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First, thanks to everyone who was concerned about the nature of this New York Times article and contacted me about it (there are more than 250 of you so far!)
I wrote last week about how to tell if an article is news or diet industry propaganda, and just in time, the New York Times published a piece by Gina Kolata called “The Doctor Prescribed an Ob*sity Drug. Her Insurer Called It ‘Vanity.’”
Let’s put this article to the test:
Are they medicalizing body size?
This one is taken care in the title, and the exclusive use of language that pathologizes fat bodies including “person-first” language continues throughout the article.
Are they quoting people who profit from weight loss?
Not only is she quoting them, she is quoting them exclusively. The doctors quoted in the article are all “ob*sity specialists” and have all taken money from the diet industry:
Dr. Caroline Apovian has taken $3,740.00 consulting fee from Novo Nordisk
Dr. Louis Aronne has taken $11,400.00 from Pfizer which has a new weight loss drug in the works, and five separate payments from Novo Nordisk totaling $148.61.
Dr. Fatima Cody Stanford took six separate payments from Novo Nordisk totaling $4637.61 for consulting, food and beverage, and travel and lodging.
Dr. Scott Kahan took 2 payments from Novo Nordisk for beverage, food and lodging totaling $126.00, and took $33,788.93 in “consulting fees” from Vivus (manufacturer of the weight loss drug Qysmia,) as well as $5,320.00 from Pfizer for “services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program”
A couple things to keep in mind. First, these figures are from openpaymentsdata.cms.gov which only shows payments from January 2014 through December 31, 2020. So any payments to these doctors from these companies after that (since they’ve really ramped up this marketing campaign) are not included.
Now, we can’t say that doctors accepting money from drug companies means that they are definitely willing to put the company’s bottom line over what’s true or best for their patients… they may actually believe what they are saying, but they should be very clear and upfront about these financial ties and insist that the information be included in anything they do that could be construed as using their “medical expertise” to marker for the drug companies that pay them.
Moreover, Kolata doesn’t quote a single “expert” who isn’t on the payroll of the weight loss drug companies (on whose behalf the article is essentially lobbying for insurance coverage,) and none of these relationships are disclosed in the piece, despite the fact that, even if the doctors failed to disclose them, the information is publicly available.
Are they suggesting that fat people shouldn’t be stigmatized, but should be eradicated?
Sort of. The article doesn’t mention weight stigma at all, but does use “not their fault” type language.
Do they suggest that being fat is a “chronic health issue” that “requires treatment”?
Pretty much verbatim. Here’s a quote from the article
Dr. Aronne and other ob*sity medicine specialists emphasize that ob*sity is a chronic disease that should be treated as intensively as heart disease, diabetes, high blood pressure or any other chronic illness are.
Do they gloss over the difference between correlation and causation?
Yes. The phrasing here is “Many suffer from medical conditions that are linked to ob*sity, including…”
There is no explanation of the fact that “linked” absolutely does not mean “caused,” and that these same conditions are “linked” to weight stigma, weight cycling (which these drugs will likely cause) and healthcare inequalities (like “ob*sity medicine specialists focusing on shrinking fat people rather than actually supporting their health.)
Are they pushing for insurance coverage?
Check, check, checkity check. It’s the entire point of the article.
Do they minimize true anti-stigma and weight-inclusive health activists?
Kolata attempts to erase the existence of all of these activists and decades of tireless work and sacrifice with the utterly false statement “No one disputes the problem.” As Kolata has previously been somewhat involved with the weight-neutral health community (using us to market her work in the mid-2000’s) it would be difficult to argue that she doesn’t know better than this.)
Do they fail to engage in actual fat liberation?
Utter failure. There is absolutely no mention of any solution for the health issues that fat people have other than making us thin, despite the fact that thin people have these same health issues, and that weight neutral options are shown to have greater benefits with less risk.
Do the links go to weight loss sites?
No. While they go to sites that repeat the message of pathologization and eradication of fat bodies, Kolata didn’t take it so far as to link to the sites of the companies the piece lobbies for.
Do they suggest that weight loss is a solution to weight stigma?
Sort of. Again, the piece doesn’t mention weight stigma (or its links to the health issues that the article is quick to blame on larger body size) but does say things like “It’s not that they don’t have willpower. Something physical is holding them back [from weight loss].”
Is Novo Nordisk involved?
In addition to having paid money to every expert quoted in the piece, Kolata writes (not as part of a quote) “Data on medication use by patients predate the newer, more effective and safe drugs made by Novo Nordisk and Eli Lilly.” Notably, there is no definition of “more effective and safe,” nor any citation here of data that would suggest that they are either.
She then quotes Novo Nordisk’s Executive Vice President, Douglas Langan, explaining why the drug costs “51 percent more if it is used to treat ob*sity than if it is used for diabetes.” He says it “reflects efficacy and clinical value in this area of unmet need.” He neglected to mention that his company promised its investors “one of the fastest Novo Nordisk launches after approval ever” that will “more than double its ob*sity sales by 2025 versus its 2019 baseline.” Apparently, Kolata didn’t find it worth mentioning either.
This is followed in Kolata’s article by doctors who take money from Novo Nordisk expressing their horror at its prices and their excitement about their fat patients being diagnosed with diabetes:
Dr. Stanford was appalled.
“It’s unbelievable,” she said, adding that it was a gross inequity to charge people more for the same drug because of their ob*sity. She finds herself in an untenable situation: getting excited when her patients with obesity also have diabetes because their insurers pay for the drug.
Dr. Apovian says she too finds herself rejoicing when patients have high blood sugar levels
Remember that they are “excited” and “rejoicing” because their patients have an actual chronic health condition (that thin people also get) but now they get to prescribe those patients a drug whose manufacturers give them money (with their focus on changing their body size rather than managing blood sugar,) rather than weight-neutral interventions that offer greater benefits with fewer risks (though they don’t hand out “consulting fees” or free food and beverages.)
In case the focus is unclear, the piece ends with a quote from the woman about whom the headline is written. She was able to access the medication because of her high blood sugar. The final paragraph of the article mentions her (at least temporary) weight loss, with no mention of blood sugar management.
So from my perspective, this Times piece is firmly in the category of diet industry propaganda. Some of those who reached out to me and have been around a while expressed surprise that Gina Kolata would write a marketing piece for the weight loss industry, since she wrote and spoke in ways that were considered “HAES™” in the mid-2000’s. While Kolata’s work was never truly weight-neutral as she has always been one to paradigm straddle between the (in reality mutually exclusive) weight-centric and weight-neutral paradigms, I absolutely agree that she should still know much better than this.
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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.
Note I don’t link to everything I discuss in this post because I don’t want to give traffic and clicks to dangerous media.
Holy moly, this is a dumpster fire. From the author to the doctors to the drug companies… I think healthcare will get a lot worse before it gets better. I hadn’t seen this article so thanks for this breakdown.
The book “Bad Pharma” by Ben Goldacre talks about how easily-influenced doctors are by the media and a shiny sales pitch delivered by a young, thin former cheerleader bearing sandwiches (not even joking)… all of these doctors are absolutely 100% biased, 100% bought and paid for by the weight loss industry.
Thank you so much for this. I remember the last time I read a Kolata piece that was utterly glowing about weight loss drugs and was shocked since I associate her with her HAES leaning book that I only vaguely remember reading. (But I have always HATED the cover art!) I didn't read this most recent piece because by now I recognize that she doesn't care about reducing weight stigma, she cares about promoting the eradication of fat bodies with articles that may as well be written by the Novo Nordisk PR team. I have been looking forward to your response and it did not disappoint! She is shameful.