Happy Highway Future

Six Hurdles for the Future of Obesity

Obesity is a unique challenge for global health. Other chronic diseases present problems that yield to systematic research, treatment, and prevention efforts. Heart disease, diabetes, cancer, and HIV have all become steadily more manageable. People affected by these diseases — even if cures might not be possible — can often lead relatively normal lives. For the future of obesity to reach such a state, six hurdles must be cleared.

  1. Bias and Discrimination. Right now, bias and discrimination affect every aspect of obesity. Research is compromised by a dearth of curiosity and unwarranted assumptions. Prevention is compromised by presumptions about what ought to work. Quality of care and access to care are compromised when patients are blamed for their condition.
  2. Evidence-based Prevention.   In a systematic review of childhood obesity prevention, Peirson et al recently concluded that “No intervention strategy consistently produced benefits.” Though we have good ideas about promising strategies, much work in refining their implementation and measuring results remains to be done.
  3. Deeper Insight into the Disease. Knowledge of the biological underpinnings of obesity has grown recently, but remains superficial and not widely shared. Understanding the disease in all of its forms is essential to managing it more effectively.
  4. Better Access to Care. At present, self-care is really the mainstay of obesity treatment. People spend billions of dollars out of pocket for interventions that are at best mildly effective and too often fraudulent. Evidence-based medical and surgical care for obesity is out of reach for most people with obesity because of routine exclusions by health plans “regardless of medical necessity or potential health benefit” (language regarding obesity treatment routinely found in health plan documents).
  5. Expanded Options for Treatment. Current interventions for nutrition, physical activity, obesity medicines, and surgery can be helpful, but they have important limitations. Innovation to produce more options that will work for more people is essential.
  6. Integration of Treatment and Prevention. it’s delusional to think that prevention programs can work for children in families where adults with obesity have no options to improve their own health. In the absence of access to effective treatment, obesity prevention efforts will have limited effectiveness.

That’s it. Just six little things on our to-do list and we’ll have this obesity thing under control.

ConscienHealth founder Ted Kyle is presenting this perspective to the Obesity Research Interest Section at the annual scientific sessions of American Society for Nutrition. To view his slides, click here.

Happy Highway Future, image © James Vaughan / flickr

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