ECO2022: Obesity Hype, Hope, and Progress

As we prepare to put a bow on ECO2022, it’s plain that some things in obesity are changing rapidly. But others are not. Though the reality of coping with it is still far from ideal, the options are getting much better. The scientific understanding of it has grown sharper, but messages to the public aren’t keeping up. Some folks are busy hyping the problem while suppressing solutions. It’s a mixed picture of hype, hope, and halting progress against obesity.

Hype About the Threat

For literally decades now, many folks have been hyping the problem of obesity as a dire threat to individual and public health. This week at ECO, the World Health Organization pushed out yet another declaration of alarm:

“Overweight and obesity rates have reached epidemic proportions across the Region and are still escalating, with none of the 53 Member States of the Region currently on track to meet the WHO Global Noncommunicable Disease (NCD) target of halting the rise of obesity by 2025.”

It’s a crisis, bringing Europe a “tsunami of obesity,” says the WHO’s Kremlin Wickramasinghe. “We urgently need to pull together all that we have in order to stop this pandemic.” For good measure, they add that it’s causing 1.2 million deaths and 200,000 new cases of cancer every year in Europe.

Epidemic, pandemic, tsunami, cancer, death, and crisis – the hyperbolic threat could hardly be clearer. But hype is not help.

Hope?

WHO sees hope in many of the same policies public health gurus has been pushing for some time. Tax sugar sweetened beverages, subsidize healthy foods, shut down the marketing of unhealthy foods to children, improve diet and exercise throughout life. Nothing new in that list. Nor has that list done anything discernable to move the needle on obesity yet.

However, we do note a fresh emphasis on “access to obesity and overweight management services in primary health care, as part of universal health coverage.”

This offers a flicker of hope because it reflects a recognition that overcoming obesity requires efforts to both prevent and treat it. It’s not especially specific or realistic because primary health care is not well equipped to deal with the complexity of obesity. But at least it’s a nod in the right direction.

Further hope comes from the pipeline of more effective treatment for this complex, chronic disease. Semaglutide is the first of a whole generation of new products that work better than anything obesity care providers have ever had before. Tirzepatide is coming along nicely and may even offer further improvements. Perhaps just as important is the hope for more tailored therapies that can better meet the needs of individual persons with obesity. In the opening plenary, Rachel Batterham captured everyone’s imagination with the possibilities that personalized medicine and nutrition holds.

She also offered caution against hype. The precision therapy concept has been floating around for a while and it’s taking time to deliver on its potential.

Tentative Progress

Perhaps the best evidence of progress comes from the fact that people living with obesity were a very visible part of this meeting. In the past, the human story of obesity has most often been an abstraction. At ECO2022, it was integrated into the meeting.

This helps because real human experiences have a way of taking us past the hype to see real hope for progress in actually overcoming the harm of obesity – to both public and personal health.

Click here for more from the UN report on obesity in Europe. For more on the possibility for progress in obesity, click here and here.

Maastricht Helpoort, photograph by Ted Kyle / ConscienHealth

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May 6, 2022