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40 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 8 education PATHOLOGY PERSPECTIVES Demystifying Obesity Looking Beyond the Scale, Part 1 By Ruth Werner It is with a great deal of trepidation that I approach the topic of obesity in a pathology column. "Oh, there she goes, pathologizing a behavior. Aren't there enough real diseases to discuss?" I can hear some readers say. "Obesity is a disease now? There's a simple, cheap cure: eat less and get off your ass," I have heard from others—including medical professionals. The American Medical Association declared an opinion on this matter in 2013: in the United States, obesity is now considered to be a freestanding disease. The Canadian Medical Association, the World Health Organization, and the World Obesity Federation have all followed. This article will be a two-part effort. In this edition, we will look at the background information about obesity, what repercussions it has on general health, and some important accommodations in the massage therapy session room for clients who are overweight or obese. Next time, we will explore treatment options for obesity, including diet, exercise, drugs, and surgery, with emphasis on massage therapy accommodations for people who are going through treatment for this condition. I want to thank in advance the many people who have contributed to these articles; your wisdom and generosity are much appreciated. WHAT'S IN A NAME? Obesity. The word is both a diagnosis and a descriptor that carries an undeniable and pejorative value judgment. In simplest terms, obesity means being substantially heavier than is considered to be healthy for a person's height: it is a mathematical, objective reality. But in cultural terms, the word obesity can be an accusation of weak character, self-indulgence, laziness, and worse. "Marvelous, gluttony becomes a disease. What's next?" —Pharmacist, during a public discussion of obesity for medical providers