Uncaring Healthcare That Fuels Obesity

What is healthcare when providers don’t provide care for a chronic disease and, in fact, make it worse? That is a glimpse of the care people mostly don’t receive for obesity. In a study of adults with overweight or obesity, Beini Lyu and colleagues found that use of anti-obesity medicines was rare. But instead, prescribing medicines that actually cause weight gain was common. This is uncaring healthcare that fuels obesity.

Common Lapses in Care

These observations come from NHANES data on 10,673 adults with overweight or obesity. The observation period spans from 2009 to 2018. Less than one in a hundred (0.65 percent) received an anti-obesity medicine. Odds were better for people with higher social and economic status (SES), but even for the high SES group, it was less than one percent.

On the other hand, 38 percent of these people received drugs that can spark obesity by causing weight gain. Worse, persons in the low SES group were more likely to receive such drugs. This pattern reflects a callousness about both obesity and disparities in health that is jolting.

Unacceptable Disparities

The disparities these data reflect are striking to obesity medicine physician Fatima Cody Stanford:

“If having the disease of obesity were not hard enough, if you have low socioeconomic status, the likelihood is a higher that you will be on a weight-promoting medication AND less likely to receive an anti-obesity medication. This is highly unacceptable. Every patient, regardless of SES, should receive the best possible care. We should go above and beyond to ensure that the most vulnerable among us receive high-level care, especially with regard to obesity.”

Misplaced Blame

People living with obesity are quite accustomed to healthcare providers blaming every symptom on their weight. The problem of weight bias in healthcare is well-documented.

But these data make the problem a bit more vivid. This is healthcare that appears to be uncaring about obesity – in fact, making it worse. And with lower SES, the bar is even lower.

Providers who might blame the patient should look in the mirror first. Without a doubt, we can do better than this.

Click here for the study by Lyu et al, here and here for further perspective on disparities in obesity. For more on prescribing of drugs that cause weight gain, click here.

Portrait of a Nurse, painting by Zinaida Serebriakova / WikiArt

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April 9, 2022