I Wish

Obesity Wish List for 2015

The wish list generates a lot of activity this time of year — with lots of wishes and hopefully lots of fulfillment. Looking to the year ahead, here are a few wishes for a fresh new list to fulfill.

  1. Access to care. We have skilled clinicians — obesity medicine physicians, surgeons, dietitians, exercise physiologists, psychologists — who can make a tremendous difference in the lives of people with obesity. We have a growing arsenal of drugs, devices, and procedures that can help. Everyone agrees that addressing obesity is critical. Yet we systematically deny people access to care. We put idiotic obstacles in the way of patients and providers. The hypocrisy is hard to swallow.
  2. Evidence-based prevention. Because obesity is so resistant to treatment, prevention has great appeal. Yet we often invest in prevention without measuring the return. The investment must continue, guided by rigorous evidence for interventions that work.
  3. Genuine, competitive innovation to cure obesity. A little weight loss is great for serious obesity. More is better. Preventing a few extra cases of obesity and the attendant chronic diseases is wonderful. But we must aim higher. We’ve got to pursue a fundamental understanding of all forms of obesity with the same vigor we applied to pursuing cancer 40 years ago. One by one, we’ve got to bring forward prevention that really prevents, along with treatments that provide remission and cures for every form of obesity.
  4. No more fat shaming. In so many ways, gross and subtle, the response to obesity involves shame and blame. Recognition of counterproductive fat shaming is growing, but it’s far from gone. We should no more ask people to “take personal responsibility” for obesity than we ask people to take personal responsibility for breast cancer. And yes, when we face adversity — whether it’s cancer or obesity — we have to choose how we will respond. That’s very different from laboring under a crushing load of blame and shame.
  5. No more fat letters from schools. These artifacts of weight bias need to become embarrassing historical artifacts — extinct. Screening children for a problem and then telling parents they’re on their own is unethical and indefensible. The energy needs to go into promoting healthy nutrition, physical activity, and freedom from bullying. Schools are not equipped to provide the healthcare that’s necessary for diagnosis and treatment of obesity. It’s simply not their business.

There you have it — five little wishes and a whole year ahead to work on them.

I Wish, photograph © mio-spr / flickr

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