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Treating Obesity Seriously at Obesity Week



obesity week logoThis week I am in Atlanta, where the first ever Obesity Week (Where Science and Treatment Meet) is being co-hosted by The Obesity Society (TOS) and the American Society of Metabolic and Bariatric Surgery (ASMBS).

What you have, are two major obesity conferences running back-to-back with a slight overlap, thus bringing together those of us primarily engaged in obesity research, behavioural and pharmacological interventions with those of us, who are primarily involved in bariatric surgery.

This not only makes sense but many may indeed wonder why it has taken this long for these two societies to synchronize both their the timing and venue for their annual meetings. After all, as regular readers will be well aware, bariatric surgery is never just about surgery. Nor, can those involved in behavioural and other non-surgical interventions ignore the substantial contribution that bariatric surgery is making made to the field.

Obesity Week also draws attention to the Treat Obesity Seriously campaign, initiated by TOS, which urges Obesity Week participants to take the following pledge:

“I believe obesity isn’t just a problem. It’s a disease that warrants serious evidence-based treatments. Nutritional and physical activity guidance. Intensive Behavioral counseling. Drug Therapy. And Surgery. I agree to learn more and help more. I treat obesity seriously.”

While purists may quibble with the wording, the intention of this pledge is clear: belittling obesity as merely a matter of poor lifestyle “choices” and sending those with excess weight off with friendly but useless advice to simply “eat less and move more” is not only contemptuous but also a major disservice to those with weight-related health problems.

The point of the pledge is to remind us to treat overweight and obesity as seriously and with the same diligence, be it behavioural, pharmacological or surgical, as we would any other disease.

Of course, regular readers will know my bias against simply using BMI as the means to decide who needs treatment and who does not – fortunately, this will be exactly the topic of several talks that I will be giving at this conference – where I will do my best to further promote the Edmonton Obesity Staging System (EOSS) as a means of making meaningful clinical decisions.

I look forward to a week of hundreds of original presentations, review lectures, and (most importantly) intense discussions with my colleagues from the US and around the world.

@DrSharma
Atlanta, GA

5 Comments

  1. Because obesity is a serious disease, it also needs serious effort directed at prevention.
    Also, as with other serious diseases, early detection and treatment is best.

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  2. Although your rational for using co-morbidities such as diabetes, high blood pressure and other factors ( I believe you might have mentioned smoking and being male as risk factors) make logical sense for rationed health care as provided in Canada, I am deeply mistrustful of these same criteria being imported into the American insurance industry. As it is, the major insurance companies are not at all eager to work with MO individuals without these same co-morbidities. Most insurance companies now require a BMI of 40 with no co-morbidities or a BMI between 35-35.9 with at least two co-morbities in order to cover bariatric surgery. What you are proposing, although scientifically sound, unfortunately provides cover to the insurance companies to limit access to bariatric surgery for even more patients with high BMI but without relevant co-morbitities. There are many reasons to seek bariatric surgery and although saving life is the most crucial, health, both physical and psychological as well as quality of life is also important. Many people feel stuck in a prison of fat and cannot find a way out through any other means except surgery. You have often expounded in great detail about the difficulties faces by SMO and MO individuals when attempting to lose and maintain weight loss. The loss of surgical intervention would doom many American individuals to a significantly more difficult life. I wounder if you have considered what your EOSS criteria would mean for these “healthy” fat people should the American insurance companies adapt your standards.

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  3. Your point is a good one, except that there are actually not many severely obese people who would be considered EOSS Stage 0 – in out NHANES analysis of those with BMI>40, only 5% of individuals were EOSS Stage 0 – only another 10% were EOSS Stage 10 – this means that even with very restrictive EOSS criteria, 85% of individuals with BMI>40 would still qualify for surgery.

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  4. Treating Obesity seriously is vital as obesity as i know it from my practice is a serious international healthhazard that is spreading as we speak and serious outlook on obesity assures nonuse of backfiring strategies that exacerbate the problem even further
    Wise and intelligent guidance of patients into appropriate means of treatment as needed will magnify success rates and will lessen the harmful effects of commercialized weight loss campaigns that keep budding out attracting thousands of desperate overweight &obese individuals into dark allys of false hope destroying their self esteem when weight is regained &topped to reach a new max
    The pledge should be taken by all professionals dealing w obesity to ensure health and wellbeing for all those suffering and give them a better quality of life diminishing accompanying obesity comorbidities and preventing relapse Good luck for all presenting at Obesity week

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  5. Are you having trouble controlling the way you eat? Many of us with this problem have found help in Food Addicts in Recovery Anonymous (FA). FA is a program based on the Twelve Steps of Alcoholics Anonymous. The program offers help and recovery to those whose connection with food can be understood as a form of addiction. There are no dues or fees and the meetings include no weigh-ins. Membership is international and includes men and women, adolescents, and the elderly. All are welcome.

    People who find help in FA vary greatly. Some of us have been diagnosed as morbidly obese while others are undereaters. Among us are those who were severely bulimic, who have harmed themselves with compulsive exercise, or whose quality of life was impaired by constant obsession with food or weight. We tend to be people who, in the long-term, have failed at every solution we tried, including therapy, support groups, diets, fasting, exercise, and in-patient treatment programs.

    Some of our members have been in continuous recovery (maintaining a stable, healthy weight and enjoying freedom from obsession with food, weight, bingeing, or bulimia) for over twenty-five years. Members with five to ten years of recovery are increasingly common.

    FA has over 350 meetings throughout the United States in large and small cities such as Boston, San Francisco, Los Angeles, New York, Charlotte, Grand Rapids, Atlanta, Fort Lauderdale, Austin, and Washington, D.C. Internationally, FA currently has groups in England, Canada, Germany, New Zealand and Australia. If you would like more information about FA, please check out our website. If there arenÔÇÖt any meetings in your area, you can contact the office, where someone will help you.

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