With the recent election and naming of the US Health Secretary, Ozempic is back in the news again with people choosing sides of lifestyle change versus medication for weight management. Unfortunately, I read the stories and see the usual pattern of people picking sides. One side seems to say that America needs to make healthier lifestyle choices and medications are not needed. The other side, including doctors, say that lifestyle changes don’t work and obesity needs to be treated with medication. But, come on, is it really one or the other? Isn’t it all of the above? I believe the science shows:
The entire population of America and the world has gotten a lot heavier in the last 50 years. The shift is from the modernization of society including sedentary lifestyles and the abhorrent food environment.
Our food manufacturers have added sugar and processed our foods and made them potentially addicting and highly obesogenic.
Much of our work and recreational time is spent on a screen, where we are inundated with advertisements.
Everywhere we go, we see sugary foods for sale, even at Home Depot.
The pharmaceutical industry is correct about the physiology of weight regulation, but they do not acknowledge the role of the environment, which belies their trust.
On the other hand,
Not everyone has the same metabolism. Some people put on weight and keep it on easier than others.
The disease of obesity is real.
Medical treatments, when available, should be a person’s choice. If they are available and appropriate and a person wants to use them, that choice should be respected.
Equity in healthcare is morally the right thing to do.
So, let us not create divisions between us and divert attention from the real issues. The real issues are:
We need to destigmatize obesity and stop discriminating against people with this disease.
We need to diagnose and treat obesity like any other chronic disease. We have done this with mental health and substance use disorders.
We need to respect an individual's choices for their healthcare.
We need to improve healthcare delivery so we can scale the treatment of obesity.
In other words, if someone wants to use this treatment and it is medically appropriate, they should be able to. These treatments work really, really well, for the most part.
We need equitable access to the most recent advances in chronic weight management pharmacotherapy.
AND, we need a healthier environment. So, fewer people need treatment and those that do, have better outcomes. No one wants to have overweight or obesity.
We need to work together on these things.
We need to make courageous and uncomfortable and brutally honest changes quickly.
Take Back Your Common Sense,
Valerie Hope-Slocum Sutherland, MD
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