Recognizing overweight and obesity as chronic diseases and acknowledging root causes.

As obesity increases in the global population, it is important to recognize that obesity is not a willpower failure but a chronic disease regulated by genetic, environmental, and hormonal control of energy balance. Obesity is also caused by social and political factors, including poor regulation of the food industry and lack of access to healthy, affordable foods. To de-stigmatize obesity, we need to understand and teach the pathophysiology of overweight and obesity in the same way we teach the pathophysiology of cardiovascular disease or type 2 diabetes. The controversy surrounding the need for new incretin-mimetic obesity medications illustrates the lack of understanding of obesity as a chronic disease. While we may not be able to change social conditions, modify genetic or environmental factors, or regulate the food industry, we can de-stigmatize obesity and overweight in our clinics and offer appropriate treatment.