Five Dimensions of Obesity in America

With so much health reporting about obesity that’s superficial, thoughtful reporting on the subject is worth noting. Last week, WBUR spent the entire week reporting on five dimensions of obesity in America. Despite significant gaps, the information they present is worth hearing.

Click on each of the five links below to listen for yourself.

1. The Threat to Public Health. NPR’s Allison Aubrey points out that “we’re kind of stuck. Overall, obesity rates have continued to inch up.” Bruce Lee of Johns Hopkins points out that “it’s not an individual behavior problem.” He explains how “it’s a very complex problem and we’re seeing a complex set of factors that are changing throughout the world.”
    
2. Living with Obesity. Three people living with obesity discuss their very different perspectives and experiences with obesity. This ranges from a person receiving care in a medical obesity clinic (though it’s not described as such) to someone who has decided to describe herself by simply saying, “I’m fat.”
    
3. Searching for Solutions. NIH Director Frances Collins gives an overview of the complexity of obesity and efforts to find solutions that will work. Unfortunately, he omits mention of anything but “diet and exercise” for “people that have already slipped into that state” of obesity.
    
4. The Food Industry’s Role. Michael Moss describes how “snacking became the fourth American meal” in the 1980s and how the food industry has responded to fuel a compulsion to “eat anything anywhere anytime.”
    
5. Fat Shaming. In what’s undoubtedly the best segment of this series, Rebecca Puhl gives a wide-ranging interview to explain how pervasive bias gets in the way of meaningful progress against the disease of obesity.

 
As thoughtful as the reporting is, it’s stunning that a full week of it would include no mention of evidence-based care for obesity. Diet and exercise are discussed and acknowledged to be incomplete answers. But obesity medicine physicians, drug therapy, and bariatric surgery simply don’t appear in these reports.

That omission reflects a bias that is pervasive: treating obesity is not just hard, it’s futile. That’s the bias that makes it possible for people with this chronic disease to encounter routine denials of medical care, “regardless of any potential benefits.” Sigh.

Fifth Columnist, photograph © filtran / flickr

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December 14, 2015