Public Funding For Obesity Treatments?

In any public discussion of obesity, the prime concern appears to be about health.

Interestingly, however, the same public does not seem to actually support treating obesity like any other health problem – at least not in a publicly funded healthcare system.

This, perhaps not all that surprisingly, is the result of a study by Lund and colleagues from the University of Copenhagen, Denmark, just published in OBESITY.

Thus, in this representative survey of the Danish public (N = 1,141), although the majority supported prevention measures and ‘softer’ obesity treatments (read ‘diet and exercise’), more radical treatments like bariatric surgery only found limited support.

The best predictor of these attitudes to the treatment of obesity was the belief that individuals are personally responsible for their own obesity.

This is perhaps not surprising given that public health messaging as well as many ‘well-meaning’ health professionals continue to propagate the stereotype that obesity is largely a self-inflicted condition easily prevented or remedied by simply choosing to eat less and move more. The fact that this piece of ‘advise’ is largely ineffective and does little more than increase weight-bias and stigmatisation, still appears to fall in the category of ‘privileged information’.

What is particularly paradoxical about this situation is that every single health economic assessment to date supports the notion that obesity treatments (particularly bariatric surgery for people with severe obesity) are far more cost-effective than many of the other ‘health’ services routinely provided to patients.

Thus, you would imagine that anyone who pays taxes (or insurance premiums) for health care, would be far more enthusiastic about their taxes (or premiums) being spent on treating obesity rather than watching them disappear into the black hole of treating its many complications.

Apparently, this is not how most tax payers think – not in Denmark and probably not in Canada either.

Interestingly, based on my own conversations with patients, people with obesity pretty much think the same.

Thus, even people who suffer from obesity themselves (or have battled it all their life) are far more enthusiastic when it comes to raising money for breast cancer, heart disease, diabetes, or arthritis than for obesity itself.

Thus, for example, as I have blogged before, it is rather funny how, although obesity is one of the biggest drivers of post-menopausal breast cancer, virtually none of the money raised for breast cancer each year ever finds its way into obesity research (or better treatments).

In fact, it would be fair to assume that the same people, who will happily give generously to cancer research, will be appalled if any of their money found its way into researching better surgical treatments for obesity, a treatment that is known to reduce cancer mortality by 60%.

How can anyone ever expect the ‘public’ to support obesity treatments, when even people with obesity (and apparently their friends and family) themselves don’t seem to think this a worthwhile cause?

Where are the donors, the sponsors, the trusts, the foundations, the campaigns, the armies of volunteers when it comes to finding “the cure” for obesity?

Just wondering – that’s all.

AMS
Toronto, Ontario

Lund TB, Sandøe P, & Lassen J (2011). Attitudes to Publicly Funded Obesity Treatment and Prevention. Obesity (Silver Spring, Md.) PMID: 21512511