Nine Dimensions of Progress in Addressing Obesity

UThree years after the AMA decided that obesity is a chronic disease, have we seen progress in addressing obesity? Earlier this year, Arya Sharma commented that “The U.S. has made remarkable progress in policy recognition of obesity as a disease.”

In a new paper to be published in Endocrinology and Metabolism Clinics, Ted Kyle, Emily Dhurandhar, and David Allison assess the progress on nine dimensions.

1. Public Understanding of Obesity. Ongoing tracking of public perceptions about obesity finds a slow decline in the perception of obesity as a personal problem of bad choices. This trend may be fostering more consideration of the environmental and medical causes of obesity.
    
2. Stigma. In the three years since AMA’s decision, shaming people because of obesity has entered the public consciousness as a problem with a name: fat shaming. Though such explicit expressions of weight bias are becoming unacceptable, implicit forms of bias and stigma remain prevalent.
    
3. Prevention. “Patchy progress” in obesity prevention has produced only “isolated areas of improvement,” as Christina Roberto and colleagues noted last year in Lancet. The latest statistics for U.S. obesity prevalence show continued growth and a new record of 40% prevalence among women.
    
4. Treatment. Options for treating obesity are expanding. Four new drugs and four new medical devices for obesity care have been recently approved by FDA.
    
5. Insurance Reimbursement. Access to effective obesity care within most health plans remains a problem. Some progress is evident, but it is coming in small increments.
    
6. Medical Education. The Bipartisan Policy Center is doing excellent work to advance the goal of equipping healthcare professionals to provide better care for obesity.
    
7. Consumer Protection. Fraudulent weight loss products remain a significant problem in the realm of consumer protection. The Obesity Society, the Obesity Medicine Association, the Obesity Action Coalition, and the Academy of Nutrition and Dietetics recently issued a joint position calling for more stringent regulation of dietary supplements that make therapeutic claims for obesity.
    
8. Discrimination. The recognition that obesity is a chronic disease has brought increasing attention to the risks for employers who discriminate against people with obesity.
    
9. Credibility. More serious consideration for obesity research and clinical care is an important outcome that might result from recognizing obesity as a disease. Substantial growth in the number of physicians seeking board certification in obesity medicine suggests that this might be happening in clinical care.

 
Our bias of optimism might be at work here. But we do see signs of progress in the three years since AMA decided that obesity is a disease.

Click here for the paper by Kyle, Dhurandhar, and Allison. Click here for perspective from Sharma.

9, photograph © Sonny Abesamis / flickr

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August 12, 2016