Threads and Hands in Blue

Three Threads in Public Discourse on Obesity

Anyone who doesn’t think a major shift in public perceptions about obesity is not underway has simply not been paying attention. Public discourse about this complex chronic disease is more intense (albeit sometimes frustrating) than we have seen in more than two decades of work on obesity.

We see a pattern of three threads in this conversation.

The Medical Spa Thread

Yes, the medical spa industry is alive and well. Grandview Research tells us that it will be an 18.6 billion dollar global business in 2023, growing by double digits through the rest of this decade. People care about their appearance and some have a whole lot of money to spend on it. This is the thread that thrives on TikTok and in fluffy articles (even in serious media) about the “miracle jab” for weight loss.

Much of it is dangerous and misleading – these are serious prescription medicines indicated for a complex disease. But the vibrancy of the medical spa industry makes one thing clear. These people will not stop doing whatever they can to enhance their image anytime soon. Detractors will not stop from criticizing them, either.

The Hostility Thread

The undercurrent of hostility is impossible to miss. There’s the hostility from HAES activists who are willing to sprinkle misinformation into their agenda to fight pervasive weight bias. It’s a shame to dilute good work to overcome bias and stigma with misinformation, but it happens. Coming along for the ride are some advocates for people with eating disorders. These are folks who cannot accept that obesity care for those who need it can coexist with good care for people with eating disorders.

But even more troubling hostility in this thread comes from people who are in a very different place. These people feel free to demean anyone who has obesity. Financial analyst Guy Adami served up a vivid example on CNBC recently, tossing an irrelevant, ignorant crack about laziness into a discussion about obesity:

“Obesity is clearly a problem. It’s a health problem. But being chronically lazy is something entirely different. Maybe that’s a societal problem that you can’t trade a stock around, but maybe we should be thinking more about it.”

Hate is poison, but it’s out there.

The Health and Science Thread

The image enhancement and hostility threads are nothing new. But what is new is the ubiquity of serious conversations with a health and science focus on obesity. Stat is currently running a big series on it, with two detailed pieces just this week. Julia Belluz contributes good reporting here, as she has done on the subject for the New York Times. These are just a few examples of a growing volume of substantive reports on obesity in popular media.

This is honestly thrilling. It has taken decades to get to a place where the science of obesity can support a standard of care for the people living with it that will deliver major improvements to health and quality of life. We’re glad to see serious public discourse about it.

It’s about time.

Click here for the opening segment in the Stat series on obesity, here, here, and here for some of the excellent reporting by Belluz.

Threads and Hands in Blue, photograph by Alberto Buscató Vázquez, licensed under CC BY-SA 4.0

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March 10, 2023