Walking on the Staudammkrone Dam at Lünersee

The Winding Path Toward Better Coping with Obesity

Seeking better ways of coping with obesity has taken us on quite a twisted path. From more than 20 years we’ve been working on this disease, the last two have brought exponentially more change than we’ve ever seen. This week, in an outstanding report for the Atlantic, Daniel Engber offers up the clearest, most objective, and complete account of this path to date.

In addition to reporting on just about every aspect of developments along the way, he follows Barb Herrera through a lifetime of more than 60 years living with this disease:

“In a way, Barb has never stopped trying to change her life. At 10 years old, she was prescribed amphetamines; at 12, she went to WeightWatchers. Later she would go on liquid diets, and nearly every form of solid diet. She’s been vegan and gluten-free, avoided fat, cut back on carbs, and sworn off processed foods; she’s taken drugs that changed her neurochemistry and gotten surgery to shrink her stomach to the size of a shot glass. She’s gone to food-addiction groups; she’s eaten Lean Cuisines; she’s been an avid swimmer at the Y.

“Through it all, she’s lost a lot of weight. Really an extraordinary quantity – well more than a quarter ton, if you add it up across her life. But every miracle so far has come with hidden costs: anemia, drug-induced depression, damage to her heart. Always, in the end, the weight has come back. Always, in the end, ‘success’ has left her feeling worse.”

A Lifetime of Struggles and Progress

This story is an amazing account of a lifetime of struggle for Herrera – woven together with an account of impressive but incomplete progress in understanding obesity. Of course, her experience is the account of only one person. But it is remarkable because it covers the path of a lifetime of coping with severe obesity. This is something we rarely see so fully.

In his reporting, Engber talks to people who have been fully engaged in coming to terms with metabolic, nutrition, and behavior science related to obesity. He covers the development of fat acceptance and health at every size movements. He puts research into weight bias and stigma into a historical perspective in an exceptional way.

The Present Confusion

In parallel with Engber’s remarkable reporting, New York magazine reflects on the implications for the body positivity movement. Was it a big lie? asks Samhita Mukhopadhyay.

Likewise in Time, Jamie Ducharme tells us that “no one knows how to talk about weight loss anymore.”

That’s OK with us. Maybe this is where we are on the twisted path of coming to terms with obesity. Perhaps we are coming closer to being ready to obsess less about weight, think a bit more about health, and let go of some of the ignorant stigma attached to obesity.

For her part, Herrera is in a much better place today because of all this progress. She’s making travel plans that were not an option a few years ago – to see her grandkids. “I’m so excited, I can hardly stand it.”

Click here for Engber’s outstanding writing in the Atlantic. Read every word now, because the free access with this link is only good for two weeks. For the reporting by Mukhopadhyay, click here, and then here for the piece from Ducharme.

Walking on the Staudammkrone Dam at Lünersee, photograph by Böhringer Friedrich, licensed under CC BY-SA 2.5

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May 10, 2024