For the last two days, the national board of the Obesity Action Coalition has been thinking deeply about its strategic direction for the next

five years. It was an occasion for two very different mindsets. On one hand, we see that much has changed in just the last few years with regard to the problems we’re facing with obesity. But on the other, not nearly enough has changed.

How can it be that both of these things are true?

The bottom line is this. The OAC is the only public-facing organization that is fearlessly facing obesity. OAC doesn’t sugar-coat, doesn’t catastrophize it, doesn’t try to pretend it’s not a thing. OAC faces it and deals with it. At the same time, the organization is ready to stand up for the dignity of people living with obesity.

Because of the unique work of OAC, much is changing about obesity. But at the same time, changes in weight stigma are coming slow. It’s a hard slog.

Facing Obesity

Sadly, even though it affects more than 40 percent of the population, few people are ready to face it. This reluctance comes in two flavors.

The longest-standing form of avoiding obesity comes from people who say it’s really bad but tell themselves that it’s not their problem. Or it’s not the problem of people who are close to them. They’ve just got a little weight to lose. Nothing that’s so bad as obesity. This is all about holding stigmatized views about obesity. It’s bad, I’m good, so this is not about me. So goes that train of thought.

The second form of denial comes from fat activists. It has its roots in strong feelings and experiences of weight bias that are completely valid. But one narrative from this community says that obesity is defined by BMI and BMI is flawed, so obesity is a fundamentally flawed idea. In fact, this school of thought holds that obesity is a slur, not a medical condition.

The truth is that obesity is a complex chronic disease defined by abnormal or excess adipose tissue that harms health. The stigma attached to it is wrong. It’s just as wrong to deny the science that documents the harm obesity causes. People are entitled to their own opinions, but not their own pseudo-scientific facts.

Standing Up for People

At the end of the day, though, people do deal with the subject of obesity in very different ways. Some are engaged, informed, and seeking effective obesity care. Others aren’t ready to deal with it or just want to lose a little weight. Still others don’t see it as a problem.

For all of these people, standing up for their right to make their own decisions about their own lives is essential. Providers must offer patient-centered care that respects patient autonomy. People should not have to put up with an obesity diagnosis rammed down their throat. People living in larger bodies who want nothing to do with the word obesity deserve respect – for their humanity and their human right to follow the course that works for them.

This is a core value for OAC that we respect.

Moving the Needle on a Wicked Problem

Obesity is a wickedly complex problem that resists tidy solutions. On top of that, weight stigma is deeply embedded in our culture. So progress is frustratingly slow.

However, much is changing. Recognition is growing that obesity is a problem of biology, not choice. Options for people who are living with obesity are growing today. When OAC was founded, innovation was at a standstill. Explicit bias keeps going down, even though implicit bias is still going strong.

For further perspective click here for the new 2021 annual report of the Obesity Action Coalition.

Originally posted on ConscienHealth.org.