Face in the Mirror

Facing Facts About Obesity – Selectively

The angst caused by Cancer Research UK’s Obesity-Is-Like-Smoking campaign is continuing to bubble. At this point, approximately 6,000 people have signed a petition asking the charity to stop it. We’ve been clear enough about how bad this campaign is. However, it’s worth noting a surprisingly thoughtful argument for the campaign from Deborah James. Believe it or not, it appeared in The Sun. James says she hated the campaign when she first saw it. But then, she says, maybe it’s time for facing facts about obesity.

And she’s partly right. The only trouble is her view of obesity is very selective. “If losing a few extra pounds saves you the agony of cancer and the gruelling treatment that goes with it, it’s one worth taking note of,” she says.

That bit is fiction and it goes straight to the heart of what’s wrong with this campaign.

“Losing a Few Pounds” Doesn’t Prevent Cancer

The only evidence that obesity treatment might prevent cancer comes from bariatric surgery. Observational studies document a significant reduction after surgery in the risk for cancers linked to obesity. But no other form of obesity treatment can match this.

So saying that “losing a few extra pounds” might prevent cancer is simply false.

Facing Facts Selectively

For folks with thin privilege, it’s easy to think about obesity in terms of “losing a few extra pounds.” For people living with obesity, though, it’s very different. Losing a few pounds might improve your health – if you can keep your body from packing that weight back on. But it doesn’t cure obesity.

That’s precisely why obesity is a complex chronic disease. Like heart disease, or cancer, or diabetes. Unlike heart disease, cancer, or diabetes, though, we don’t have a lot of great options for managing this condition. Nor do we have many healthcare providers who are skilled in delivering effective obesity care.

Nope, we mainly have ignorant folks suggesting that we “face facts” and “lose a few extra pounds.”

People with Obesity Face Unpleasant Facts All the Time

Perhaps the most infuriating aspect of this thinking is the assumption that people with obesity are not facing facts. It’s utterly false. We all have mirrors. Trolls and bullies, strangers and friends – they all tell us we ought to lose some weight. We read the news about this risk or that risk that comes from the dire threat of obesity over and over.

In a world that denies people access to good care for obesity – we’re looking at you, NHS – people living with it respond in diverse ways. Some people tune it all out. Others blame and mistreat themselves. Despite all the barriers to care, some people relentlessly pursue the options they have and do the best they can. This includes people who follow a strategy of good health regardless of body size.

So no, we don’t need simplistic public awareness campaigns to persuade people that obesity is bad. We need better public policies for preventing it. We also need better care for the health of people living with it.

And we need CRUK to face the fact that “losing a few extra pounds” neither cures obesity nor prevents cancer.

Click here for James’ essay. For more on obesity and cancer, click here, here, here, and here.

Face in the Mirror, photograph © Léa Chvrl / flickr

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July 8, 2019

5 Responses to “Facing Facts About Obesity – Selectively”

  1. July 08, 2019 at 8:12 am, Mary-Jo said:

    So, so true, Ted! I think, for me, what is most key is that until and unless good, effective care is accessible and delivered to all people with obesity, no medical provider, organization, or any person has a right to opine about what losing weight will do for people. Although far from perfect, enough is known about suitable options so as to offer and cover helpful treatments to people. This campaign from CancerUK continues to feed the narrative that people with obesity ‘should’ do this or that or else. Well, IMO, CancerUK ‘should’ know better than to peddle this simplistic message considering the plethora of information out there re: weight bias, weight stigma, genetics, pathophysiological aspects, lack of access to care, and every other reason why people with obesity need help with their disease. No one is going to go out and lose weight from this ad.

  2. July 08, 2019 at 8:27 am, Ted said:

    Amen, Mary-Jo.

  3. July 08, 2019 at 10:18 am, Richard Atkinson said:

    Excellent column regarding the slightly useful but mainly hopeless Cancer Research UK campaign on obesity. Your response is very thoughtful, but I believe you left out the most important thing that the UK, USA, and other governments can do to fight obesity, and it is not increase funding for public health policies. Even “better care”, if it is the current types of care, are likely to be not very helpful. What we really need is a recognition about the disease of obesity by both politicians and health professionals alike that we have only the faintest of beginnings about understanding it We need a massive influx of basic research funding to get at the causes of obesity, biochemical and genetic mechanisms, and a concerted effort to develop new and better drugs with that knowledge. We do not need more ways to try diet, exercise, and behavioral modification. A PubMed search with the terms “diet and physical activity and obesity and treatment” yields 11184 references, none of which show a long term success rate of weight loss. A weight loss of 5%, which some studies claim is “success” is a cruel joke and gross discrimination against obesity. A 5% reduction in severe hypertension, or cancer, or cholesterol, or almost any other chronic disease would be viewed as totally unacceptable. Why is it “success” for obesity?

  4. July 08, 2019 at 4:30 pm, Ted said:

    You’re making a good point, Dick.

  5. July 08, 2019 at 6:41 pm, John Dixon said:

    Spot on Ted and Dick. This blog is so valuable it should be promoted widely to a broader concerned audience.

    It’s up to us the US to get these facts out there.