Medicalization, Pharmaceuticalization, and Nonsensification

We are living in a profoundly disorienting time. Because of this, we are learning that people have the capacity to rationionalize just about anything. People are plunging into rabbit holes where they encounter mazes of rationalizations about conspiracies all around them. It’s a great tool for politicians who find themselves on shaky ground. But now it also pops up in scholarly journals. A new essay in the Canadian Journal of Public Health offers a case in point. Employing dozens of scare quotes, Andrea Bombak, Louise Adams, and Patricia Thille weave a tale of an elaborate medical conspiracy. Guidelines for obesity care represent nothing more than a conspiracy of medicalization and pharmaceuticalization.

Rejecting Obesity

Bombak et al quite clearly reject obesity as a health problem. They have a tough time even writing the word without scare quotes. Rather, they rationalize it as the product of medicalization and pharmaceuticalization of larger bodies. They reject the idea that obesity is chronic disease characterized by abnormal or excessive adipose tissue. Instead, they insist that obesity is a bogus diagnosis that includes healthy and unhealthy individuals alike. They reason that obesity is surely all about body size and thus “may be divorced from health outcomes in clinical practice.”

So they conclude that guidelines for clinical obesity care represent little more than medicalization that focuses on body size as a crisis and magnifies “the ‘otherness’ of higher weight people.”

Gross Distortions in Pursuit of a Conspiracy

It’s hard to read this treatise on medicalization and pharmaceuticalization without thinking that it’s really about nonsensification. Rather than explore the substance of the Canadian Obesity Clinical Practice Guidelines, Bombak et al focus on perceived conflicts of interest. They dismiss the medical research as attempts “to create an illusion of certainty” funded by industry.

The essay by Bombak et al reads as an anti-science screed, rather than a serious expression of concern about physical and mental health for people living with the complications of obesity. Denying that obesity is a health concern is just fine for people who feel no impairment to their health. But for people who are living with obesity, who feel the harms it’s causing them, denial gets in the way of finding the good care they want and need.

This is the care that the Canadian Obesity Guidelines define quite well. Conspiracy theories should find no home in a public health journal.

Click here for the Bombak essay. For more on the Canadian Obesity Guidelines, click here and here.

Return to Reason, painting by Man Ray / WikiArt

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

August 30, 2022