Ideas on Obesity, Nutrition, and Health to Leave Behind in 2025
The best thing about this day is that we can finally say we are done with 2024. We can savor the good news it brought and put the bad behind us. And while you are shaking off that bad news, we want to offer you some bad ideas on obesity, nutrition, and health that perhaps we should leave behind us, too.
Calories In, Calories Out
H. L. Mencken long ago told us “there is always a well-known solution to every human problem – neat, plausible, and wrong.” For obesity, the paragon of this is the conviction that the challenge of overcoming obesity is really quite simple: “find a way to convince patients to consume fewer calories.” As recently as 2018, this false, but elegant approach to obesity was dominant. Today, it tops the list of ideas to leave behind in 2024.
Eat Less, Move More
This restatement of calories-in-calories-out thinking shifts the emphasis a bit toward physical activity. Right about now, it’s doing a great job of selling gym memberships that will quickly lapse. While an active life and a healthy diet are great aspirations for improved health, they don’t often work as a simple solution to obesity. Too often, this has become an excuse to blame people for obesity, instead of helping them with it.
Children Will Grow Out of It
This false presumption has long been the basis for dodging the task of providing obesity care to young persons who need it. In 2023, the American Academy of Pediatrics repudiated this idea. So it’s time to leave it behind.
Medicines and Surgery Are Cheating
No. Neither taking obesity medicines nor having metabolic surgery represents an “easy way out” of dealing with obesity. This expression of weight bias has got to go.
You Have No One to Blame but Yourself
This rubbish truly belongs in the dumpster of 2024. But too often it lands in the psyche of a person living with obesity. Researchers call it self stigma and tell us it is a key barrier to improved health.
Healthy Eating Is the Answer
This one is tricky. Not for a minute do we question that healthy patterns for eating are worth pursuing. But overselling them as the answer to obesity and other prevailing problems with non-communicable diseases is a mistake. It leads people to neglect complex causes of these problems and slows us from finding solutions that will move the needle.
Obesity Care Is Unaffordable
Yes, drug pricing is a problem. So, too, is the cost of medical care in America. But simply walking away from equitable access to obesity care is not the answer. When health plans and policymakers tell us that they can’t afford to pay for advanced obesity medicines, they are merely making an excuse. What they are really saying is that they don’t care enough to do anything. That is inexcusable and unacceptable.
What is truly unaffordable is the loss of health, productivity, and lives to untreated obesity.
Obsolete Thinking
Our point is simple. We know better. Let’s shake off these obsolete ideas and move with confidence into a happy new year.
An Abandoned Farmhouse, painting by Louis Valtat / WikiArt
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December 31, 2024
December 31, 2024 at 9:11 am, John DiTraglia said:
“Evidence supports that obesity treatment is safe and effective. There is no evidence for a watchful waiting approach; therefore, pediatricians and other pediatric health care professionals (PHCPs) should offer treatment options early and at the highest available intensity. The CPG recommends using principles of the medical home and the chronic care model with a motivational interviewing approach.”
It does happen that children somehow grow out of it at a higher rate than adults manage to permanently lose a meaningful amount of weight.
There is no good evidence for obesity treatment that is safe and effective as promulgated there by the AAP.
It’s a continuing shame.
December 31, 2024 at 4:28 pm, Ted said:
Thanks for sharing your thoughts about this, John. I realize that people have strong and conflicting feelings about the subject. But I respect the expertise of the pediatricians and scientists who painstakingly reviewed evidence for this guidance, taking years to do so. Evidence does not tell us that “children grow out of it [obesity] at a higher rate than adults.” In fact, early onset of clinically significant obesity often suggests a more aggressive and biologically-driven form of the disease. The evidence review by AAP experts tells us:
“There is no evidence to support either watchful waiting or unnecessary delay of appropriate treatment of children who have already developed obesity. Many children are only referred to treatment programs when their obesity has become more severe. A delay in care ultimately reduces the likelihood of treatment success for the child.”
For a more detailed review of the evidence, I really do recommend reading the entire guideline at https://doi.org/10.1542/peds.2022-060640. It is quite thorough.