Food & Fitness After 50: What I’ve Learned About Obesity

I’ve been a registered dietitian for 45 years and I still have a lot to learn about the disease of obesity.

I had the chance to meet and interact with medical experts in the field of obesity medicine at a recent sponsored conference and through a webinar on World Obesity Day (March 4, 2020) on changing the narrative on obesity by addressing weight bias and stigma.

Here are the big takeaways:

• Obesity is a disease. That’s right, obesity is a disease and was classified as such in 2013 by the American Medical Association , but most of us were slow to catch on. “Obesity is a disease of abnormal or excessive fat accumulation that may impair health.” This from Dr. Gabe Smolarz, Diplomat, American Board of Obesity Medicine. “Obesity is a chronic disease and is marked by progressive weight gain over many years.”
• Because obesity is a disease the words we use matter. You wouldn’t call a person who has cancer by her disease (“she is cancer”) yet we routinely say, “she is obese.” Changing the way we talk about obesity can help chip away at the bias and stigma surrounding the disease.
• Obesity is underpinned by genetics. Seventy percent of obesity is determined by genetics. Yet many, including health care providers, still think obesity is a lifestyle choice. “Eat less and move more” might be the only medical care that a person with obesity receives from his or her doctor.
• Personal choice is important but should be viewed in the context of the disease. As Ted Kyle, founder of ConscienHealth puts it, “genetics sets the table and the environment serves it up.” We should all be eating a healthy diet and getting regular physical activity, but we wouldn’t tell a person with serious heart disease or advanced cancer to only eat well and exercise. We would provide quality medical care to address the underlying disease while helping them modify their lifestyle. And, another myth is that exercise is the cure for obesity. To be sure, it is crucial for good health, but a “cure?” No.
• Bias towards those with obesity is strong. Explicit bias towards weight (the things people say) is going down, yet implicit bias (Ted Kyle describes this type of bias as the “knee jerk” reaction we have to an issue) is going up. We have many demeaning stereotypes of people with obesity as shown on this slide from Ted Kyle.

In a recent episode of the Hulu series, Shrill, starring Aidy Bryant as a young journalist who lives in a larger body, her character has an emotional conversation with her roommate. This honest scene really touched me and brought to life all the demeaning stereotypes listed on the slide. Her character Annie says, “You don’t think I know that the whole world isn’t constantly telling me I’m a fat piece of s__ who doesn’t try hard? Every magazine and commercial and weird targeted ad telling me to freeze my fat off and at this point I could be a licensed nutritionist because I’ve literally been training for it since the 4^th grade.” (To hear an interview with Aidy Bryant on NPR’s Fresh Air, click here. It’s worth a listen.

• Weight bias and stigma leads to stress which can make the disease worse and people sicker. To recognize this a Joint International Consensus Statement for Ending Stigma of Obesity was recently published in Nature Medicine calling on health professionals, the media, and basically all of us to think about our actions to end the stigma surrounding obesity. In addition, a campaign and pledge to end obesity stigma was started and you can click here to lend your support by taking the pledge. I did.
• For a video on stigma and obesity, watch this one from Ted Kyle.

And, stay tuned for a PBS Nova special, “The Truth About Fat,” airing April 8 at 9 PM. I’m set to record!

Thanks to the experts, Dr. Gabe Smolarz, Dr. Matthew Hutter, Dr. Robin Blackstone, and Ted Kyle for their insightful presentations.

Chris Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.