OCW2023: Defining Basic, Decent Obesity Care

Obesity Care Week has come as we are in the midst of a great public re-thinking of obesity care. Feelings about this subject are strong, but facts are catching up with those feelings and causing people to reconsider old ways of thinking. The dialogue goes in many directions, but a key issue is access to care. Does everyone get the care they need? Or only the care they can afford? In other words, will we have an egalitarian, libertarian, or simply a decent standard of care for obesity?

Medical Ethics and Justice

The dialogue on this question amounts to a discussion of medical ethics – sorting out ideas about the right or wrong things to do in providing care. At the recent CPOM conference on Advanced Therapies for Pediatric Obesity, Professor Mary Brandt described this question about the standard of care as an appeal to justice. It was a only one part of a broad and excellent discussion of medical ethics in surgical care for pediatric obesity.

But she explained that this question determines the care that people can access:

“This is really what is used in every healthcare system in the world – a basic decent minimum standard of care. Everyone should receive healthcare in proportion to their basic medical needs. But beyond that, they should receive it in proportion to what they have paid.”

In obesity care, defining that basic decent minimum standard of care is the challenge. Until now, that minimum was essentially only lip service – brief and ineffective advice to lose weight or eat healthy and exercise.

Re-Thinking Obesity Care

With the advent of more effective options for obesity treatment, lip service is no longer passing as decent care. Advice columnist Annie Lane recently learned this and wrote:

“Dear Readers: In a recent column, I was critical of the sudden popularity of using diabetes drugs to lose weight. I was responding to news reports that a growing number of people are using them for casual weight loss to drop a few pounds. But too many readers felt that I was not current on the latest scientific studies for obesity. I am grateful for the many letters I received on this topic and want to share a few of them with you.”

Thus we are closely watching the great re-think of what is a decent basic standard of medical care for obesity. Health insurance plans will have to adapt.

Click here, here, here, and here for more on ethical issues that relate to obesity and medical care.

Liberty, Equality, and Brotherhood, poster of the French Revolution in Alsace / Wikimedia Commons

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March 2, 2023