Efforts to normalize obesity?

The following is a news analysis.

As an American obesity epidemic expands, there seem to be efforts to normalize obesity rather than address the root of the unhealthy trend.

A new editorial published in liberal-tilted Medpage declares it’s time to retire Body Mass Index (BMI) as a clinical metric.

According to the authors:

The genesis of BMI as a metric dates back nearly 2 centuries to the work of Belgian mathematician (not physician) Adolphe Quetelet, who had the singular idea to create a quick way to approximate body composition in the society. In the 20th Century, BMI was resurrected as a risk prediction tool for insurance companies. Though BMI was never intended as a measure to be applied to an individual’s health, by the 1990s, as panic arose over increasing weights nationwide, Quetelet’s metric — once so obscure that it was known only in the rarefied world of historians of 19th Century mathematics — became a household word. BMI has now become the organizing principle of a massively sprawling surveillance system and the default tool in society’s arsenal in the “war on obesity.”

The authors go on to say that BMI measurements and discussions about being overweight are too discouraging to patients and could be counterproductive to “people living in larger bodies” and those “experiencing weight-based shame.”

Yet, a growing body of research on weight stigma in medicine has identified routine BMI assessments as a key barrier to care for people living in larger bodies and for others experiencing weight-based shame. Studies and patient stories tell us that anticipating being weighed in medical settings leads many to delay or avoid medical care altogether, resulting in missed preventive care or worse. When patients do arrive to care, a focus on BMI can cause more problems than it resolves. Clinicians’ focus on BMI can lead to unproductive weight-related conversations that fracture the doctor-patient relationship and may introduce mistrust. This can lead to patients opting not to follow physician advice, even when that advice is not weight-focused, and not pursuing follow-up care due to faltering trust — a vital element of effective doctor-patient relationships. Additionally, misplaced BMI assessments can unnecessarily divert clinician focus to weight, an easy default but often misguided explanation for various signs and symptoms, and can result in missed diagnoses, sometimes with grave consequences.

Other experts are weighing in saying that focusing on obesity is not “shaming,” but striving for a healthier population amid trends that are going in the opposite direction. More Americans than ever are suffering chronic illnesses with no specific, identified cause; and more Americans and other western societies are seeing record obesity among children and adults alike.

According to doctors, obesity plays a key role in many illnesses. People who are grossly overweight cost society dearly in terms of insurance and medical costs, according to insurance industry analysts.

During the Covid epidemic it was learned that people of a healthy weight suffer a near zero chance of serious complications. However, obese people were far more likely to become seriously ill, according to the Centers for Disease Control (CDC). Studies indicate obesity causes an ongoing state of inflammation, which can interfere with normal immune responses.

Ironically, CDC notes that during the Covid pandemic and forced shutdowns of schools and other public places, obesity exploded.

According to CDC:

A study of 432,302 children ages 2 to 19 years found the rate of body mass index (BMI) increase nearly doubled during the COVID-19 pandemic compared to a pre-pandemic period. This faster increase was most pronounced in children with overweight or obesity and younger school-aged children.

In addition to lack of exercise and a poor diet, studies have linked a host of other factors to the obesity epidemic. They include vaccines, which are also linked to Type 2 Diabetes and other immune disorders in children; the processing of the food we eat today; and other environmental or external causes.

Amid the obesity problem, there is a strong lobbying effort to normalize the trend. More corporations are using extremely obese models in their ads and to show off products, and a focus on healthy weight is often termed by propagandists today as “shaming.”

Read more of the Medpage opinion article below:

https://www.medpagetoday.com/opinion/second-opinions/101296?xid=nl_secondopinion_2022-11-27&eun=g1861897d0r