Competing Lies About Obesity Fall Apart

Card TrickWe are living in a pivotal moment for the public understanding of a common and complex chronic disease. It is a moment when two competing, but very different, lies about obesity are falling apart.

Simply Bad Choices

On one hand, the big lie about obesity for decades has been that it is a simple matter of bad choices. Many public health campaigns to “fight the obesity epidemic” were founded on this lie. The result was years of campaigns that most thoughtful people now agree were highly stigmatizing and harmful.

The truth is that obesity is a problem of biology. People inherit a susceptibility to obesity and then many different factors in our environment can trigger it. A person’s genes set the stage and the environment gets it going. Some people are highly susceptible, some are highly resistant – biologically.

What is exposing the longstanding lie that obesity is a matter of choice? Breakthroughs in treatment. As it is becoming plain that advanced medicines can correct the metabolic functions that go awry and cause obesity, it gets harder and harder to promote the idea that most every person with obesity can reverse it simply by making better choices.

Gina Kolata suggested two years ago that this might happen and her reporting has proved, once again, to be prescient.

Ob*sity Is Not a Problem

The other half of this pair of competing lies is the notion that obesity is an utter fiction. Not a problem, except for the stigma that people attach to it. This is a reaction to the grievous mistakes made by promoting blame and shame for obesity. But hearing one lie does not justify telling another.

Folks who are invested in fat acceptance activism are absolutely right to stand against weight bias. But some of them also promote the false idea that acknowledging any problem with obesity will always promote body dissatisfaction and, even worse, eating disorders. So they feel fine with labeling bariatric surgery as “stomach amputation” and dismissing new obesity medicines as dangerous and ineffective. Documented health benefits are not part of this discourse.

Two Lies Do Not Add Up to Truth

Ultimately, these competing narratives don’t hold up in a world where healthcare professionals get their act together and stop shaming people with higher body weights. Some people living in larger bodies have real medical issues with obesity and pursue treatment. Some do not.

Increasingly we will see health professionals meeting all of these patients where they are and serving their needs for better health.

Click here, here, and here for further perspective on how better obesity treatment may counter false narratives about obesity.

Card Trick, painting by Andre Masson / WikiArt

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January 18, 2023

2 Responses to “Competing Lies About Obesity Fall Apart”

  1. January 28, 2023 at 10:00 am, Owen Kelly said:

    I used to enjoy reading this website, however recently the views are less unbiased.
    GLP1R agonists were an accidental finding in diabetes studies.
    GLP-1 levels are higher or normal in obesity (doi: 10.1210/clinem/dgab098) not obesity caused a large decline in GLP-1, . this would provide some logical need for high doses of GLP-1R agonists.
    These weight loss drugs are only beneficial if you don’t stop taking them The long term consequences are unknown – will these weight loss drugs reduce the endogenous GLP-1 production over time, just as exogenous testosterone reduced endogenous production? In this case one would become dependent on the weight loss drugs, which seems too convenient (for drug companies) to me.
    Overall, the medical community is rushing down an unknown path with only one goal in mind – weight loss. Health has been weight obsessed for too long and has not gotten us anywhere. Weight is not a perfect measure of health. We will find out in 20 years whether or not the overprescribing of these particular weight loss drugs is beneficial or not – reminded of the overuse of antibiotics. I would be okay to use them as an alternative to bariatric surgery.

    • January 29, 2023 at 3:27 am, Ted said:

      Thanks for sharing your opinion. We all have our biases, don’t we?