Obesity: It's Complicated

Huff Post recently published “Everything You Know About Obesity Is Wrong,” by Michael Hobbes highlighting a significant gap between science and practice in the treatment of obesity.

Huff Post recently published Everything You Know About Obesity Is Wrong, by Michael Hobbes highlighting a significant gap between science and practice in the treatment of obesity. The article draws a comparison to the deaths of 2 million sailors over a 300-year period from scurvy – a disease medical experts knew could be prevented with daily citrus consumption yet was not (for 200+ years) due to competing traditions, assumptions and financial incentives.

Why is this relevant to obesity, where the solution is far less simple than an orange a day?

What we’ve been doing to prevent and treat obesity isn’t working. That includes denying obesity is a disease, blaming the victim and trying the same (failed) approaches over and over. We know that:

  • Obesity is a complex, chronic condition that remains present in affected individuals even when a healthy weight is achieved. It’s a metabolic disorder with psychosocial and other health consequences.
  • Obesity management is about more than reducing BMI or numbers on a scale; success looks different for every individual.
  • Diet and exercise alone don’t work for most adults with obesity, who on average make 5 serious attempts at weight loss.
  • Every larger person is aware of her size – and of society’s judgement. Research shows that women face discrimination at a BMI of 27 or higher, while for men it’s a BMI of 35. Stigma and implicit bias – aka blame and shame - are counterproductive, causing a stress reaction in those affected by obesity that harms progress toward better health.
  • Most physicians are not equipped to support and treat obesity; they tend to share society’s biases about their patients as well as about available treatments (such as FDA-approved prescription drugs and bariatric surgery), they spend less time on average with these patients and often lack sensitivity to the emotional burdens and underpinnings of obesity.

The infographic Treating Obesity is Everyone’s Business recaps these challenges. A forthcoming “Practical Playbook: Managing Overweight and Obesity” will provide a deeper look into how employers can help employees by investing in what works.

Let’s work together to overcome the gap between science and practice.