Reader Question - Who Exactly is Part of the Weight Loss Industry?

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I received this question from reader Louise:

I see you and other people talk about the weight loss industry, but what does that mean? Is it just drug companies and places like weight watchers? Do doctors who recommend weight loss count?

In their article “U.S. Weight Loss Industry Grows to $90 Billion, Fueled by Ob*sity Drugs Demand” Market Data calculated that “The total U.S. weight loss market is estimated to have grown to a historic peak of $90 billion in 2023”

To calculate that they included weight loss medications, medical weight loss programs and services (which they define as “provided by independent physicians (incl. bariatricians), clinics, hospitals and medical weight loss franchises,) commercial weight loss chains,  and meal replacements and retail appetite suppressants.

They also reported that “Commercial diet companies and ob*sity drug manufacturers spent $882 million on advertising in 2023”

This is where I lose focus for a moment and start daydreaming about how much research around weight-neutral health and healthcare research could be funded by this money.

Ok, I’m back.

I think that this is a pretty solid list. Other reports include things like diet sodas and gym memberships which I think are a lot less clear since people of all sizes spend money on these things for many reasons besides weight loss.

For my definition, if someone makes money selling/supporting weight loss, they are part of the weight loss industry. Said another way, if a change to a weight-neutral healthcare paradigm in which the focus shifted from weight loss to supporting the health of higher-weight people directly, would have a negative impact on someone’s career and/or earnings, or render their work moot, they are part of the weight loss industry.

Sometimes people within healthcare who sell weight loss (bariatric surgeons, ob*sity medicine providers, people who own weight loss clinics or run weight loss labs, researchers funded by the weight loss industry etc.) argue that they shouldn’t be included in the “weight loss industry” and I think that’s a massive problem.

When a healthcare provider is profiting from and/or has built their career on the concept of weight loss, that can create issues around paradigm entrenchment and bias.

One of my frustrations with weight loss research, for example, is that healthcare providers whose entire careers are rooted in selling weight loss are not necessarily required to list that as a conflict of interest. If they take payments from a weight loss pharma company, for example, they are ethically obligated to disclose that, but if a bunch of bariatric surgeons write research that promotes bariatric surgery, it is more likely that they will be touted for their expertise, rather than examined for potential bias in research design and methodology. Similarly, if a group of pediatricians who sell weight loss to children write guidelines that, again, will directly benefit them and their employers financially, there is often a lack of scrutiny around the potential for bias.

Also, the weight loss industry has been under scrutiny for years around the massive failure rates and harms of intentional weight loss and by trying to claim that, though they profit from selling weight loss, they aren’t part of the weight loss industry, these healthcare providers are trying to have their {substitute-some-carrots-or-whatever-for] cake and eat it too. And that, along with our culture’s willingness to blame higher-weight people for the failures and harms of intentional weight loss and the weight loss industry, allows them to continue to dodge, duck, dip, dive, and dodge accountability for any harm that they do.

I think that when we talk about the weight loss industry we have to start from a place of honesty around who is a part of it, and that includes anyone and everyone who profits from intentional weight loss.

Again, I understand why people, often due to paradigm entrenchment and bias (including subconscious entrenchment and implicit bias) may want to distance themselves from the weight loss industry (or co-opt the concept of weight-neutral while still selling weight loss.)

Again, though, we have to be honest - if you makes money selling/supporting weight loss, then you should be fully willing to admit that you are part of the weight loss industry. If you’re not willing to admit that, then then consider that you might want to find another way to make money.

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More research and resources:
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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’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.