The Truth About ObesityWeek - Part 2

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In part one we talked a bit about who was behind Ob*sityWeek and the money involved. Today we’re going to look at how this plays out.

As I mentioned in part 1, OW is a week dedicated to propping up the weight-centric paradigm in general (this is the massively profitable paradigm that uses weight as a proxy for health, tries to define simply existing in a higher-weight body as a “disease” that requires “treatment”) and trying to tamp down any weight-neutral paradigm principles that have been gaining ground whether by (truly questionable) research, or an attempt to co-opt principles (like anti-weight stigma work) and make them about selling weight loss.

It's neither here nor there, but it was amusing to me that when I clicked on the OW website, the first thing I saw was a large graphic with the text “DON’T FALL FOR A SCAM.” For a quick moment I thought maybe they had come to their senses or been hacked by someone who had, but it turns out there were some scam sites selling tickets to the event. Still, don’t fall for a scam is certainly good advice when we’re discussing the weight-centric paradigm and the people who have built their careers and finances on it.

I started with the program. Propping up the weight-centric paradigm is an overarching theme throughout these presentations, and it starts before OW even kicks off.

It turns out that prior to OW one can attend “Ob*sity Treatment Bootcamp.” Militaristic euphemisms for the way that healthcare practitioners are going to engage with higher-weight people are always a cause for concern. So is a complete lack of evidence-basis for your program, but we’ll get to that momentarily. For some background, this “bootcamp” is put on by the UTSW Medical Center which, per Zippia, has an annual revenue of $795.7M. I couldn’t find the specific amount of their revenue that comes from their “Weight Wellness Clinic” but Zippia found that “the revenue per employee ratio is $1,438,839” and just in terms of the MDs, there are 11 listed on the UTSW website for the weight loss clinic. I also found a job opening for a dietician in this “Clinic” with a salary range of $206,746-$265,604.

Let’s talk about content. They claim that this “bootcamp” is “designed to provide health care providers with practical advice for achieving healthy weight loss in patient with overw*ight and ob*sity”

First, note that now it’s the practitioners who are “achieving” weight loss – the patient becoming further dehumanized as simply a conduit for practitioner “achievement.” Also, we see the use of “person-first language” which is a weight loss industry marketing tactic hidden under a smoke screen of being “anti-weight stigma.”  More to the point, we know that in terms of behavior-based interventions and pharmacotherapy there is no research demonstrating long-term significant weight loss, but there is research demonstrating harm for the weight cycling that is, by far, the most common outcome. When it comes to surgeries, in addition to high rates of weight regain, the combination of dangerous side effects, catastrophic poor outcomes, lack of prognostics and long-term data, and issues with research ethics and methodology draws the idea of these procedures constituting ethical, evidence-based medicine into question.

I’m pointing these issues out here with the acknowledgment that they are a running theme throughout all of OW and to keep this from becoming a novel I won’t point them out every time.

Let’s get to the actual OW programming.

In the “Presidential Plenary” Dr. Rena Wing will get an award for her “contributions” to the field. She is one of the founders of the National Weight Control Registry which I often use in talks as one of the clearest examples of the total failure of weight science research to adhere to the most basic of research methods ethics and best practices.

Put plainly, they are handing out awards to the people who have been at the “top” of the weight loss field for the last fifty years while simultaneously bemoaning the fact that the population of higher-weight people has been ever-growing over that same time frame. The fact that they are doling out awards when, by their own measure (the eradication of existing fat people and the prevention of additional fat people from existing) the field has been an abject failure is a pretty good reminder that the field of so-called “ob*sity medicine” has, and continues to be, not about supporting the health of fat people, but about exploiting them for money and then giving each other a pat on the back for doing such a good job of it.

They have a special section for “corporate supported symposia” They advise that they are free to attend but most require that attendees “have a professional role related to ob*sity research and treatment.” Here we have a talk about pharmacotherapy put on by Currax Pharmaceuticals LLC and a talk that tries to increase the rates at which primary care providers engage in weight loss talk (in a similar vein as the workshops that Purdue Pharma used to put on to encourage discussions about pain management to increase oxycontin prescriptions) put on by Lilly (who are hoping for massive profits from Tirzepatide prescriptions). Finally, a talk from Novo Nordisk (the Purdue Pharma of weight loss companies) that turns healthcare for higher-weight people into a “fun escape room.” No surprise the speakers in these talks are either directly part of these organizations or taking payments from them.

The danger here is that the fact that they have a special section for “corporate supported symposia” will mislead people into believing that the rest of the talks aren’t “corporate supported.”  Let’s take a look at some of their “key lectures” to investigate this.

First we’ll look at “Key Lecturer Ildiko Lingvay: The Time Is Now – Ob*sity-centric Approach for the Treatment of Type 2 Diabetes” This appears to be another dangerous (but profitable!) attempt to create standards of care that treat higher-weight people with Type 2 Diabetes differently than thin people with T2D, even when the presentation (A1C, complications etc.) is the same.

Per openpaymentsdata.cms.gov (and all the payment information here is for the years 2015-2022) the main lecturer (Ildiko Lingvay) has taken $557,326.18 in direct payments from the pharma industry, $89,688.67 in research payments, and $6,174,115.79 in associated research funding. The majority was from Novo Nordisk with a massive increase between 2021 and 2022 (when they started pushing their weight loss drug). Lingvay took $125,388 in 2022 alone (for comparison purposes, the US mean among doctors for that time period was $4,218.)

Or how about “Key Lecturers Lee Kaplan and Ania Jastreboff: Around the Corner and Into the Future - What's in the Pipeline for Anti-Obesity Medications?” The first line is “Anti-obesity medications are fast becoming the most promising of all obesity therapies.” Speaker Lee Kaplan has taken $1,727, 078 from the pharmaceutical industry, most from Novo Nordisk but also from Eli Lilly, both of whom are aggressively marketing weight loss medications. Session chair and Q&A moderator Angela Fitch has taken $65,526.48 in direct payments and another $2,298.13 in research funding, again predominantly from Novo Nordisk. Co-speaker Ania Jastreboff has taken a total of $216,710.24 in direct payments, $21,790.60 in research funding, and $172,150.47 in associated research funding, predominantly from Novo Nordisk and Eli Lilly with, again, a massive jump between 2020 and 2022.

As is common in the big pharma to “medical education” pipeline, none of those financial ties are mentioned on the workshop description pages. Those leading the sessions are variously referred to as speakers, experts, and using all of their credentialling, but they fail to mention the fact that they are taking thousands, hundreds of thousands, even millions of dollars more than average from the pharmaceutical companies that manufacture the products their sessions are promoting is not mentioned.

This year, in terms of their attempt to push back on the weight-neutral paradigm, there were a number of talks about multiply marginalized fat people that tried to shift the narratives about how these folks are often the most harmed by the weight-centric paradigm to the suggestion that the real harm done is that they don’t have enough access to the weight-centric paradigm and its drugs and surgeries.

In one example (with a title that is in competition with Novo Nordisk’s Grand Rounds for most offensive workshop name,) we have a lecture about youth populations called “Two Birds, One Stone – Ob*sity Prevention in Today's Mental Health Crisis.” Just as a reminder, in this charming saying the two birds are killed by the stone – sadly, given the increased rates of self-harm associated with weight loss pharmacotherapy, weight loss surgery, and weight stigma, this title may be tragically accurate. In the description, there is no mention of these intersections, nor the ways in which weight stigma (like that generated for profit by OW and those who participate in it) can harm mental health in myriad ways, drive disordered eating, eating disorders, lowered health care engagement etc. While info on pharma payments is not available on open payments for these speakers, one of the two speakers is the associate director of a weight loss clinic putting them in a position to profit from the recommendations of this talk.

 The weight loss industry makes tens of billions of dollars every year, and they use a significant amount of that money to market their products directly and indirectly, including by enmeshing themselves in the healthcare industry, including in “medical education.” Making things worse, much of the media takes weight loss industry propaganda and prints it as fact, that’s why we have to be aware and on guard – following the money, critically analyzing the research and its purported findings, and, sadly, protecting ourselves by assuming the worst about the people who are profiting from the weight-centric paradigm.

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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 Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.