The 3 Dís of ObesityÖ
A few years ago, I was talking with our public relations and communications consultant for ASMBS, Roger Kissin (also the editor of our connect news magazine), about how we can more effectively talk about obesity treatment. He said that we have to focus on the ď3 Dís of Obesity: Denial, Discrimination, and DollarsĒ The challenges we face today around obesity treatment really boils down to these three things, and finding solutions to them is more important today than ever.
Denial. The ASMBS completed a national survey to assess attitudes about obesity and its treatment last year under Raul Rosenthalís leadership. One thing that was clear in this and other national surveys about obesity is that many people with the disease of obesity donít acknowledge that they have it. People consistently underestimate the severity of their weight problem and their weight-related health issues. Even though most people recognize obesity as a serious national problem, most donít think it applies to them. Physicians are part of the problem too. Denial among doctors that obesity is a chronic disease is pervasive and drives discussions toward ineffective treatment options, or worse, that obesity is a choice or due to lack of willpower. We know better and need to educate our colleagues.
Discrimination. The magnitude of this problem is far too great to discuss in one paragraph, but it is abundantly clear that our society has allowed discrimination against obesity and access to obesity treatment. Look no further than the ďone per lifetimeĒ insurance policies for bariatric surgery, lack of coverage for revisional surgery for recurrent disease, the lack of obesity care coverage in 22 statesí essential health benefits plans for the ACA, many insurance plans that still donít cover bariatric surgery at all, workplace discriminatory practices, or the arbitrary 3, 6, or 9 month waiting periods imposed by payers that serve only as a barrier to care for our patients. The ASMBS lives and breathes to fight against these discriminatory policies and to make sure our patients have access to effective treatment.
Dollars. Unlike cancer or other chronic progressive diseases, the field of obesity research suffers from lack of funding. Bottom line is that, despite the association of obesity with a litany of other life-threatening diseases (including cancer!) no one sheds a tear or opens their philanthropic wallet for obesity. Changing the way people think about obesity will require changing how we teach the science of obesity in medical school and how we present this science to the lay public. Similarly, the attitude that obesity is a choice makes it permissible for insurance companies and employers to discriminate against this disease. Can you imagine a patient who needs a revision heart valve, or another hernia repair, or a second joint replacement being told that they arenít covered for the procedure because they already had one shot at it?
These are fundamental problems that we all face in our practices and with our patients. Rest assured that the ASMBS is going to continue to provide science, education, and messaging to challenge the three Dís of obesity. Have a great week and I look forward to seeing you all in June at the ASMBS Weekend in San Diego!