Obesity? What Obesity? It’s Only Ideology

We live in a polarized age of brittle ideologies. Is the connection between obesity and health merely a product of ideology? A new paper in Critical Public Health argues for that view. And the authors propose “an end to seeing obesity as a significant health issue.”

Right now, we need more respect for diverse views on difficult subjects. So, let’s look closer. How do these authors conclude we must dismiss obesity as a health issue?

Obesity Strategies That Harm Health

Stella Medvedyuk, Ahmednur Ali, and Dennis Raphael describe the response to obesity as a health concern. And it’s not good. Too often, health researchers falsely categorize adiposity as a behavior. Health professionals falsely assume obesity is a condition easily modified by simple choices. The result is stigma. It promotes poor health. It leads to relying on ineffective behavioral strategies for obesity care.

On this point, the authors are correct. Sadly, the most common responses to obesity harm health. They don’t promote it.

Neglecting Social Determinants of Health

In addition, the authors describe the emphasis on stigmatizing responses to obesity. Stigma prevents a focus on social determinants of health. They say:

The key assumption is too much eating and not enough exercising over a lifetime is the main cause of obesity and its adverse health effects.

A much more complex web of social, economic, and environmental factors play a big role in obesity. Once again, they are right. Strategies that neglect these facts are doomed to failure.

Questioning the Biological Effects of Obesity

Here, we part ways with these authors. They assert that the biological effects of obesity on health are “minor.” They claim an “extensive” body of literature supports their conclusion. But, the preponderance of evidence is quite the opposite.

Type 2 diabetes, cardiovascular disease, and certain cancers become more common with obesity. Treatments for obesity have been shown to prevent or reduce the harm of those diseases.

Two Out of Three

Agreement on two out of three points isn’t bad. We agree that the primary responses to obesity are failures. But those failures don’t justify self-deception.

For example, the initial response to HIV was terrible. Healthcare disrespected and dismissed the needs of people affected. Activists demanded a better response. Slowly, but surely they got it.

Obesity is a health issue made worse by a poor response. People affected by obesity deserve better. We fully expect that a better response is possible and even inevitable.

Click here for the paper in Critical Public Health and here for more on sensitivities about obesity. For perspective on science and ideology, click here.

Suggestion, photograph © Distant Reality / flickr

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September 7, 2017