to alcoholism in his sarcastic title, “Obesity is not a disease - and neither is alcoholism”.  It is imaginable that the title Dr. Keith Ablow chose has a distasteful and honestly hurtful impact on those who are suffering from the disease of obesity. Ablow even goes on to be as cruel as stating, “Last time I checked, there was no known gene that would make people veer off into the McDonald’s drive-through lane or direct them to choose whole milk over 1 percent milk.  No known gene can make you raid the refrigerator at midnight” (Ablow, 2013). Ablow’s claims although are rude are indeed in fact true in some sense, but only in describing one of the various causing factors of obesity. Ablow is using the one situation in which obesity is a choice to try and argue against the various situations in which it is a disease. Ablow’s assumptions and accusations of those suffering from the disease are very stereotypical and unfair to those who are obese. People with cancer, hypertension, diabetes, cirrhosis, Hepatitis C or a number of other conditions are not blamed or denied treatment even though they could have acquired these conditions from lack of activity, lack of diet, smoking, drug use, alcohol use and more; all of which are choices that are made by the individual. Based on all of the evidence presented in previous paragraphs, Americans and people around the world should encourage obese people to try and lose weight and become healthier individuals. People such as Dr. Keith Ablow should stop discriminating against people with the disease, obesity. 

Due to the evidence behind gestational weight gain in mothers, illness of mothers, drug use of mothers, unhealthy habits in parents, psychological factors, one’s genetics, one’s environment and socio-cultural factors, obesity can and should be defined as a disease that individuals can acquire by chance and not choice. People who are not obese should not discriminate against people who may be overweight or obese, as it is a disease and not their choice in many different situations. Instead, Americans should be supportive of obese people and try to encourage them to participate in surgery, exercise, and bettering their diet. 
