OCW2020: We Care Because . . .

We are accustomed to talking in the language of “us” and “we” here at ConscienHealth. But as Obesity Care Week comes to a close, we’re shifting to a more personal focus. The theme of this day is “I Care.” So we’re sharing perspective from our founder, Ted Kyle, on why he devotes time and energy to this subject.

You can read it below, or simply click on the video to watch and listen. This explains why we do what we do here every day.

Personal Experience

I’ve been working on obesity for the better part of two decades But my personal experience goes back even further. I spend a lot of time thinking about it. Quite naturally, though, my feelings about it run much deeper.

I’ve watched loved ones and myself grow into obesity along with most of the people around me. I married the love of my life in the eighties and we had three wonderful sons. Those are big life changes and times when many men start growing heavier. Believe it or not, men gain weight, too, when they have children. So bit by bit, my weight grew toward obesity.

As my parents grew older, I also saw them having health problems that result from obesity.

Starting to Think

After a while, I started working on and thinking about obesity in my professional life. But when I did, my feelings were very much stuck on obesity as a product of choices.

So I focused on solutions that depend on personal choices, motivation, and readiness to change.

Clues

However, I started getting a ticket to the clue train because of the work I was doing back in 2001.

I was listening to literally hundreds of people who were living with obesity. But they never said the O-word. They just knew they wanted to lose some weight, and never have it come back. They knew how hard it was, because many of them had been dealing with it for a lifetime.

Intense Experiences

But most of all, I remember how grateful they were to have someone listen to them and try to understand their experiences. We would do long days of in-depth interviews and focus groups. Those days were marked by people who couldn’t help crying when they talked about it.

For us it was market research. For them, it was their life. And it was painful.

That’s what gave me a clue that all the talk about obesity wasn’t matched by action to help the people affected. Mostly it was serving to place blame and shame on people. It was all talk and no listening – let alone action.

Complex Facts, Strong Feelings

As I continued to work on this, I could see how complicated it is. And the intensity of feelings about it.

At the same time, scientific facts were lining up to show that obesity is not a simple matter of behavior and choice. Families live with it for generations because 70 percent of a person’s risk is inherited.

That’s a fact that doesn’t square with the own-your-destiny culture of Americans. “Personal responsibility” has long been the rallying cry for dealing with obesity. Nonetheless, heritability is a fact. Your genes set the table for obesity. And the environment serves it up.

Personal Responsibility

Public health has begun to understand that stressing individual responsibility for obesity wasn’t working. So public health experts started looking at triggers for obesity that are nudging the rates higher. They focused on stuff like ultra-processed foods, lives that make physical activity rare, stress, drugs, and chemicals that prompt weight gain.

All of that brought us a new concept. The obesogenic environment. It’s a great concept. It explains why we have more obesity, even though our genes haven’t changed. It gives public health some targets for preventing obesity down the road.

But it does nothing for people who already have obesity.

A Turning Point

For those of us affected by obesity, a real turning point came in 2013. That’s when the American Medical Association resolved that obesity is a complex, chronic disease.

It turns out that 2013 was merely a start, though. Resolving that obesity is a disease is surely progress. But it’s safe to say that the wise brains of the AMA were ahead of the gut instincts of its members and the public, too.

Six Years Later

Six years after the AMA resolved that obesity is a complex chronic disease, some things have changed a lot. Others have changed a little. And some things have barely changed at all.

We have more options more providers, and more momentum. That old idiotic cliché – just eat less and move more – is on its way to the graveyard.

Knowing in Our Heads

That’s because in our heads we know obesity is a disease. It’s a disease of fat tissue, not a disease of size. It’s a disease where your brain, your gut, and the rest of your body isn’t doing its job to regulate the energy it stores.

Scientists know more and more about how this works. And that’s going to bring us better treatments. A lot of doctors – almost 4,000 board-certified obesity medicine physicians – now know it, too.

Feeling in Our Hearts

We’ve also seen a lot of progress on bias and stigma. Explicit bias – fat shaming – is no longer acceptable. Very few schools are sending home fat letters. Because it’s just not right. Objective measures of explicit bias are down, too.

But even so, implicit bias is up. It’s the kind you don’t even think about. So a person with obesity still faces a thousand tiny cuts from weight bias every day. It comes at work and school and even at home. It comes from colleagues, friends, and family. It even comes from strangers.

That’s because the truth about obesity that we know in our heads – that it’s a complex chronic disease – has not fully penetrated our hearts. Not yet, anyway.

Real Voices, Real People

When it does penetrate, the spark comes from the voices of real people living with obesity. I first realized this 18 years ago, when I was listening to hundreds of people living with obesity.

As long as obesity was all about size and statistics and food choices and exercise, we were caught in a blame game. Better science has helped. It tells us that this is a disease. And some basic brain functions to regulate energy storage aren’t working right when obesity becomes a problem.

But all the science in the world doesn’t overcome intense feelings about obesity and about the people living with it. For that, we need the real voices of real people living with obesity.

Stepping Up

Thankfully, more people are stepping up to tell their stories. To make it clear that obesity is something they never chose for themselves. And they deserve better care and better options. They deserve respect.

Thanks to organizations like the Obesity Action Coalition, ECPO, and others, more people are coming to understand the lived experience of obesity. And I have no doubt that understanding will change their hearts.

Call to Action

So I ask you. If you have a story to share, please do. And if you have a loved one affected by obesity, be sure you are ready to listen and care. However you can, lift up their voices and give them yours.

Kyle delivered these remarks last September as part of a series of “DEEPtalks” from people living with obesity. For more from these DEEPtalks click here. Click here for a broader perspective on Obesity Care Week and why people care so deeply about this subject.

The OAC Board of Directors, 2020 Strategic Planning, photograph by Tony Comuzzie / Twitter

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March 7, 2020

6 Responses to “OCW2020: We Care Because . . .”

  1. March 07, 2020 at 8:04 am, Eileen Myers said:

    Thank you Ted. Your work and this daily blog has educated so many and made us all do a better job in advocacy and in how we help those we touch.

  2. March 07, 2020 at 11:44 am, Allen Browne said:

    One word – WOW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  3. March 07, 2020 at 5:53 pm, Suzan Nashashibi RNutr said:

    An ultra nice paper going deep into Obesity actual complexities Im a Registered Nutritionist Scope certified Obesity management specialist working in my own clinic in Jordan I have been working for over 25 Years trying to figure out best way to help people with obesity improve their health and gradually reach a healthier weight that they are comfortable with and more relaxed and confident using change of lifestyle strategies and acquiring maneuvering adaptive skills to manage this with whatever is going on in their lives trying hard to unlock the deprivation mindset enjoying gradual changes as it becomes automated habits that dictate a healthier response to cravings or any disordered eating tendency .Most important is allowing time for all this to happen this being a major culprit as people with obesity are always in a hurry and tempted to do quick fixes that usually backfire

  4. March 07, 2020 at 6:07 pm, joanna Strober said:

    Thank you for your work on this. I am hopeful that in particular we will become more open to proactively help overweight children before they become adults with overweight/obesity. Your advocacy is really important i this area.

  5. March 08, 2020 at 4:51 am, Ted said:

    Thanks Suzan for sharing some important observations. I find that people can be in a hurry whether or not they have obesity. Also that some people with obesity are in a hurry while others are more patient. Keep up your good work.

  6. March 16, 2020 at 5:01 pm, Richard Atkinson said:

    Great column, Ted. A wonderful anecdote from Dr. Nikhil Dhurandhar illustrates the ignorant thinking of many doctors and lay people:

    If a patient with swollen legs sees the doctor, the doctor does NOT say, “I know what is wrong with you – you just need to stop drinking so much water!” However, when a person with obesity comes in, the doctor immediately says, “I know what is wrong with you – you just need to eat fewer calories!” Obviously in both cases it is not the intake that is the problem, it is some physiological/biochemical alteration that is causing the people to retain water or retain fat, respectively. We need to stop focusing so much on diet and do a lot more research on the underlying causes of obesity, of which diet plays a small role. We should all urge our Congress people to vote for more money for obesity research – and not diet and exercise research, but true basic research into the causes of obesity and especially a lot more money for obesity drug research. Name another chronic disease that is not treated with drugs – why is obesity different? Current obesity drugs are pitiful. The Obesity community should demand better from the government and from drug companies.