The Issue: Is obesity a disease or a lifestyle choice?

CHICAGO, June 23 (UPI) -- Women in stretch pants who should know better, men with guts hanging over their belt buckles walking around shirtless -- we've all had that nasty thought: Look at that fat slob.

The American Medical Association last week declared obesity a disease on the final day of its policymaking meeting in Chicago, going against the recommendations of its advisory council.

There's no question obesity is a national epidemic: Statistics from the Centers for Disease Control and Prevention indicate nearly 36 percent of U.S. adults more than 20 years of age were considered obese in 2009-10, with 18.4 percent of adolescents hot on their heels. Rates are higher for African-Americans, with more than half of black women in that category. Projections are for obesity rates to hit 44 percent by 2030 if current trends continue, with the attendant increase in such ailments as diabetes, high blood pressure and heart disease.

With the focus on reducing medical costs, it may have been inevitable attention would be directed to a problem responsible for triggering much of that spending.

"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans," AMA board member Patrice Harris said in a news release wrapping up the policymaking meeting. "The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity."

The statement triggered predictable reaction with organizations such as Weight Watchers and the American Association of Clinical Endocrinologists applauding the stance and the National Association to Advance Fat Acceptance rejecting it.

"Physicians' weight bias, already a major problem, is now moving beyond just stigmatization to clear dislike and negativity toward the overweight," the NAAFA said in a statement. "Couple this with the fact that physicians have received insufficient or no training to address or examine fat patients and are frustrated with the lack of resources available to them setting the stage for a powder keg of discrimination, the likes of which we have never ... seen before."

"Economic greed and weight stigma have trumped science and the advice of the AMA's own expert committee, and it is a sad day for the relationship between doctors and their higher-weight patients," NAAFA Advisory Board member Deb Burgard said. "People are losing confidence that their doctors have their best interests at heart. This decision represents a clear victory of economic interests over science."

There's also a hashtag on the issue on Twitter: #IAmNotADisease.

"What fat people need: medical care that does not focus solely on weight. Access to healthy food. Safe spaces for movement," Michelle tweeted.

"Serious actual diseases [y'know, like cancer] go unnoticed in fat patients because all symptoms are chalked up to weight," said another woman whose Twitter handle is not suitable for polite company. "PS it would be a lot easier for me to exercise if I could walk to the store without getting mooed at."

"Waging a war on obesity means waging a war on fat people, and I refuse to allow anyone to call my body a disease. I am fat," Jodie Austen posted.

They have a point. A study in the International Journal of Obesity last summer indicated some employers automatically reject overweight applicants on the assumption if they're fat, they're lazy, and unproductive as well.

"The reasons behind obesity discrimination are complex and perhaps the most prominent theory is controllability theory, suggesting that the most stigmatized conditions are those that are widely perceived as controllable," said researcher Janet Latner, a professor of the Department of Psychology at the University of Hawaii.

NAAFA demanded the AMA reverse its decision and urged it to sponsor a roundtable discussion that includes "higher-weight people from every community."

Marilyn Wann of San Francisco posted a petition on Change.org, encouraging people to demand the AMA "stop defining 'obesity' ... as a disease."

"Using weight to define health is inaccurate, unscientific prejudice. It directly fuels discrimination in the workplace, from insurers, in medical care and in social interactions. The war on so-called 'obesity' ... is a war on fat people. Doctors already exhibit dangerous levels of weight bias. Fat people deserve care, not condemnation. Correlation [does not equal] causation. Behavior [does not equal] BMI. Weight [does not equal] health. Hate is not good for public health," the petition reads.

"'Just lose weight' is not an answer to medical problems. Losing weight will not cure my depression [Google it -- this has been proven], losing weight will not make cancer go away, losing weight will not clear up lupus, losing weight will not magically fix a broken limb nor will it stop a heart from getting palpitations. Fat hatred in the medical community is already rampant and we do not need another reason to be treated like piles of [expletive]."