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In discussing weight stigma and diet culture in medicine in general and, recently, the new AAP guidelines that recommend “intensive” weight loss attempts to toddlers, a common question I get is - How did we get here? How did doctors get so totally invested in this paradigm that they can’t see past it? I think that a huge part of this is how enmeshed the weight loss industry is in every aspect of the healthcare system, including (and perhaps especially) provider education.
Recently I was contacted by Dr. Clarissa O’Conor and Dr. Will Ward, both family medicine residents who wanted to let me know about something that has been happening in their program regarding the education they are being offered.
Just for starters, some background about the process of becoming a doctor in the US - it is both intense and hierarchical. After four years of medical school, newly minted doctors enter their residency. This stage of their training is specific to their chosen specialty (for example, internal medicine, ob/gyn, family medicine etc.) At this point, they are medical doctors practicing under supervision. In their first year, residents are known as “interns,” in their second year they become “residents.” In later years (residency can last from 3-7 years depending on specialty) they become senior residents, overseeing the work of newer residents. Some senior residents will become a Chief Resident. Chief Residents lead a group of residents both clinically and administratively. Those who choose additional training in a subspecialty fellowship are known as “Fellows.”
The doctors who contacted me are senior residents. They had been invited to a “Chiefs Resident Summit on Ob*sity” and a “Family Medicine Chiefs Resident Summit on Diabetes.” Both were free (to the attendees) and were billed as “evidence-based” educational conferences.
One of the residents did some research and found that the seven speakers at the “Ob*sity” summit had collectively accepted $2,651,160 from pharma companies that market weight loss since 2015 (when data collection started). Five of the physicians accepted money from Novo Nordisk in 2021, with an average payment of $18,000. (As a reminder, Novo Nordisk sells the weight loss drug Wegovy which they promised their shareholders would be massively profitable.)
The Summit on Diabetes was headlined by five doctors (some of whom also spoke at the ob*sity summit.) Collectively these doctors had taken $7,106,460 from pharmaceutical companies that sell diabetes medications and supplies.
Note that these numbers only include direct payments. These doctors have also collectively received millions more in research payments and associated research funding. It also only includes data up to 2021 and we know that Novo Nordisk has been absolutely pouring money into their Wegovy campaign in order to make good on their promise to shareholders of doubling their ob*sity sales by 2025.
You can see the resident’s full research spreadsheet here.
In the “ob*sity summit lineup, in addition to taking a ton of money from industries whose products the summit promotes, the speakers who are physicians have all pinned their careers to the “body size as disease” framework, including several who own weight loss clinics. One speaker was the President of the “Ob*sity Action Coalition.” This is an astroturf organization that purports to be an advocacy group for higher-weight people but is, in fact, funded by and acting as a lobbying arm for the diet industry. Novo Nordisk is their chief funder.
Let’s be crystal clear about what is happening. As part of their training, these doctors are being invited to “evidence-based, educational” summits, but what they are actually attending are, essentially, pharmaceutical company seminars. They are being indoctrinated with pharmaceutical/diet industry talking points without consent (or knowledge unless they do their own research (which it’s pretty difficult to find the time to do when you are training to be a doctor,) and under the guise of unbiased, expert tutelage.
This is not ok. This is a big part of how another generation of doctors are proselytized into a weight loss paradigm that has been actively failing patients for at least a hundred years.
In part two we’ll learn about the company behind this, and take a closer look at what they are passing off as “evidence-based medicine.” For now, another example can be found in Novo Nordisk’s horrifying nursing grand grounds, which I wrote about before.
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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.
“New AAP guidelines that recommend “intensive” weight loss attempts to toddlers.” This is the most terrifying sentence I have ever read. It makes me scared to take my son to the doctor for well visits. He is bigger because his parents are bigger. He’s also super tall for his age but no one wants to make him shorter. His doctor will joyfully ask how tall we are and say oh that why he is so tall, why can’t we just apply that to body size. You can clearly see we are fat and tall.
In my field of chemistry we get to go to these type of events where a vendor will teach a class about a general topic. We all know the vendors are trying to sell you or at least show you their newest thing. But the class is still relevant even if you don’t use the brand the vendor has because chemistry is chemistry. I just don’t get how the people in healthcare seem to not even listen to what science tells them.