Ten Years, Ten Milestones in Obesity and Health

We’re just about done with this decade that started in 2010. And if you look back over these ten years, it’s plain to see that we’ve marked some big milestones in obesity and health. Here are ten that stand out.

No doubt, others will seem big to you. So please, use the comment function below to add to the list.

1. Less Explicit Bias

Ten years ago, explicit weight bias was no big deal. Medical experts could get away with questioning the credibility of a brilliant nominee for Surgeon General, purely because of her size.

No more. Fat shaming gets called out today. The public won’t put up with it. Explicit bias has declined. But that doesn’t mean that weight bias is a problem no more. Because while explicit bias is down, implicit bias is up. It’s sneakier and just as harmful as ever.

2. Sleeves Take Over from Bands

With the great recession, bariatric surgery numbers fell. Fewer people could afford to pay for the surgery or the out-of-pocket costs, even if their health insurance covered it. But when the numbers recovered in this decade, some big shifts happened. In 2007, gastric bands were the most common bariatric procedure. But now, the gastric sleeve is number one. It accounted for 59 percent of all bariatric surgeries in 2018. Numbers for the band have dropped like a rock.

3. New Drugs for Obesity

A decade ago innovation in anti-obesity meds had stalled. Rimonabant had failed spectacularly. Pharmaceutical research had slowed to a trickle. Nothing new had been approved for more than a decade.

But today, we have four new drugs on the market. One of them – Saxenda – is well on its way to being a billion-dollar blockbuster. Even more options are on the way. And the goal is to have drugs that will match the effectiveness of bariatric surgery. This is what progress looks like.

4. Surgery for Diabetes

Throughout this decade, the evidence has grown. Bariatric surgery gives patients with obesity and type 2 diabetes the best shot they have at putting diabetes into remission. In 2016, a remarkable global consortium of experts agreed. Bariatric surgery makes sense for many patients with these two diseases. Now clinical practice must catch up with this consensus.

5. A Whole New Specialty for Obesity Care

In 2010, the American Board of Obesity Medicine did not exist. Today it serves to certify physicians in the fastest-growing medical speciality in America. Nearly 3,400 physicians are now diplomates and the critical mass continues to grow.

6. Sugar Is Poison

Back in 2010, dietary guidelines still told Americans to be careful about eating too much dietary cholesterol. Low-fat dietary dogma was on its way out. Added sugar was the new boogeyman. Then in 2012, Robert Lustig launched his sugar-is-toxic trope. And thus, we have spent much of this decade in a frenzied fight against the toxic danger of sugar in the food supply.

Obesity is not impressed. Its prevalence has continued to grow, even as we have reduced our sugar consumption.

7. Vibrant Support and Advocacy for People with Obesity

Ten years ago, support and advocacy for people living with obesity was a new thing. Only a handful of people were spending time with policymakers to make their case for better care and more innovation. Today we have an army of people. The Obesity Action Coalition was just a few years old back then. A decade later, it’s grown with the addition of more than 50,000 members. It is a vibrant community of support and advocacy. And what’s more, the success of OAC is encouraging patient groups all over the world to lift up the voices of people living with obesity.

8. Plants Are In But Carbs Are Out

As we approach the issuance of new Dietary Guidelines for Americans next year, two things are clear. Plant-based diets are in. Carbs are out. In addition, keto is hot and meat enthusiasts are pushing back. If that sounds messy, we can assure you that it is. Everyone has an agenda when it comes to food and nutrition and people are not in a mood to compromise. But we’re ready for a truce. Can’t we just agree that one size will never fit all when it comes to healthy dietary patterns?

9. The Mediterranean Diet Hits a Speed Bump

In the first part of this decade, the Mediterranean diet was on a roll. A huge, randomized, controlled study called PREDIMED hit the New England Journal of Medicine and told the world that dietary prescriptions really could deliver better health.

But then in 2018, the authors retracted that publication and replaced it with a more nuanced one. The randomization had been flawed. And people are left to argue about the significance of much softer evidence for the benefits of the Mediterranean diet.

10. The Rise of ObesityWeek

Ten years ago, there was no ObesityWeek. Individual scientific and medical groups had their own little meetings. Silos all around. Communication between the disparate tribes of obesity was less than ideal. Then in 2013, ObesityWeek made its debut in Atlanta. It was huge and vibrant and continues to this day. Though other societies may continue on their own tracks, this phenomenon continues with a momentum that seems unstoppable. ObesityWeek 2019 was a huge success and we’re already looking forward to the ObesityWeek 2020 in Atlanta

Ten Years of Progress

Yes, we have a long way to go before we can be satisfied that the health effects of obesity are under control. But these ten years just past tell us that progress is possible. And it’s measurable.

We are proud to say that this decade also marks the first decade of ConscienHealth’s efforts to advance this cause. It’s a privilege to work with so many talented and energetic people on a common cause.

Ten, photograph © Roland Brunner / flickr

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

December 9, 2019