Food activists love to blame "Big Food" for turning a profit from obesity. But few ever wag their fingers at those most responsible for the hype about the "obesity epidemic": the diet and pharmaceutical industries, which stand to gain the most from a population obsessed with weight.

Consumer demand for diet books, powders, programs, and pills has driven the growth of the weight loss industry (with $61 billion in profits projected for 2008) and drug companies. And now health-insurance coverage for obesity procedures and prescriptions promises a new way to guarantee the green. Many insurance policies don't cover weight loss interventions, but an editorial in the May issue of the American Journal of Psychiatry wants insurers to break out their checkbooks:

[T]his condition [obesity] is not only a metabolic disorder but also a brain disorder … Here, we propose that some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V … Obesity is characterized by compulsive consumption of food and the inability to restrain from eating despite the desire to do so.

The DSM-V handbook (Diagnostic and Statistical Manual of Mental Disorders) will be the next edition of the standard reference book used by doctors, policy makers, and insurance companies to diagnose and treat established mental disorders. Turning love-handles into a mental illness would affect everyone, regardless of their girth. Premiums would go up to offset costly treatments (donut interventions?) for this newly defined disease.

The psychiatric establishment should remember that obesity is a mouth-related and leg-related (exercise, anyone?) condition — not a brain disorder.