An Action Gap in the Chronic Disease of Obesity

Four years after the American Medical Association decided to regard obesity as a chronic disease, we have a serious action gap. Research published this week in Obesity and presented at ObesityWeek makes it clear. Three major groups all regard obesity as a disease: people who have it, healthcare providers, and employers. Yet they leave it to patients alone to deal with it.

Lead author Lee Kaplan reflected on this gap, saying:

We need to fundamentally rethink obesity so that the public and healthcare community understand more about the biology, chronicity, and overall health impact of this disease

Varying Degrees of Alignment

This new survey research assessed self-reported attitudes and responses to obesity. Among healthcare providers, 80% regard obesity as a chronic disease with an impact on health and life expectancy. For people living with it and for employers, the numbers are a bit smaller. Among people with obesity, 65% regard it as a disease. For employers, the number is 64%.

Despite that fact, 82% of people with obesity felt “completely responsible” for dealing with it.

Employers essentially said it’s not their problem. Only 18% felt any responsibility for addressing it. And it shows in their wellness programs. Despite lots of talk about obesity, employer wellness programs are essentially irrelevant to people with obesity. Only 17% of them thought their employers’ programs were even helpful for dealing with weight management.

Healthcare providers understand the issue as a health problem. But they don’t act. They say it’s an embarrassing topic (65%) and they don’t have time to deal with it (52%). So roughly half of people with obesity never hear about the diagnosis from their healthcare providers.

Internalized Stigma and Personal Failure

It’s long been true that the public regards obesity simplistically as a matter of personal responsibility.  These findings suggest that view is still dominant among people who are living with obesity. We know that self blame and self stigma don’t help. Nor does ignoring the problem.

Healthcare professionals and even employers can be more helpful. Progress will come when we all close the action gap to reduce the burden of obesity.

Click here for the study and here for more from FierceHealthcare. You can also read more about the study and hear more from Kaplan on the subject here.

Action, photograph © Evelyn Berg / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

November 3, 2017