I Know I Have Lost

Knowing What We Know & Don’t Know about Obesity

A remarkable core of scientists and clinicians devote themselves to knowing everything they can about obesity and caring for the people who have it. These people have amassed tremendous knowledge about the disease of obesity. A whole new medical specialty — obesity medicine — is emerging with the leadership of the American Board of Obesity Medicine. Clinicians who devote themselves to caring for people with obesity — bariatric surgeons, dietitians, clinical psychologists, and fitness professionals — make a huge difference in the lives of people with obesity.

And yet, many frustrations remain. At the top of the list of frustrations is the underutilization of this knowledge base. A deep understanding of the basic science of obesity has grown exponentially over the three decades of this epidemic. But the public and way too many healthcare professionals are hanging onto a simplistic notion that obesity is just a personal failure of sloth and gluttony. Sadly, this misperception influences the policy response to obesity far more than we should expect.

Unsurprisingly, policies based upon such misperceptions have been spectacularly ineffective in bending the curve of the obesity epidemic. While countless programs have urged people to get moving and eat less, the prevalence of obesity has continued to grow. Meanwhile, public policies have largely ignored the treatment needs of people with obesity. Access to care is a huge challenge.

The second frustration is the gap in our knowledge about obesity that remains. We don’t really know what has caused the excess of obesity that has grown over the last three decades. Strong opinions about how to prevent obesity are abundant, but we don’t really know what will work to reverse the trend. Most frustrating is that we don’t really know how to treat obesity with the degree of effectiveness that people can expect for other serious medical conditions.

Today, the life expectancy for a gay man with HIV is longer than the life expectancy for a person with severe obesity. These two epidemics started at approximately the same time — in the 1980s. The tremendous progress in HIV disease came from an intense curiosity and commitment to research at a scale that could solve the problem.

Commitment to obesity research is hindered by the simplistic view of obesity the public holds. We must translate the knowledge we have into public awareness. And we must develop a much more robust knowledge of obesity.

“The only true wisdom is in knowing you know nothing.” — Socrates

Click here for a challenging assessment of the response to obesity and here for a discussion of persistent myths and presumptions about obesity.

I Know I Have Lost, photograph © Sarah Galasko / flickr

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