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v 四级2021.12.2-Passage 1
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 discase “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.
【原文翻译】
现在肥胖影响了英国29%的人口，预计到2030年将上升到35%，我们现在应该把它视为一种疾病吗？约翰·怀尔丁教授认为，肥胖是指体内多余的脂肪积累到一定程度，可能会对健康造成不利的影响，符合字典对疾病的定义。他指出，影响体重的基因有200多种。“因此，体重受到生理因素的强烈影响，肥胖并不是一个人的错。”然而，人们普遍认为，肥胖是自我诱发的，采取行动完全是个人的责任。承认肥胖是一种慢性疾病，严重的并发症，而不是一种生活方式的选择应该有助于减少许多肥胖的人所遭受的耻辱(耻辱)和歧视。
怀尔丁教授不同意：将很大一部分人口贴上疾病标签会使个人责任消失，或者可能使医疗服务不堪重负。他指出，其他常见疾病，如高血压和糖尿病，需要人们采取行动来控制自己的病情。他认为，大多数肥胖患者最终都会出现并发症。并且他总结道“但除非我们承认肥胖是一种疾病，否则我们将无法解决它”。
但对糖尿病有特殊兴趣的内科医生理查德·派尔(Richard Pile)认为，采用这种方法“实际上可能会给个人和社会带来更糟糕的结果。”他认为，词典对疾病的定义“如此模糊，以至于我们几乎可以把任何东西归类为疾病”。他表示，问题不是我们是否可以，而是我们是否应该，以及目的是什么。
他写道，如果给肥胖贴上的疾病的标签是无害的，那么肥胖也就没什么大不了了。但把肥胖视为一种疾病会“冒着削弱自主权的风险, 以及剥夺人们的动力，而这种动力则是非常重要的变化助推器。”更重要的是,把肥胖列为疾病 “可能无法让病人受益, 但当健康保险和临床指导方针促进治疗药物和手术时，它将有利于医疗服务提供者和制药(制药的)行业,”他警告说。
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