Progress in Obesity: Both Infinite and Slow

Opening the Blackburn Course in Obesity Medicine yesterday, Lee Kaplan painted a clear picture of progress in obesity. We’re making progress on many fronts and it still feels like we’re getting nowhere.

Progress comes in the form of the first new obesity treatments in more than a decade, obesity rates that seem to be slowing overall, deeper understanding obesity mechanisms, and improving prospects for treatment access.

Yet all this progress starts from a really low base of knowledge and options. We know enough about obesity mechanisms to know how complex obesity really is. In fact, it’s becoming clear that it’s not just one disease — it’s a range of many different diseases that Kaplan says “hide in in plain sight.” We all know it’s a problem with devastating effects on patients and public health. Yet doctors confront it as a health issue all too seldom.

Even though the overall prevalence of obesity seems to be stabilizing, severe obesity is still growing relentlessly.

Medicare is tentatively leading the way to begin covering intensive behavioral treatment for obesity. But the coverage is so limited, it hardly feels like a victory. Likewise, poor coverage has contributed to a very slow start for the first of two new obesity treatments.

The only devices approved for obesity treatment, gastric bands, are falling out of favor and it’s not clear when new devices will come to replace them.

While we have reasons to be hopeful, but we can’t afford to be patient for more progress on all fronts: prevention, treatment, access to respectful care, and research to provide the necessary foundation for all of this.

Click here to read more from the Institute of Medicine about accelerating progress to solve obesity and here to read more about the need to accelerate progress in obesity research.

Progress Coffee, photograph © dingatx / flickr

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