I would like to engage you in a little theater of the mind. Let us imagine that an anonymous donor has bequeathed $10 billion for research into 1 of 3 therapeutic areas. Moreover, this donor orders that the entire grant goes to the disease state that receives the most votes from a nationwide Internet poll. The 3 candidate illnesses are:

  • Obesity
  • Addiction
  • Lung cancer

Without ever conducting this poll, I am reasonably certain that the results would be overwhelmingly in favor of cancer. Why? Because a great number of respondents, if not all, would say that cancer is a terrible disease, which it is; few will ever deny that fact. In contrast, the other 2 illnesses are considered by many to be self-inflicted, created and perpetuated by the person. Although this may be the popular point of view, it is wrong.

Despite growing recognition of it as an important international health problem, addiction suffers neglect from clinicians, researchers, and the pharmaceutical industry. This is largely because addiction is viewed as self-inflicted and caused by personal weakness.

More than 72 million people in the United States are obese. More than 30% of US adults and 16% of US children are obese. According to the Centers for Disease Control and Prevention (CDC), the medical cost of obesity may be as high as $147 billion annually. This is almost 10% of US medical spending. Are all these people weak of will, or are they actually sick?

The National Cancer Institute says on its website, “Lung cancer is the leading cause of cancer death among both men and women in the United States, with 90 percent of lung cancer deaths among men and approximately 80 percent of lung cancer deaths among women attributed to smoking.” Whoa! Does that mean that over 80% of all lung cancer deaths are self-inflicted by the act of smoking, which, by the way, is a common behavior brought on by an addiction to nicotine? Let us take this 1 step further. Ask smokers who have tried to quit smoking what happens to their weight; it often goes up, and for some that weight never comes off. Some former smokers gain so much weight that their BMI classifies them as obese. These 3 therapeutic areas are so interrelated that it is difficult to see where one begins and the others end.

My point is that the public has preconceived ideas of which disease states should be given the most support and which patients the most sympathy. The idea that any person who is suffering from a disease or disorder should be viewed as a second-class citizen because of etiology is illogical. Illness, no matter what its origin, is devastating to patients, their families, and society as a whole. We must recognize that the cause of disease or illness is irrelevant when considering the need to devote time, energy, and funding to its study and treatment. It is time to view these and other diseases as preventable—and not self-inflicted—for no other reason than it is the right thing to do.

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