Obesity Care Week is well under way, so it’s time to take a minute to reflect upon how we frame obesity and how that matters for everyone’s health.

It is instinctive to frame obesity as an issue of weight. But it is also utterly false. Though excess weight is the most prominent and visible symptom of obesity, it does not define the disease. Obesity itself is a disorder of metabolism that results in patterns of adiposity harmful to health.

When we frame obesity in this way, it brings a fresh perspective. Through this lens, merely losing weight does not cure the disease – especially if that weight lose comes solely through restrictive diets and punishing exercise regimes. This is precisely why The Biggest Loser was, at its heart, an exploitive lie.

Even with extreme weight loss, after such a punishing regimen, the disease of obesity is still at work, harming the health of the people who are living with it. Almost inevitably, the symptoms of excess weight and adiposity return. Metabolic function is still dysregulated. Complications of obesity that come from systemic inflammation rage on.

Weight Loss, Obesity Treatment, and Health Gain

Even with the advent of important new obesity medicines that deliver benefits beyond mere weight loss, public discourse about obesity comes in a frame that distorts our shared understanding of it.

Our analysis of recent news coverage about Wegovy and Zepbound tells us that almost two-thirds (64%) of the time, the frame is weight loss. Only 36% of headlines put these drugs into the context of treating obesity or improving health. Headlines about new studies focus primarily on weight loss outcomes. New drugs for obesity are labeled and judged primarily for the weight loss they produce, not the health gains they deliver. Even FDA describes medicines for obesity in terms of weight – not health – outcomes.

Let It Go

This is hard. But if we want to make progress in obesity care, we will all have to let go of our preoccupation with body weight. Not to pretend that it does not matter, but to focus on the real problem at hand.

We understand this from other chronic diseases. For example, when we treat rheumatoid arthritis, one of the most prominent symptoms of the disease – pain – subsides. But this does not mean that the advanced immunotherapies bringing such relief are analgesics. No, they are treating the underlying disease and, as a result, providing relief from its symptoms.

Likewise, if we are to meet the goals of Obesity Care Week, the frame matters. Only by framing obesity care as delivering gains in health can we actually help everyone gain consistent access to safe, effective, and compassionate obesity care. It may serve to reduce their burden of excess weight, but more important is to help people achieve their best health possible.

And that is the whole point of Obesity Care Week.

Click here for more on Obesity Care Week. For further perspective on health outcomes in obesity care, click here, here, and here.

Interior with an Easel, painting by Vilhelm Hammershøi / Wikipedia