Obesity Week 2019: The Recap

At the beginning of this month, I had the pleasure of attending Obesity Week 2019 alongside a delegation of physicians from Obesity Canada. In the middle of the bustling Las Vegas strip, we hunkered down and immersed ourselves in the latest advancements in obesity research. From the TOS/WOF Joint Symposium on sugar consumption to the presentation of the Obesity Risk calculator from the team at the Cleveland Clinic, the future of the field proved bright. Despite the wide variety of topics covered over the course of the week, two specific points struck a chord with me, weaving themselves through every discussion and presentation. First, was the importance of the recognition of obesity as a chronic disease rather than a choice; and second, that weight bias poses one of the most difficult barriers to the treatment and management of obesity.

The recognition of obesity as a chronic disease with a defined pathology is a key milestone in the evolution and emergence of modern obesity treatment and management. Yet while obesity has been given “disease” status by the WHO, approaches to treatment have failed to evolve in tandem. Our traditional approach to care treats obesity as a risk factor rather than a disease, simplifying this complex and chronic condition to a case of exceeding the energy balance equation In the simplest terms: patients need to eat less and exercise more.

While exercise is an excellent way to improve your health, it does little to assist weight loss. And while a healthy diet is key to management, it fails to account for a broader range of factors that impact obesity. The science has shown that obesity isn’t a simple equation; it’s a multivariate system. Age, genetics, environment, emotional stability, sleep patterns, lifestyle and co-morbid diseases all play into disease progression. Consequently, physicians and clinicians need to take these factors into account when designing and implementing systemic approaches to treatment and management. We must focus on a holistic approach intended to improve the patients’ overall health and wellbeing, rather than simply focusing on weight loss.

One of the greatest barriers to this new system of care is obesity bias, or the negative attitudes and views about obesity, and the people that suffer from it. While obesity bias is most easily recognizable when it manifests as verbal or physical discrimination, it can present in a multitude of ways. From the lack of appropriately sized chairs in a doctor’s office to denial of healthcare affiliated costs by insurance providers, weight bias can have serious implications for patients’ well-being and may even lead to further weight gain. By perpetuating the traditional view of obesity as a self-inflicted condition rather than a biological disease, it redirects “blame” onto patients and creates negative associations with weight and self-care, resulting in a reduced efficacy of treatment and increasing the likelihood that patients will not seek out treatment.

So how can we, as physicians, combat obesity bias in our everyday practice? An easy first step is to revisit the language we use when discussing obesity. Many of my colleagues at Obesity Week 2019 advocate for the use of “people first language” to reduce stigma and avoid reinforcing negative attitudes around obesity. Initial studies from the Perelman School of Medicine looking at the implementation of this practice are encouraging, suggesting that patients are more likely to engage with healthcare providers about their weight. By avoiding defining patients by their disease, we can facilitate positive and productive discussions around weight and overall health, improving treatment outcomes and preventing the development of comorbid diseases. 

Want to learn about a few more key takeaways from Obesity Week 2019? Check out these top ten highlights from our week in Vegas: