I have a piece in Salon about how the concepts of “homosexuality” and “obesity” are examples of how deviance from social ideals gets medicalized, and how recognizing this requires recognizing that definitions of health and disease often have an unavoidably political component.
Update :Responding to a couple of comments:
(1) LP2 suggests that food is to the relapsing “obese” person who cannot maintain enough weight loss to become and remain non-obese as cocaine is to the relapsing drug addict. This seems to me a problematic analogy for a number of reasons. Most people who have used cocaine do not become drug addicts, and most people who eat, including most fat people, don’t become food addicts (some fat people, of course, engage in addictive behavior toward food, but so do some non-fat people). Furthermore while the person who does become addicted to cocaine can stop using cocaine, the person who has an addictive relationship to food can’t stop eating. Beyond this, saying that someone who has a BMI of 30+ is “sick” in the same way that a drug addict (as opposed to a drug user) is sick seems to me clearly wrong. So the food to fat people = drugs to drug addicts analogy doesn’t really work very well.
(2) Bijan asks if I consider anorexia a disease. Anorexia is a disease, but the problem with identifying anorexia with a particular body state, so as to make the analogy between anorexia and obesity a close one, is that defining anorexia as a certain level of thinness is both over and under-inclusive. Unfortunately the clinical definition of anorexia uses an absurdly low criterion (you have to be significantly below a BMI of 18.5, which is already in the second percentile of BMI for the population), which means that many people who have every diagnostic criteria for anorexia except for extremely low body weight aren’t clinically considered anorexic. In addition there are some very thin people who aren’t eating disordered — they’re just very thin. Again, the point is that a body state in and of itself shouldn’t be considered diseased, except in truly extreme situations.