Greetings!
I was recently part of a meeting where someone suggested that America's approach to overweight and obesity was one rooted in virtue-based medicine rather than evidence-based medicine. The comment has stayed with me ever since.
Are we avoiding the science? Is there even enough science to avoid? Either way, the concept seemed an interesting filter through which to consider both the advancements and shortfalls that have transpired in 2010... in how we worked to both define and address obesity and weight-related health issues. It also might prove helpful as we develop our work in the year ahead.
In 2010, we saw how the evidence helped ignite a significant public health dialogue about weight and weight-related chronic disease. We kicked off the year with an intense health reform debate and lofty goals of looking holistically at the individual. First Lady Michelle Obama zeroed in on childhood obesity with her "Let's Move" initiative. And the CDC chose obesity as one out of six "winnable battles" - those that describe public health priorities with large-scale impact, which have known, effective strategies to intervene. These initiatives garnered widespread - and much deserved - attention. We really cannot underestimate the powerful impact of assembling the facts and data to spark a wider and more comprehensive conversation about obesity and its serious consequences.
This year was also noteworthy for the subtle shift we began to see from prevention-only weight-loss strategies that exclusively focus on individual action, to those that embrace weight loss through creating environments that support healthful choices and clinical support. More health care professionals are addressing obesity holistically in the doctor's office - taking into account psychological, physical, social and emotional well-being in treatment plans. And while we watched a pair of weight-loss treatments get denied by the FDA, just this month, U.S. health advisers recommended approval for a new pharmaceutical obesity treatment, the first such approval in a decade.
Even with these advances in thinking about obesity, there is still reluctance by many to move beyond the idea that one's weight problems are a reflection of his or her lack of discipline. There remains an idea that providing help to someone to overcome a weight issue is rewarding his or her "bad behavior." This thinking reinforces a failed notion: that we can force change by simply shunning those affected by overweight and obesity, despite its prevalence and impact in our society.
So, in 2011, will we remain rooted in virtue-based medicine or will we continue to shift towards an evidence-based approach? Even with the progress, it's important to recognize how stigma continues to serve as an obstacle to a truly evidence-based approach when treating overweight and obesity. We must fine-tune how we define obesity - as well as healthy weight loss - to make the condition manageable. And while obesity researchers continue to gather more data, it is important that we make sound obesity policies and recommendations.
To help with the dialogue, the Alliance recently released media recommendations in collaboration with the National Eating Disorders Association (NEDA) that identify the media as a bridge between the research community and the public - a bridge that can communicate and advance more realistic weight-loss goals that focus on health rather than appearance. While these recommendations are a step in the right direction, there are other barriers that still need to be addressed, including the need to create a society where healthy food options are accessible and good choices are possible, as well as the acknowledgment that sustaining weight loss will be a key part in finally overcoming this epidemic.
2011 will bring new opportunities to refresh our thinking on this important issue. For our part at the Alliance, we will continue to look at the available evidence, and also participate in the work to advance it. It's an endeavor we look forward to making with you.
