We have all heard the words chronic diseases and non-communicable diseases before. But have we ever considered defining obesity as one? In this afternoon’s session, Jacqueline Bowman-Busato, the policy lead of the European Association for the Study of Obesity, asked a controversial question: What would happen if Europe approached obesity like other chronic disease epidemic and focused on addressing the biological causes in approaches to policy along the obesity continuum?
We have all heard someone say “just eat less and exercise more and you will lose weight.” Is that the magic formula to solving the challenge of obesity? Clearly not. Despite a set WHO target to halt the rise in diabetes and obesity by 2025, prevalence is rising globally. Across Europe alone, almost all countries have an obesity prevalence above 15%. But the worse news is that it keeps increasing, meaning that whatever we have been doing to address the problem is failing. Why is that? As highlighted by Abd Tahrani, an NIHR clinician scientist, we are failing because we are not treating obesity as a chronic, relapsing disease, but as an individual choice and despite severe long-term health, social and financial repercussions, health care systems around the world are failing those living with obesity.
Yet, the complex foresight obesity map highlights the hundreds of inter-linkages surrounding and having a direct – or indirect – impact on individuals. For the scientists and biologists in the room, Abd Tahrani also stressed that obesity meets the American Medical Association criteria to be classified as a disease, namely:
- It leads to the impairment of normal function
- It has characteristic signs or symptoms
- It causes harm or morbidity
While this lesson in obesity 101 was enlightening and hopefully led many people around the room to have a “Eureka” moment, I still wonder if calling obesity, a disease really is the solution. How is that going to change the number of challenges that exist such the awareness, discrimination and stigma associated with those living with obesity, or address infrastructure, health system and data challenges?
Current treatment and prevention interventions focus on directly tackling obesity but fail to address any of the underlying causes. But what about the impact of our external environments? Supermarkets are filled with products high in fat, sugar and salt. We are bombarded with advertisements that shows the consumption of excessively sugary drinks as very appealing. Cities are built in ways that promote sedentary behaviours. Does an individual approach to the treatment and prevention of obesity take into account any of these environmental factors or the different stakeholders that play a role in sustaining – and even encouraging – these environments? People living with obesity are stigmatised and discriminated against. What if we shifted our angle of attack? It is time to change the narrative about obesity and adopt a systems approach and shift the blame away from those living with obesity and acknowledge that it is the result of the complex interactions of many factors that surround us on a daily basis.
Health systems around the world are failing people living with obesity. We need to stop pointing fingers at those suffering today and start an open, non-discriminating dialogue that includes all stakeholders. This approach needs to empower individuals to leverage the system. This is everyone’s responsibility and our work start today. So now I am asking you: is it time to adopt a new narrative to address obesity?
This Blog is written by the Young Gasteiner Margot Neveux