Personal Convictions, Money, and Conflicts

BalanceTamar Haspel is angry. She notes that many of the people expressing righteous concerns about advanced obesity medicines are also folks who have a book to sell you. Or a diet or a supplement or an exercise program. Personal convictions, money, and the conflicts that go with all of that are a jumbled mess when the subject of obesity arises and Haspel has her sights on something that’s very real:

“Okay, I get it. If you make a living selling some kind of diet or supplement, you’d understandably root against these drugs. Ditto if you think fat people should have to work hard for their thinness and don’t deserve a shortcut. But I’m having a hard time coming up with another reason you’d prefer that these drugs don’t pan out.”

The Righteous Cause

It’s easy for a person to sound righteous when they’re deeply invested in living out their personal convictions. For example, Jillian Michaels made a career for herself as a celebrity fitness coach. No doubt she believes she did good work on the Biggest Loser reality show – even if the weight loss was unsustainable and the fat-shaming ethos of the show was clearly repulsive. So she’s quick to tell people that obesity medicines are bad – that losing weight with diet and exercise is not hard. It’s the right way to do it. She takes pride in telling people to stop taking their meds.

Another righteous line of thinking is that these new meds will let those bad food companies off the hook. Writing in the Guardian, Sarah Boseley says treating obesity will do no good. “Preventing it in the first place is the only way.” Tax the bad foods, subsidize the good stuff, and promote healthy, virtuous lifestyles. Yes indeed, she says, her prescription the only way to go.

Someone should tell her it’s tough to prevent something that’s already happened.

Pursuing an Agenda

Long ago, we convinced ourselves that obesity comes from eating the wrong things the wrong ways. We’ve been certain that the root of the problem is dietary fat, saturated fat, sugar, refined carbs, and now ultra-processed and hyper-palatable foods. Questioning these articles of faith invites the label of a heretic or a shill. Coming along for the ride is much easier – plus it opens doors for funding and commerce.

In this way, convictions, money, and the potential for conflicts flow together and become virtually impossible to disentangle. Because most everyone has an agenda in nutrition and obesity, objectivity becomes a challenge. This is equally true for people who are angry at the food industry and for people who are making money in that industry.

The only antidote is curiosity about different perspectives and how the facts line up with them. Right now, the facts are telling us that we have much better options for treating obesity. Progress is a good thing, even though it often brings us new challenges.

Click here for Haspel’s essay in the Washington Post. For further perspective on agendas and conflicting interests, click here, here, and here.

Balance, painting by Francis Picabia / WikiArt

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April 26, 2023

4 Responses to “Personal Convictions, Money, and Conflicts”

  1. May 08, 2023 at 12:37 pm, Valerie said:

    “… the fat-shaming ethos of the show was clearly repulsive.”

    There is some fat-shaming ethos in the promotion of anti-obesity drugs too. Like, being fat is always BAD, or you MUST want to be thin.

    I know there are strong correlations between obesity and several diseases, but I am not sure if obesity drugs truly improve health. I figure it probably depends on the individual (what type of food do they eat? how active are they? what is their family history? etc.) I haven’t heard much of those caveats from obesity-drug enthusiasts.

    Another cause for concern is the fate of previous anti-obesity drugs. Many were taken off the market because it was found later that they actually caused harm. I hope that’s not the case for the current batch of anti-obesity drugs. But I understand if people don’t want to get their hopes up and be let down (in a couple of years (and regain all the weight they had lost — and then some).

    • May 08, 2023 at 1:13 pm, Ted said:

      Valerie, I’m happy to post your comment as a fine example of misinformation.

      Obesity clearly causes several diseases, including type 2 diabetes, NASH, heart disease, and certain cancers. It’s not the only cause of those diseases, nor does it cause those diseases in every person who has obesity. But it clearly causes them in many people. Thus, your suggestion that obesity merely has “strong correlations with several diseases” is misleading. Perhaps you have come to believe this misinformation yourself, but that does not make it true.

      It surprises me that you would suggest that, when people develop diseases caused by obesity, it is because of how they move or what they eat. Obesity and its complications are most often due to the interactions of a person’s genes with their environment.

  2. May 09, 2023 at 9:12 am, Valerie said:

    You didn’t address my main concern: Do those obesity drugs truly improve health (in the long run)?

    • May 09, 2023 at 9:45 am, Ted said:

      If you have an interest in facts and data, I recommend familiarizing yourself with the SELECT and Surmount-MMO studies. These are large, careful studies ongoing to answer the questions you are raising. Results from the SELECT study will be available later this year. The SURMOUNT-MMO study will be complete in 2027.

      Already, we know that diabetes patients live longer and have fewer cardiovascular events when they receive semaglutide. So we know quite a lot about the safety of these medications.