10 Years of Obesity Solutions at the National Academy of Sciences

It has been ten years that diverse stakeholders have been meeting at the National Academy of Sciences in the Roundtable on Obesity Solutions. In our role as advisor to the Obesity Society, we participated in a symposium at the Academy focused on looking back and moving forward.

A Fraught History of “Solutions”

For looking back, Shiriki Kumanyika took us way back through three decades of “crisis control” as obesity prevalence began rising and policymakers tried vainly to stop that rise. Obesity prevention was the rallying cry and Kumanyika told us that many issues arose from this. How do we define obesity? Is it wise to call this an “epidemic”? Should we focus only on children? If so, are we blaming parents? How do we address a tension between personal and social responsibility? Or racial and ethnic disparities?

A Shift in Focus

At the outset of the Roundtable’s work, the focus was clear. How can we have more people eating healthy and living more active lives. This reflected the prevailing bias that obesity is a simple problem of poor diets and sedentary habits – eating too much and moving too little.

But Christina Economos described a strategic shift in the Roundtable’s focus five years ago. That shift brought three issues to the surface: social justice, biased mental models, and effective health communications.

With these issues in mind, we have seen a dramatic shift in the Roundtable. Most notable is the focus on the lived experiences of people with obesity. At the outset, we were living in a world where a Surgeon General’s competence was questioned because of her body size. An exclusive focus on obesity prevention was symptomatic of this.

Today, the Roundtable is careful to give the lived experience with obesity a central place in its work.

Where Are the Solutions?

With all this said, it is fair to ask, where are the solutions? Ten years on, we don’t really have them. Because the truth is that obesity is a wickedly complex problem that defies simple solutions. Some panelists at the symposium lamented the influence of effective treatments for obesity, saying that they have made us focus much more on treatment than on primary prevention.

Others see a world where half of the population is living with obesity and faces impossible hurdles to treatment for their condition. In a closing conversation about goals for the future, OAC Chair Kristal Hartman said, “We’ve got to stop the madness of people having to get really sick with the complications of obesity before they can get care.”

Amen.

Click here and here for more on the tension between treatment and prevention for obesity. For more on the 10th Anniversary Symposium of the Roundtable, click here.

Roundtable on Obesity Solutions, photograph by Ted Kyle / ConscienHealth

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July 25, 2024