When an epidemic is not one

It's all in the genes and I'm not accountable
Take back this burden, I've something to blame
For though I've made choices, I am not responsible
And patriarch, patriarch, permits it the same

I've got a bone to pick with some terminology that I'm super sick of. It's word "epidemic." I'm not entirely sure when the meaning of this word got distorted, but it did at some point, and now we're using left, right, and centre to deflect blame, hide the issues, and it's only the people who are sick that are really suffering.

Epidemics (and pandemics) have occurred throughout history: the bubonic plague of the middle ages, polio in the 1900s, HIV/AIDS today (maybe...?), Spanish influenza in 1918. Epidemics generally refer to infectious diseases because while precautions and prophylaxis can be undertaken and used to prevent spread, infection happens (which is why I'm not sure that HIV is the best example...but I'll throw it up there). Where I start to take exception is when we label obesity as the next great epidemic.

Sure, there are genetic factors at work, and yes, some people are more prone to overweight (and potentially obesity) than others. But where the label falls short, is that most of the obesity prevalence is due to, not genetics, but an excessive caloric intake.

Fact is, when it comes to obesity, in general, we're fat because it's our fault. We make lifestyle choices in terms of our diet and activity, and poor choices lead to overweight and obesity (with genetics playing a smaller role). And that's the equation.

The problem is that people need to realize that just because you come from an overweight family, doesn't relegate you to being obese -- there are things that can be done. And while they're not easy, the can make a huge difference on quality of life, morbidity, and indeed mortality.

My big exception to the use of the label "epidemic" is that it disempowers people who are overweight or obese, and makes it sound like it's something they caught or contracted, when in reality, that's far from the truth. There were decisions that were made along the way that, at least in part, contributed to one's overweight. Tiptoeing around the issue in fear of offending people does not help the problem. We've never called smoking an epidemic, have we? It's a conscious decision (at least in part), and the fact that addiction may have genetic links doesn't convince anyone that a smoker isn't responsible for the sequelae of smoking. Why is this so different for obesity?

I think one of the biggest problems in health care is the lack of power that a patient has, and in rampantly using terminology like "epidemic" to describe something that is, for most part, preventable based on modifiable risk factors, is doing a severe disservice to patients and to population health. We need to empower people to feel as though they can be a key player in their own health, and in their health care no less, if we want to beat this.

Maybe we should be calling it "widespread obesity" instead. It doesn't have to be innocuous. In fact, it shouldn't be. That's all.