A Top 10 List of Wishful Thinking in Obesity

Wishful thinking jumps off the page from a new publication in Health Education Research about the “Measure Up” mass media campaign in New South Wales, Australia. Investigators found that the campaign did a great job of raising awareness for the link between waist size and chronic disease risk, but nothing to change diet or physical activity. Their conclusion? Continued long-term investment may contribute to behavior change and reduce chronic disease.

This kind of wishful thinking is not so rare in obesity research and policy. Here’s a subjective top 10 list.

1. Obesity is a choice, not a disease — just eat less and move more.
   Given the billions of dollars people spend trying to lose weight, one wonders how people can persist in thinking that people with obesity just don’t care enough to make better choices. Admonitions to eat less and move more dominate health policies aimed at obesity. Good choices are important, but often not enough to overcome obesity.
2. Eradicating food deserts will reduce obesity.
   Many programs to bring food stores and healthy food into food deserts have had little impact to date on obesity. The relationship between food deserts and obesity is far more complex than simple cause and effect.
3. Sugar-sweetened beverages are the biggest source of added sugar.
   CDC data shows that most of the added sugar in American diets comes from solid foods, not beverages. Consumption of added sugar in yogurt is growing, while sugar-sweetened beverages are dropping like a rock.
4. Obesity surgery is an easy way out.
   Ask anybody who has had the surgery, has a loved one who’s had the surgery, or cares for bariatric surgery patients. Surgery might be the most effective tool we have for treating obesity, but it’s a big commitment and it’s only a tool — definitely not a miraculous, easy way out.
5. We can’t afford to pay for obesity treatment.
   What we can’t afford is to keep denying coverage for this disease and pretending we’re not paying for it when we treat diabetes, heart disease, joint damage, liver disease, cancers, and a long list of other conditions.
6. Menu labeling promotes healthier choices.
   It only makes sense that people should know what’s in the food they buy in restaurants, but studies are pretty consistent in showing that menu labeling does little to promote healthier choices.
7. Obesity is entirely preventable.
   Considerable energy goes into figuring out if obesity has surpassed smoking as the leading cause of preventable death in the United States. But who says it’s preventable? We spend lots of money on obesity prevention, but the best we’ve been able to do is declare that obesity rates are holding steady at historically high levels. When we finally figure out how to prevent obesity, then we can celebrate and honestly call it preventable.
8. Breastfeeding prevents obesity.
   Breastfeeding benefits the health of both mother and child and we should be doing everything possible to promote it. But promising that it prevents obesity is wishful thinking in light of considerable research that shows no effect.
9. Weight loss is the whole point of obesity treatment.
   Employers are the latest folks to get it into their heads that the answer to obesity is to set a BMI goal of 25 or less for everybody. But the fact is that a 5-10% weight loss is what’s achievable for most people and most people can achieve that in 6 months or less. A much larger effort needs to go into maximizing health and maintaining a life-long healthy weight, even if that weight leaves you at a BMI greater than the magic number of 25. One size does not fit all.
10. Weight loss is pointless.
    For some people, the stupidity of others who harbor bias against anyone with a larger body becomes an excuse to ignore the benefits of losing a modest amount of weight and maintaining it. Nobody’s entitled to tell someone else how much they should weigh, but finding a healthy weight for yourself is essential.

 
What’s your perspective? Take a moment to share your opinion about the wishful thinking in obesity that bugs you the most and see what others say.

Click here to read the study in Health Education Research.

A Child’s Wish, photograph © John Liu / flickr

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