LAKSHMI KOTHANETH
The question of whether obesity should be classified as a disease took centre stage during the recent Oman Summit for Diabetes and Endocrine Across the Lifespan, as leading international and national experts called for a shift in how obesity is understood, treated, and managed.
“It is time to recognise that obesity can be a disease for some, though not for all,” said Dr Francesco Rubino, a renowned clinician and scientist and Chair of Metabolic and Bariatric Surgery at King’s College London, while addressing the summit.
Dr Rubino, an honorary consultant surgeon at King’s College Hospital and a pioneer in metabolic and bariatric surgery, explained that obesity has long been misunderstood due to an overreliance on Body Mass Index (BMI) as a diagnostic tool.
“Obesity has been ill-conceived for many years. We have focused on BMI as a measure of excess body fat, but it does not tell us whether organs are functioning properly or whether the body is healthy or sick. This has made it difficult to define and treat obesity effectively,” he told Observer.
He noted that this limitation prompted the launch of an initiative four years ago to redefine obesity using criteria beyond BMI, including the impact of excess fat on organ function. Dr Rubino’s work also focuses on clinical research, surgical interventions, public education, and combating obesity-related stigma.
Echoing similar views, Sayyidah Dr Noor al Busaidy, Director of the National Diabetes and Endocrine Center, stressed that obesity is a disease and should not be associated with a lack of willpower.
“The physiology of obesity is vast. Some doctors define it as a neuro-endocrine disease, while others view it as a gastrointestinal disorder. The key message is that obesity is highly complex,” she said.
She emphasised that patients should not be blamed and that obesity requires long-term management rather than a one-time intervention. “Management involves multiple pathways—medication, lifestyle modification, surgery, and more. There is no single solution. Lifestyle intervention remains the core, including balanced nutrition, physical activity, adequate sleep, and stress management,” she added.
Dr Amira al Kharousi, Specialist in Obesity and Bariatric Surgery at the National Diabetes and Endocrine Center, noted that global scientific organisations no longer regard obesity as merely a lifestyle condition.
“The traditional belief that obesity is just a lifestyle disease is outdated. Obesity is a disease that can be treated, and there are multiple therapeutic options available to address obesity and its related complications,” she said.
Dr Al Kharousi outlined a structured, three-pillar approach to obesity management, beginning with lifestyle and behavioural medicine, including psychological support, followed by pharmacological treatment, and, when necessary, bariatric surgery. She added that several less invasive procedures are also available between these stages.
Experts at the summit agreed that recognising obesity as a complex, chronic disease is essential to improving patient care, reducing stigma, and ensuring access to comprehensive and effective treatment pathways.
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