Rocky Landscape

Obesity Care Is Emerging as an Effective Tool for Prevention

For decades now, thinking about obesity that pits treatment against prevention has hampered efforts to “tackle” obesity. At the Boston Course in Obesity Medicine yesterday, ConscienHealth founder Ted Kyle examined this either/or thinking and suggested it is a mistake. In fact, it is becoming apparent that obesity care is a critical tool for prevention of the harm that obesity can do to the health of the population.

An Ounce of PreventionMany Forms of Prevention

Lisa Kisling and Joe Das tell us that prevention strategies come in many forms, starting with primordial prevention. The aim of primordial prevention for obesity is to work across the entire population and stop it from occurring. Primary prevention comes next, with the aim to prevent obesity in vulnerable populations at risk for it.

Kyle pointed out that we are fast approaching the time when all but 25 percent of the population is living in the range of overweight and obesity. The remaining 25 percent of the population may well be biologically resistant to weight gain.

And thus, secondary, tertiary, and quaternary prevention take on increasing importance. Their aims, respectively, are to prevent progression, reduce symptoms, and prevent iatrogenic harm.

Primordial and Primary Prevention

There can be little doubt that policy efforts for primordial and primary prevention of obesity have failed us. The prevalence of obesity and overweight have kept rising for four decades now. Some argue (and we agree) that we have no evidence for effective primordial and primary prevention strategies.

Others argue that nutrition policies could prevent the problem. They say policymakers must pursue these policies more vigorously and food companies must stop thwarting them.

Gains in Secondary and Tertiary Prevention

What is becoming undeniable is the growing evidence for interventions that will prevent or reverse the progression of obesity and also prevent major health complications from it. Landmark studies are showing that advanced obesity medicines can prevent a whole range of cardiovascular, renal, metabolic, and respiratory complications – including death.

In this way, it will soon be unmistakable that obesity care is an effective tool for secondary and tertiary prevention of the harms to population health from obesity.

A Rocky Road to a Bright Future

So the future looks bright for prevention in obesity. But it will be a rocky ride to that bright future. Change is hard. Prices for obesity medicines will come down as options proliferate. Access to care will improve. Health systems are rapidly learning how to deliver effective secondary and tertiary prevention for obesity. Advances in obesity care are making it happen.

Though primordial and primary prevention has been stuck on ineffective old paradigms, better scientific insights can lead the way to better approaches. Old and ineffective ways of thinking will, eventually, fall away.

Yes, the future is bright for preventing the harm of obesity at every level.

Click here for Kyle’s presentation on the future of obesity prevention.

Rocky Landscape, painting by August Macke / WikiArt

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June 15, 2024