New Group Seeks to Remove "Invisible Hurdles" to Weight Loss

A new alliance of business, insurance and health associations has been formed to take a crack at the obesity problem from a different angle: rather than focus solely on exercise and eating habits, the diverse group of processional organizations wants nothing less than to change the way America views its fatty dilemma.

Unveiled May 7, the Strategies To Overcome and Prevent (STOP) Obesity Alliance boasts membership from the American Diabetes Association, the American Medical Group Association, the American Academy of Pediatrics and the National Business Group on Health, among several others. The STOP Obesity Alliance is headquartered at George Washington University in Washington, D.C. and will be led by Christine Ferguson, a professor at GWU’s School of Public Health & Health Services and the former commissioner of public health in Massachusetts. She also has 15 years of Capitol Hill experience.

"The idea was really to try and look at this from a very practical perspective," Ferguson told OPR. "There are a lot of institutions on obesity out there now; what can we do to change how we see the problem of obesity, how we approach the problem, and provide the kinds of tools that are needed to address it, and to provide hope to people who are struggling with the issue?"

Ferguson continued: "We're looking at obesity as a race that we're in the midst of, and there are a series of hurdles that we're tripping over and we're not even seeing them. Those hurdles relate to bias, a sense of futility of treatment, how we define success, and a lack of really good multi-faceted interventions."

Ferguson said the STOP Alliance's goal is to investigate that vast territory between the notion of "eat right and exercise" on one end of the prevention spectrum and morbid obesity surgery on the other. She also eschews the notion of a "silver bullet" for obesity – a single action that will cure the problem, both for the individual as well as for society as a whole.

"If there was a silver bullet we’d have found it by now," she said. "As a person who has been very overweight in her past, it’s a huge burden to wake up in the morning and know you have to face all the stigma that exists. If that was enough [to spur people to find a solution] we wouldn't have a whole lot of obese people today."

"It’s really hard to study multi-faceted, multi-component interventions," she added. "The focus in quality and cost-benefit analysis is always on what is the one intervention that is going to work. In the case of obesity or overweight, I really don't believe there is a one-bullet solution that is going to work."

Ferguson acknowledges that personal responsibility is part of the solution, but adds that "the more we learn about the science, the more we learn about what contributes to this condition, and the more we realize that it really isn’t just about someone not pulling themselves up by their bootstraps."

To illustrate the complex nature of the problem, Ferguson suggested imagining a doctor and an obese patient sitting in an examining room. Both are likely to think that the patient is to blame for his or her weight problem, and that a successful outcome would involve losing a large amount of weight. Doctor and patient are probably both a little skeptical that any medical treatment will actually work for the long term – and the doctor is also thinking that additional interventions likely won’t be covered by the patient’s insurance. "It’s a recipe for disaster, pretty much," Ferguson said.

"The definition of success is a huge problem," she added. "People are focusing on how they look, and so is everyone else. Science tells us that a 10-15% weight loss leads to very significant improvements in health. But we’re all so focused on losing this huge chunk of weight instead of what the health improvements are with a smaller amount of weight loss. We lose the opportunity to look at health outcomes."

The STOP Obesity steering committee will meet in July to discuss first steps, Ferguson said.

Obesity Policy Report, May 2007, Volume 5, Number 5, Copyright © 2007, Agra Informa, Inc.
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