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Wednesday, 10 April, 2002, 10:08 GMT 11:08 UK
Doctors draw up list of 'non-diseases'
Obesity was highlighted as a 'non disease'
Obesity was highlighted as a 'non disease'
Infertility, obesity and depression are "non-diseases" according to some doctors, a poll for the British Medical Journal has shown.

The journal put together a list of 174 medical complaints which it argued could be defined in non-medical terms.

It then asked doctors to vote for those they wished to be re-classified as a "lifestyle condition".

Top 10 'non-diseases' (% of votes)
Ageing - 44
Work - 35
Boredom - 32
Bags under eyes - 31
Ignorance - 28
Baldness - 28
Freckles - 27
Big ears - 26
Grey or white hair - 25
Ugliness - 24
But patient groups have criticised the poll, saying it is "crude" and "unhelpful".

About 570 readers responded to the BMJ's poll.

Top of the list came ageing, work-related problems and boredom.

The top 20 also included jet lag, cellulite, and anxiety about penis size.

But the poll also showed that obesity was seen as a non-disease by 8%, infertility by 4% and depression by 2%.

Chronic fatigue syndrome / myalgic encephalomyelitis (M.E.) and the menopause were deemed non-diseases by 13%.

Fibromyalgia and transvestism were named by 8%.

And 7% wanted both Gulf War syndrome and premenstrual syndrome reclassified.

Diabetes and osteoporosis were named by 2%.

'Genuine suffering'

The BMJ is looking at the issue of medicalisation, where more and more aspects of human life are redefined as medical problems, in its forthcoming issue.

Some conditions on the 'non-disease' list (% of votes)
Domestic violence - 14
Menopause - 13
CFS/ME - 13
Obesity - 8
Gulf War syndrome - 7
Prementstrual syndrome - 7
Infertility - 4
Depression - 2
Diabetes - 2
Osteoporsis - 2
Richard Smith, editor of the BMJ, wrote: "To have your condition labelled as a disease may bring considerable benefit.

"Immediately you are likely to enjoy sympathy rather than blame, and you may be exempted from many commitments, including work.

"You may also feel that you have an explanation for your suffering."

But he added: "The diagnosis of a disease may also create problems. You may be denied insurance, a mortgage, and employment.

"Some diseases carry an inescapable stigma, which may create more problems than the disease itself.

"Worst of all, the diagnosis may lead you to regard yourself as forever flawed and incapable of 'rising above' your problem."

He said: "We are not suggesting that the suffering of people with these 'non-diseases' is not genuine, but surely everything is to be gained and nothing lost by raising consciousness about the slipperiness of the concept of disease."

Dr Ian Banks of the Doctor Patient Partnership said: "It is important that people who are suffering from conditions which require advice or medical treatment are not discouraged from seeking the right advice be that from their GP, practice nurse, pharmacist or NHS Direct.

"Making sure people are clearer about the kind of advice or treatment they may need should be the main aim of classifying conditions which affect people's health."

'Crude'

But Dr Peter Skolar, a London GP, told the BBC more and more of doctors time was being taken up by the worried well.

"People are now concerned more over items such as their self-image, their self-esteem, their workplace related stress, their cosmetic problems, their lifestyle problems.

"These now become more important as illness, as such, is better dealt with."

Theresa Coe has had CFS/ME for 12 years. She said: "It can make you feel like a fraud, which is really damaging if you're already feeling fatigue and pain and weakness and flu-like illness which is very debilitating."

Brian Dow of Action for M.E. told BBC News Online he did not object to a mature discussion about what constituted a disease.

But he added: "I don't think it's a particularly responsible way of going about this.

A spokeswoman for the National Osteoporosis Society said it was "very disappointed" that a small number of doctors felt osteoporosis was a "non-disease".

She said: "There are in excess of 300,000 fractures as a result of the condition every year - the people who are suffering these painful and debilitating fractures would, we think, be disappointed and annoyed to hear their suffering is considered by some to be a 'non-disease'."

Mike Stone, chief executive of the Patients Association, said: "There may be things doctors can't deal with, but surely the first place people should go to get themselves checked out is the doctors."

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The BBC's James Westhead
"Doctor's behind the survey say they are not being unsympathetic"
See also:

31 Aug 01 | Health
Gulf War Syndrome fear persists
21 Mar 02 | Health
Women 'fail to spot menopause'
11 Jan 02 | Health
M.E. treatment 'must improve'
04 Jan 02 | Health
Bedside manner under spotlight
05 Dec 00 | Health
NHS 'faces 16bn obesity bill'
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