On the first day of ObesityWeek 2016, The New York Times featured a major story on obesity with the headline, “Americans Blame Obesity on Willpower, Despite Evidence It’s Genetic.” This was no coincidence. The story was timed to the release of a national consumer survey conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) on perceptions Americans have about obesity and its treatment. Major national news outlets including People magazine, Medscape, Yahoo News, CNBC, MedPage Today and even Cosmopolitan covered the ASMBS/NORC Obesity Poll.

The ASMBS Executive Council decided several months earlier to partner with the highly regarded independent research organization NORC at the University of Chicago to identify current views, perceptions, and misperceptions about obesity and its treatment held by the American public. Additionally, the ASMBS wanted to use the survey as an educational and public awareness platform to inspire national dialog on the diagnosis and treatment of obesity and generate national media coverage on the issues that interfere with the treatment of the disease.

“The barriers to treatment go beyond insurance,” said Raul J. Rosenthal, who was president of the ASMBS during the time the survey was conducted. “We felt the survey could uncover other barriers including fear and denial about the disease and misperceptions about the safety and effectiveness of the treatments, including weight-loss surgery.”

In addition to comments from ASMBS president at the time, Dr. Raul J. Rosenthal, The New York Times contained reactions to the survey from several obesity experts from throughout the country.

Dr. Donna Ryan, an obesity researcher and professor emerita at the Pennington Biomedical Research Center in Baton Rouge, La. said, “It’s frustrating to see doctors and the general public stigmatize patients with obesity and blame these patients, ascribing attributes of laziness or lack of willpower. We would never treat patients with alcoholism or any chronic disease this way. It’s so revealing of a real lack of education and knowledge.”

“Trying 20 times and not succeeding — is that lack of willpower, or a problem that can’t be treated with willpower?” asked Dr. Louis Aronne, director, Comprehensive Weight Control Center at Weill Cornell Medicine and New York-Presbyterian.

One problem, though, is that medical professionals can be as misinformed as the public, said Dr. Scott Kahan, an obesity medicine specialist who is an assistant professor at George Washington University and directs the National Center for Weight and Wellness, an obesity clinic.

Doctors, he said, learn nothing about obesity in medical school, which might be why only 12 percent of those in the survey with severe obesity said a doctor had suggested surgery to them. “We are talking about people who are 100, 200 pounds overweight,” Dr. Kahan added.

Dr. Caroline M. Apovian, the president-elect of the Obesity Society and director of the nutrition and weight management center at Boston University, echoed Dr. Kahan’s concerns about the failure by doctors to mention the only effective course of treatment. “If I said that was the case for cardiovascular disease and bypass surgery, you would say doctors are negligent,” she said.

Major finding from the ASMBS/NORC Obesity Poll include:

• 81 percent of Americans consider obesity to be the most serious health problem facing the nation, tying cancer and ahead of diabetes (72 percent) and heart disease (72 percent)
• 94 percent think obesity itself increases the risk for an early death, even when no other health problems are present
• Most Americans think diet and exercise on one’s own is the most effective (78 percent) for long-term weight loss, saying it’s even more effective than weight-loss surgery (60 percent) and prescription obesity drugs (25 percent)
• 1 in 3 of those struggling with obesity, report that they have never spoken with a doctor or health professional about their weight
• Only 12 percent of those with severe obesity, for whom weight-loss surgery may be an option, say a doctor has ever suggested they consider surgery
• Only 22 percent of Americans with obesity rate their health positively, and half report being diagnosed with two or more chronic conditions
• 88 percent say losing weight through diet and exercise, especially with the help of a doctor, is the safest way to do it, while prescription medications (15 percent) and dietary supplements (16 percent) are perceived to be the least safe
• About one-third believe weight-loss surgery to be either safe (31 percent), unsafe (37 percent), or neither safe nor unsafe (31 percent), though 68 percent think that living with obesity is still riskier than having weight-loss surgery
• 62 percent consider obesity simply a risk factor for other diseases and not a disease itself
• 48 percent believe obesity is caused primarily by a person’s lifestyle choices and that the biggest barrier to weight loss is a lack of willpower (75 percent)

For more information, you may find two reports associated with the survey: “Obesity Rises to Top Health Concern for Americans, but Misperceptions Persist,” and, “New Insights into Americans’ Perceptions and Misperceptions of Obesity Treatments, and the Struggles Many Face.” http://www.norc.org/Research/Projects/Pages/the-asmbsnorc-obesity-poll.aspx.

The survey results are very scary. Will we ever get to a point where people begin to understand this disease?

Same is true of the medical profession. Having had to change insurance companies and states, I am no longer covered for bariatric services under my health insurance.

Every time I see a doctor, even my own general doctor, I have to come very prepared to question, challenge and educate them on my new digestive system. I have to fight every insurance bill that has anything to do with post op care. If my doctor uses the word bariatric in coding, I have to pay 100% out of pocket.

I am waiting for the day when things change but it really stinks that people do not understand this disease nor the proven cure for it.

Alex,

I can't thank you enough for this post. I forwarded it to the select few members of my family that I have told about my upcoming bariatric surgery. This information will help them so much in better understanding this disease.

It grieves me so much that obesity is such a devastating epidemic and yet is so widely misunderstood. Obesiacs are stigmatized and marginalized unfairly. Even Stephen Hawkins recently made news when he blamed obesity of willpower. News coverage such as this is badly needed to educate society about the true nature of obesity, Thank you for passing this information along.

~~Betty

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And a long irritating minor issue is the "size-ism" at stores. To buy the exact same shirt in a plus size it tacks on a fat tax....or several dollars more. If it was the extra material, why isnt a size zero cheaper than a size 8? Can you imagine any other "illness" getting charged extra for the same product or service due to their health situation. Nobody understands OR cares about overweight or obese people. If you're anorexic you get sympathy and hugs and oh poor you, get help! Fat people are just "Gross. Why are you eating? Control yourself....."

Sent from my SM-J700P using the BariatricPal App

And a long irritating minor issue is the "size-ism" at stores. To buy the exact same shirt in a plus size it tacks on a fat tax....or several dollars more. If it was the extra material, why isnt a size zero cheaper than a size 8? Can you imagine any other "illness" getting charged extra for the same product or service due to their health situation. Nobody understands OR cares about overweight or obese people. If you're anorexic you get sympathy and hugs and oh poor you, get help! Fat people are just "Gross. Why are you eating? Control yourself....."

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Oh my god, yes. Why should I pay $30 for a shirt at this "plus size store" that would be $15 anywhere else at any other "normal" size?

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Thanks for this article! I was very fortunate. My primary care dr suggested it....I thought about it, mentioned it to my endocrinologist, who was against it in principal...I let him win, temporarily.

Then he left the area and I brought it up to my primary again...he's been nothing but supportive....

6 weeks postop tomorrow! 32 pounds down since surgery

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