Essays

Essays January 2012

Why Addressing Weight Bias is the #1 Strategic Goal of the Obesity Network

Dr. Arya Sharma

Regular readers will recall a host of previous posts on the issue of weight bias and discrimination.

Canadian Obesity Network members will hopefully also be aware that for the past four years, addressing weight bias and speaking out against weight-based discrimination has been the #1 strategic goal of the network.

Rather than listing all of the activities that the Network has undertaken to address this issues (the latest one being the launch of the image gallery “Picture Perfect at Every Size“), in today’s post I would like to share a story and explain why I continue to believe that this is the central problem at the the very heart of finding solutions to the obesity issue.

I remember this as though it was yesterday. I had just arrived with my family in Canada, having accepted a Tier 1 Canada Research Chair in Obesity at McMaster University. I was just discovering Canadian television and was quite impressed the first time I saw Peter Mansbridge on the CBC’s “The National”.

Interestingly, that evening one of the news items that caught my attention was an announcement by then Health Minister Anne McLellan, that the Government would spend $15 million to support obesity research - certainly good news for an obesity researcher just arriving in Canada.

This brief sense of having arrived in the right place at the right time, however, was shaken by what followed - a scathing, derisive, and contemptuous commentary by Rex Murphy, Canada’s premier TV commentator - not known to mince words.

In brief, as far as I can recall, the gist of his commentary was that this funding for obesity research was another perfect example of wasteful spending of tax-payer dollars.

To paraphrase his words, “so now the Government of Canada is spending millions of dollars to show that Canadians get fat by eating fast food and lounging in front of their TVs“.

I don’t remember the exact wording or the many ‘humorous’ angles that Rex Murphy took in this typical meandering monologue but I do recall the immediate effect it had on me. In my mind I could see Canadians across the country nodding and agreeing with Murphy, that spending any money on obesity research was indeed a complete waste - we already know the reasons: ‘gluttony and sloth’ - what’s there to research?

It became blindingly obvious that Rex Murphy was simply stating aloud what most people think - no wonder governments would be hesitant to support obesity research, or worse still, actually consider providing obesity treatments to Canadians.

I admit that prior to hearing this commentary, I had not given much thought to the issue of how weight bias ultimately stands in the way of finding solutions to the obesity epidemic.

Unfortunately, while Rex Murphy could perhaps be forgiven for failing to recognize the true psychosocial and biological complexity of this problem, I continue to be baffled that so many of my professional colleagues continue to trumpet simplistic notions of “eat-less-move-more” as a solution to the problem.

Frankly, I do not believe that they fully appreciate how, by reducing the entire problem of obesity to simply a matter of diet and exercise, they do little more than reinforce what most people already believe - obesity is simply a matter of ‘gluttony and sloth’.

No talk of food insecurity, abuse, depression, stress, time-pressures, addiction, genes, incretins, adipokines, hypothalamic pathways, adipostats, mitochondrial inflexibility, medications, or any of the other countless ’scientific’ intricacies that may indeed result in the ’symptoms’ of overeating or undermoving.

By reducing obesity simply to a matter of ‘lifestyle’, they provide the perfect excuse for funding agencies to rather fund research on ‘real’ health problems, for regulators to tighten the criteria for obesity medications, for payers to deny or limit the access to obesity treatments, and for health professionals to not see obesity management as part of their job.

This is why there will be no solution to obesity without first solving the issue of weight bias and discrimination.

This is why, addressing this issue remains the #1 strategic priority of the obesity network.

To anyone unhappy about how much funding is going towards supporting obesity research, unhappy about availability or access to obesity treatments, unhappy about lack of obesity training for health professionals, unhappy about reimbursements to health professionals for obesity counselling, unhappy about integrations and accommodation of people struggling with severe obesity, or even just unhappy about the surprising fact that Canada’s only national obesity organisation receives virtually no government funding to sustain its efforts - I have one simple suggestion: begin by showing zero-tolerance for ‘fat jokes’ or ‘fat talk’, do not use language, images, or messages in your presentations and writings that further promote stereotypes or reduce this complex problem to simply a matter of ‘lifestyle’, and please do stand up and speak out on the issue of weight bias and discrimination.

If the Canadian Obesity Network does nothing else but bring awareness to this aspect of the obesity problem  - it will have well been worth the ride.

About the Author

Dr. Arya M. Sharma, MD/PhD, FRCPC is Professor of Medicine & Chair in Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Medical Director of Alberta Health Services Edmonton Region’s interdisciplinary Weight Wise Program and the Clinical Co-Chair of the Alberta Health Services Obesity Initiative. Dr. Sharma is also the founder and Scientific Director of the Canadian Obesity Network, a network of over 6000 obesity researchers, health professionals and other stakeholders. He is also the Past-President of the Canadian Association of Bariatric Physicians and Surgeons. His past appointments include positions as Professor of Medicine and Canada Research Chair (Tier 1) at McMaster University (2002-2007), Professor of Medicine at the Franz-Volhard Klinik - Charité, Humboldt University Berlin (2000-2002) and the Free University of Berlin (1994-2000). His research focuses on the evidence-based prevention and management of obesity and its complications.

Acknowledgment

Originally published in Dr. Sharma's Obesity Notes, December 12, 2011

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