Search Results for "discrimination"
Are Patients With Type 2 Diabetes Responsible For The Semaglutide Shortage?
Shortages in supply of semaglutide, approved in various countries (including the US, Canada, UK, and the European Union) for the treatment of type 2 diabetes and obesity, have led to calls to restrict its use to patients with type 2 diabetes (T2DM). Indeed, there has been much ado about people using (and misusing) semaglutide “simply” for weight loss, apparently depriving people living with T2DM of this “essential” medication. While it makes no sense to pit one disease against another, one could well argue that it is the people living with T2DM who are in fact depriving the folks living with obesity of this “essential” medication. For one, there are plenty of treatments available for managing T2DM. Although semaglutide may well be a safe and effective medication for T2DM, there are plenty of other GLP-1 analogues around, not to mention the many other classes of medications approved for T2DM. Thus, were semaglutide to disappear from the market, most people living with T2DM would do just fine with the many alternatives that already exist.. This, however, is not the case for obesity! People living with obesity requiring obesity treatment have no alternative that is even remotely as effective as semaglutide, which, for a significant proportion of patients, can result in weight loss comparable only to what can be achieved with bariatric surgery. Thus, while there is no discernable unmet need for people with T2DM, the unmet need for those living with obesity is indisputable. Reserving the limited supplies of semaglutide for them should be a priority. Obviously, most people living with T2DM are also living with obesity (which highlights the absurdity of pitting one disease against the other), but emphasising the need for people with T2DM while ignoring the much greater need for those living with obesity, to me, reeks of weight bias and discrimination. Hopefully, the supply of semaglutide will eventually increase to meet the demand, but perhaps in the meantime those living with T2DM who are not in desperate need of losing weight should help conserve the limited supplies of semaglutide in favour of those living with obesity, who do not have the luxury of switching to an alternative but equally effective treatment. DrSharmaBerlin, D Disclaimer: I have received honoraria as an independent medical, research and/or educational consultant from various companies including Aidhere, Allurion, Boehringer Ingelheim, Currax, Eli-Lilly, Johnson & Johnson, Medscape, MDBriefcase, Novo Nordisk, Oviva and Xenobiosciences.
Bing Chatbot Writes My Acceptance Speech
Last week at the 8th Canadian Obesity Summit in Whistler, BC, I was honoured to receive the innaugural Obesity Canada Founder Award for my services to the organisation. In preparation for this event, just for kicks, I asked Bing’s Chatbot to write me an acceptance speech. The following is verbatim what Bing came up with (in under 20 seconds!) – scary! @DrSharma,,Berlin, D p.s. I did not use any of it, but I probably could have without anyone noticing. Prompt: write an acceptance speech for Dr. Arya Sharma as recipient of the Obesity Canada Founders Award Bing Chatbot: Here is a possible thank you address for Dr. Arya Sharma: Ladies and gentlemen, it is my great honor and pleasure to receive the inaugural founder award from Obesity Canada, the leading obesity charity in this country. I would like to thank the board of directors, the staff, the members, and the supporters of Obesity Canada for this recognition and for their dedication to advancing obesity research, education, and advocacy. When I founded Obesity Canada in 2006, I had a vision of creating a network of obesity stakeholders who would work together to improve the lives of Canadians living with obesity. I wanted to challenge the stigma and discrimination that people with obesity face every day. I wanted to promote obesity as a chronic disease that requires evidence-based prevention and management. I wanted to foster collaboration and innovation among researchers, health professionals, policy makers, and people with lived experience. Fifteen years later, I am proud to say that Obesity Canada has achieved many of these goals and more. Obesity Canada has grown to become a network of over 10,000 members across Canada and beyond¹. Obesity Canada has produced the first Canadian clinical practice guidelines for obesity in adults² and children³ [sic], which have been widely adopted and endorsed by various organizations. Obesity Canada has organized six [sic] biennial Canadian Obesity Summits, which have brought together hundreds of experts and stakeholders to share knowledge and best practices. Obesity Canada has advocated for policy changes that support obesity prevention and care, such as the inclusion of obesity in the Canadian Disability Tax Credit and the recognition of obesity as a chronic disease by several provinces. Obesity Canada has also empowered people living with obesity to share their stories and voices through initiatives such as the Public Engagement Committee, the Weight of Living project, and… Read More »
Guest Post: Obesidades Mexico
Today’s guest post comes from my Mexican friend and colleague, Verónica Vázquez Velázquez, PhD, Co-founder and President of Obesidades. Is obesity a single disease or are they several diseases with common clinical manifestations? Science is trying to answer this, but every one living with obesity has their personal definition. In Mexico, more than 80 million children, teenagers and adults live with overweight or obesity (55% of children from 0 to 11 years, 44% of teenagers and 74% of adults, from a total of 126 million inhabitants). This means that most Mexican people live with abnormal or excessive body fat that may impair their health. For some, obesity is merely living in a large body, but for others, this is a disease that leads to other diseases and has alienated us from our work, social and love lives. For many, this also means living under the critical and biased eye of physicians, relatives, friends or strangers, who think that “this is our fault”. In reality, obesity results from a series of factors, some that can be controlled/treated and others that we have not chosen (such as biology, genetics and the environment). I remember talking with Dr Sharma in July 2020 and can´t forget his words: “What makes you angry about what is happening in Mexico with obesity? What can you do about it? Whatever it is, make it important and manageable. First, get together friends who think alike and understand obesity. Then, little by little, you will add people to spread knowledge and advocate for change. If you feel passionate about it, just do it. It does not have be perfect, it just has to be good”. This is why we founded Obesidades (Spanish plural for obesity), to give voice to those interested in understanding and addressing obesity. We are a non-profit organization incorporated in Mexico in 2020 by a psychologist/patient in treatment, a bariatric surgeon and a physician/patient in treatment. Our goal is to create a community that includes people living with obesity, health professionals, organizations and authorities, all joined together for changing the narrative around obesity and its treatment. Primary prevention is important, but clearly many of us will, at some point, require access to health services offering an individualized biopsychosocial approach, incorporating early diagnosis and evidence-based treatments that includes strategies to sustain the treatment in the long term. All of this may seem complicated. Nonetheless, we can start… Read More »
Guest Post: Racism and Health Disparities in Black Americans
Today’s guest post comes from Sean Wharton, my friend and colleague from Toronto, well known to all of us working in obesity medicine. Since the George Floyd incident in the United States, the entire world has taken greater account of instances of racism and discrimination in all walks of life. Medicine is no different and it is therefore no surprise that much of medicine is steeped in racism. Many people refer to this as the social determinants of health, but the structure and underlying reasons for those determinants, in many countries, is racism. In America, the remnant of slavery also lives on in the social determinants that drive the obesity epidemics in African Americans. African American women have an incidence of obesity of 57%, compared to white women at 40%. This is 42% higher! This is a staggering difference. What accounts for this? We now have a greater understanding that most disparities in health, including hypertension, diabetes and obesity, are due to racial and ethnic inequities, many of which are a legacy of their past history. For obesity in African Americans, we can start by looking at the nutrition during slavery. A slave’s diet was primarily made up of inexpensive foods that were high in sugar and fat, designed to provide fuel that would be burned off during the day. As reported historically slave rations could include: 10 quarts rice or peas 1 bushel sweet potatoes 2-3 mullet or mackerel salt fish 1 pint mollasses 2 pounds pork Thus, African Americans became accustomed to this diet and continue to have a palate for such as evidenced by the menu in many Southern African American restaurants and homes. Today food choices for African American follow a similar pattern as in the times of slavery. Foods – high starch, fat, sodium, cholesterol, and caloric content, and are inexpensive and often low-quality nature of the ingredients such as salted pork and cornmeal. This gives us some explanations regarding the disparity in the incidence of obesity between the races, and now we deal with the fact that there is are difference in success of obesity treatment between the races. Again this is likely due to the very same social determinants. Our own research has documented that women of colour lost less weight at weight management clinic, but when adjusted for the number of visits, the weight loss was the same. It was clear that… Read More »
Are We Moving the Needle on Weight Bias?
Twenty years ago, when I first became aware of the issue of weight bias as an important barrier to effective obesity prevention, treatment and research policies, there wasn’t really much in terms of research, evidence, or advocacy to go on. Back then, my friend and colleague (and fellow Canadian) Rebecca Puhl, then at the Rudd Center for Food Policy, was virtually the lone “she-wolf” in the wilderness trying her best to attract attention to this topic. Reading her papers and speaking to my patients and colleagues, it was clear to me then, that in order to move forward in terms of respectful and meaningful obesity prevention policies, improving access to obesity treatments, and increasing funding allocations towards obesity research, tackling weight-bias and discrimination needed to be a central focus for the newly created Canadian Obesity Network (now Obesity Canada). Just how far along we have come in terms of broader awareness of this issue is nicely outlined in a paper by Adrian Brown and colleagues in a paper published online in eClincal Medicine as part of The Lancet Discovery Science series. The paper summarises the current evidence to support the pervasiveness, impact, and implications of weight bias in the context of policy, healthcare, media, workplaces, and education. I was, of course, particularly tickled by the fact that the authors chose to highlight our efforts in Canada (e.g. the EveryBODY Matters Collaborative) to tackle weight bias on multiple fronts using complementary as well as consistent and persistent strategies, which have to date resulted in notable changes within Canada and beyond. At the end, the authors propose short- and medium-term recommendations to address weight stigma in an effort to end weight stigma and discrimination accross society. These include, changing the narrative around obesity and recognising it as a chronic relapsing disease, the need for a non-weight-based definition of obesity that focuses on health rather than size, the importance of using proper language, and reframing health policies to address the wider determinants of health with a focus on health behaviours rather than weight loss. At a clinical level (not extensively discussed in this paper), I would humbly add, we need policies to ensure that every person living with obesity has the same access to evidence based treatments that must include behavioural modification, medications, and bariatric surgery, in a manner comparable to treatment access for other chronic diseases like diabetes or hypetension. Although we… Read More »
