The Lovers Whirlwind

Weight Loss Commerce or Obesity Care?

The availability of advanced medicines for obesity presents a dilemma. On one hand, people are accustomed to both patronizing and disparaging a diverse industry devoted to helping people lose weight. It ranges from the obvious frauds of dietary supplements that promise to help people lose weight quickly and permanently to behavioral support programs like Weight Watchers and Noom. But weight loss commerce is very different from the possibilities that advanced medicines open for real obesity care.

The difference is quite simple. Weight loss commerce is sharply focused on a short-term goal. Obesity care is focused on long-term health. Health professionals who specialize in obesity care understand this distinction. Most people living with obesity do not.

In fact, most people living with obesity tell themselves that if they could simply lose some or all of their excess weight, then they ought to be able to keep it off – all by themselves.

Meeting People Where They Are

So the dilemma becomes one of balancing the need to meet people where they are – feeling an urgent need for weight loss – against the ethical imperative to help them come to terms with a long-term outlook for their health.

That longer-term perspective requires people to start thinking about obesity as the complex chronic disease that it is – driven more by physiology than by conscious choices.

Cue the Media Frenzy and Telehealth Marketing

In popular discourse about weight, health, obesity, and the advanced medicines, the picture is very mixed. More than ever, we see real science about the physiology of obesity coming into the picture. Yet the weight loss thread remains very strong. Subway ads in New York promise “a weekly shot to lose weight.”

Some see it as the start of a conversation about obesity care, while other simply see more of the same old weight loss commerce. In this vein, we hear from pharmaceutical skeptics, proclaiming that obesity is not an important risk for bad health outcomes. Obesity as a chronic disease is merely a “social construct,” they say.

Working for a Cultural Shift Toward Obesity Care

To be clear, we do not favor viewing the new advances in obesity medicine through the lens of weight loss. They are valuable only to the extent that they help people achieve better long-term health and quality of life.

Already we have many pieces of evidence to tell us this is likely true. Blood pressure, cholesterol, and blood sugar all improve when people take these meds. So does their quality of life. Not for everyone, but for most people. This outlook will become even clearer if results from the SELECT study turn out to be positive later this year.

Perhaps this will be a big step in a cultural shift away from weight loss commerce and toward obesity care.

Click here, here, and here for further perspective.

The Lovers Whirlwind, illustration by William Blake / WikiArt

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April 16, 2023