OK, So What Should We Do About Obesity?
It’s an obvious and fair question. Quite often, we describe serious flaws in current strategies to address obesity. If we’re going to find fault with current strategies, then what’s the alternative? What should we do about obesity?
Here, we offer three priorities that would be at the top of the list if we ran the world.
1. Remove Barriers to Health, Wellness, and Obesity Care
More than anything, many policies and practices related to obesity serve to make life worse for people living with obesity. Screening children at school for obesity singles them out for stigma and bullying, while offering no help to reverse the condition. If you’re not offering real help, stop causing harm. Likewise, many other “awareness” campaigns serve only to promote stigma without offering real help. Most people with obesity already know it – even if they avoid that stigmatized word.
In fact, life would be considerably better for people with obesity if all the energy that goes into concern trolling were redirected. Please, redirect it to fight bias and fat shaming. Promote and support body positivity.
Also, everyone who is standing in the way of people who want and need evidence-based obesity care should get out of the way. Listen up, health plans. Live up to the meaning of your first name. Promote health. Start covering all forms of obesity care – nutrition, lifestyle, pharmacotherapy, and surgery. Relatively few people actually seek it out. But for those who do, restricting access to care that will improve life and health is just plain stupid and mean. It’s especially unwise because that care can prevent serious complications of obesity.
A stitch in time saves nine.
2. Find Public Health Solutions That Work
The time has come to discard a popular fiction in public health. In truth, we’re not making progress on preventing obesity. We are not “turning the corner” on childhood obesity. Presumptions about what will work to prevent childhood obesity often prove to be wrong. If we let go of delusions about knowing what works, we can get serious about testing innovative approaches that might actually work.
3. Double Down on Research for Remissions and Cures
Though we have options for obesity care that work for many people, they are hardly ideal. We certainly don’t have any cures. Remission is possible, but not terribly common. Surgery can be very effective. But drugs that could have a similar effect would be a boon.
Better options are possible. But to find them, we need more curiosity driving us to figure out this fiendishly complex chronic disease. Let’s get on with it.
Inga Takes Action, photograph © Richard Kyle / flickr
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
January 15, 2018
January 15, 2018 at 1:50 pm, David Brown said:
Find Public Health Solutions That Work? How is that going to happen when scientists can’t agree as to what caused the obesity epidemic in the first place. The epidemiologists continue to ignore changes in the fatty acid profile of the food supply and continue to demonize saturated fats. This keeps the omega-6 content of the food supply elevated far above pre-obesity epidemic levels. Excerpt:
“Is a particular dietary recommendation harming people in the U.S.? For almost 20 years, scientists have been arguing over whether Americans and others on a typical Western diet are eating too much of omega-6s, a class of essential fatty acids. Some experts, notably ones affiliated with the American Heart Association, credit our current intake of omega-6s with lowering the incidence of cardiovascular disease. Others, which include biochemists, say the relatively high intake of omega-6 is a reason for a slew of chronic illnesses in the Western world, including asthma, various cancers, neurological disorders and cardiovascular disease itself.” http://www.asbmb.org/asbmbtoday/asbmbtoday_article.aspx?id=18365
January 15, 2018 at 1:57 pm, David Brown said:
“Over the last 50 years, general nutritional wisdom has recommended a moderate consumption of fat. We have been told to dramatically lower our consumption of saturated fats (contained in butter, lard, milk, red meat, coconut oil…) and cholesterol (found in eggs, poultry, beef…). We have also been advised to increase our intake of polyunsaturated fats (contained in soybean, sunflower, corn, cottonseed oil…) and carbohydrates (found in pasta, bread, sugar…). But fat is a complex topic and these recommendations have been debated and questioned over the past 30 years. Some experts believe that these dietary recommendations – closely followed by the US population – are the main cause behind the country’s high obesity levels and the rapidly growing number of people suffering from metabolic syndrome.” https://www.credit-suisse.com/corporate/en/articles/news-and-expertise/fat-the-new-health-paradigm-201509.html
The United States is considered a World leader. Unfortunately, the scientists in this country who inform public policy seem to have led the rest of the World down a path that has caused incalculable damage to the public health.
January 15, 2018 at 2:34 pm, Allen Browne said:
Yup – positives are way better than negatives.
January 15, 2018 at 6:39 pm, Linda S said:
Morbid obesity is called ‘morbid’ because you gain 7 excess kilos per year until you die, from excess hunger hormones in the stomach. These waves in the stomach overide the brain waves and drive one to eat, move and sleep in such patterns as to store maximum fat and slow metabolism to burn minimum fat.
By the time I was diagnosed I was too fat to have the life saving gastric sleeve surgery.
Fix that and solve the problem of obesity for the morbid condition.
Anything else is futile.
January 19, 2018 at 1:08 pm, Ted said:
Linda, thank you for sharing your experience, as difficult as it’s been. The term “morbid” obesity is obsolete and insulting to people who are trying to cope with a medical problem such as you describe. Doctors who understand this disease no longer use that word and they don’t tell people that it’s too late to help them.
I’m deeply sorry that someone told you these things. If you wish, you might find that a skilled obesity medicine physician could help you enjoy better health. You can find one who is board certified here: http://www.abom.org/diplomates.