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Does the Focus on Obesity Prevention Promote Bias and Discrimination?

Imagine walking into an emergency room with chest pain and simply being sent away with a leaflet advising you to quit smoking. Imagine arriving at a hospital with signs of stroke and simply being referred to a lecture on reducing sodium intake. Imagine being diagnosed of colon cancer and just receiving well-meanining advise on the virtue of eating more fibre. What is fundamentally wrong with the above scenarios? The simple fact that they are confusing prevention with treatment. While giving up smoking, excessive salt and eating more fibre may be valuable in preventing heart disease, stroke and cancer, as treatments (at least in the short term) they are near to useless. Once patients present with the disease, they need treatment. This is not to say that lifestyle changes are not as important for secondary prevention – but they are rarely enough. While many may agree with the above, they seem to have a hard time applying this knowledge to obesity. While every politician, non-government organization and legions of health workers are campaigning for more efforts on preventing obesity, rarely do I hear the cry for more treatments – this is blatant discrimination! When a quarter of the population or around 11,000,000 Canadians already have the “disease” focussing all available resources solely on prevention is a joke. Not that efforts at prevention are not important – of course they are. Yet, even the most optimistic experts do not think that the current epidemic can be reversed in the forseeable future. It will take time to rebuild our cities, force people to abandon their cars, regulate our food chain, focus on calories and change our culture of overconsumption and sedentariness. Even if any of these measures worked, no one expects them to have an immediate impact on those struggling with obesity today. A 200 lb 17 year-old does not have 10 years to wait for “prevention” to kick in – he/she needs help today. Even if treatment focussed only on providing minimal obesity treatments to those who most need them, i.e. those already experiencing the complications of diabetes, knee pain, sleep apnea, fatty livers, infertility – we would still need to provide obesity treatments for millions of Canadians. Ignoring their plight and focussing all resources on “prevention” is not only demeaning and in-human, it also perpetuates the wide-held notion that obesity is entirely preventable and that anyone who has obesity has obviously… Read More »

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Does Weight Matter?

Some of you may have seen the news items in yesterday’s media – a new study by Flegal et al. from the CDC, published in the Nov 7 Issue of JAMA, finds that overweight individuals (BMI 25 to

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