6-Minute Read
60 Minutes Episode on Obesity - Response
Written by: Nikki Stock
Aired January 2023 Watch the 13 minute, 23 second segment here
In a recent “60 Minutes” episode on CBS News, a meager 13 minutes was dedicated to the topic of obesity in the US. Host Lesley Stahl interviews two doctors and two guests who struggle with their weight. Since it aired, social media and online news outlets have posted dramatic headlines to draw attention to some of the over-simplified statements made within the segment. Let’s dive into the tragedy that is this “news” segment. To summarize:
Dr. Fatima Cody Stanford (“Obesity Doctor” at Mass Gen Hospital) made several claims, including:
“Almost” 50% of American adults are obese, an increase from 40 years ago
False, it’s technically 41.9% as of 2022 (https://www.tfah.org/report-details/state-of-obesity-2022/)
Obesity causes hypertension, type 2 diabetes, stroke, and cancer
True, the common comorbidities of obesity have been well-documented.
Obesity is a brain disease.
An important idea to explore, and I do not disagree, but rarely is research allocated to the interaction of the mental and physical factors on a deeper level
Your brain dictates what food you use and what food you store
Can’t say it’s false. This is a decent simplification that just highlights the fact that energy storage and use is NOT just as simple as calories in / calories out
Set Point Theory - “Her brain defends a certain set point”
This is not proven. It’s called a theory because it’s just that. A theory.
“Obesity is 85% genetics”
False. There is ZERO evidence to substantiate this random statistic.
She cites zero sources for this.
Harm: this incites a “fixed” mindset, hopelessness, and a disregard for personal power and will encourage a fixed Prediction (Embodied Cognition)
Claims that you are 50-85% more likely to be obese if your parents were/are obese even when you control for diet, exercise, sleep, and stress management - no sources cited and no elaboration on what exactly that means
Dr. Caroline Apovian (Weight Management and Wellness Center at Brigham and Women’s Hospital)
New weight loss drug is “safe” according to FDA
Drugs are constantly approved by the FDA only to be pulled from the shelves years later once long-term detrimental effects are discovered
The two guests interviewed on the segment cannot lose weight with diet and exercise
There are outliers in any group. They are most likely the exception to the rule. Or, they may have more issues that have gone untreated.
First, Let’s Define:
Overweight: BMI of 25 or greater
Obese: BMI of 30 or greater
What is BMI: A formula that takes your weight and height, plugs it into a formula made in 1830 (I wish I was making that up) and gives you a value. The categories of underweight, optimal weight, overweight, and obese were formed from gathering health and morbidity statistics. So, people in the overweight and obese categories tend to have increased risk of health issues, which is how they drew the lines.
I could write a complete stand-alone blog post on why BMI is bogus for several reasons, however, in this blog post it doesn’t change the message. The fact is, excessive weight is associated with poor health outcomes.
In the first part of this obesity segment, Dr. Stanford lists the “facts” I stated above and goes on to downplay the role of exercise, nutrition, and “willpower” in weight loss. She cites The Biggest Loser (probably the most over-the-top and extreme examples of diet and exercise interventions) and Set Point Theory to highlight the issue of weight regain and to double down on her claim that obesity is genetic and essentially out of our control.
First, The Biggest Loser was discontinued after 2016 because of how controversial the tactics (and results) became. Multiple trainers have quit the show for various reasons. There was a reboot in 2020 but allegations and negative speculation have followed the show for a while. It’s a poor example.
Second, Set Point Theory is the idea that your body has a specific weight it prefers to be at (Set Point) and it will resist change. This is the theory Dr. Stanford mentions and uses to defend her statements. I have several issues with this. First, if it were true, why is it so easy to gain weight? Shouldn’t it work both ways? Second, Set Point Theory is just a theory. It has never been proven. It also doesn’t explain why countries like the US have such shockingly high obesity rates. Many people we work with have lost weight and kept that weight off consistently across years, even after times of indulgence such as long vacations, time off, major life events, etc. The topic is complex, making over-simplifications harmful.
Dr. Stanford did mention stressors when discussing weight gain, which is a very important aspect that should have gotten much more attention during the segment! Weight gain and obesity have a huge mental/emotional component. In addition to the mental aspect of weight gain or loss, poor food quality in the US is a physical stressor that wasn’t mentioned in this segment at all.
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Next comes the lamenting over the lack of accessibility of the drug that became the star of this segment (it’s not even worth mentioning). Any doctor that wants to push pharmaceuticals as much as Dr. Apovian should be viewed with at least some skepticism. After a long tirade about the stigmatization of obesity (which was valid), she used that stigmatization to make the argument for this expensive drug that people who supposedly can’t lose weight “normally” need easier access to so their lives can be saved.
The doctors and guests complained that insurance companies tend to deny coverage for access to the drug because “the doctor has not counseled the patient on behavior change” and the pill-pushing doc claims that’s just stigmatizing. Sure, insurance companies are a pain for many reasons. But, the real problem is that few professionals are qualified to counsel on behavior change. Your Primary Care Physician is not qualified to counsel behavior change. They are taught pathology. They know what to prescribe for your ear infection and they know that exercise and good nutrition are good. Nowhere in this segment is any discussion of personal trainers, dieticians, and any fitness specialists who are actually qualified to prescribe exercise or nutrition plans.
Eight out of the 13 minutes of the segment were spent talking about this weight loss drug. Less than six were spent on understanding obesity.
No studies were cited in the segment except research regarding doctor bias. Dr. Stanford has produced copious research articles...but most of what I could find is about pharmaceutical interventions or the sociology of obesity (equity, stigma, etc.).
Next, Apovian, who boasts the benefits of this weight loss drug, insists that the FDA deems it “safe.” Unfortunately, during the portion where she was supposedly explaining to a patient (probably staged let’s be honest) what the drug does, the interview voiced over with more random babbling about drugs. Thank you for the thorough information, CBS.
Let’s dive a little deeper on Dr. Apovian -
I found an article she wrote In March of 2012 mentioning several drugs that were approved by the FDA and subsequently taken off the market years later because of dangerous side effects
(https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.111.022541). It gets better, upon further investigation, I discovered that Dr. Apovian participates on advisory boards for Allergan, Amylin, Orexigen, Merck, Johnson and Johnson, Arena, and Sanofi-aventis.” All of these companies are pharmaceutical companies.
Advisory board participants can get paid.
There’s a difference between stigmatizing, insulting, and gaslighting, versus expanding professions to actually understand why behavior change isn’t just about motivation.
The emphasis of the show shifts not to understanding what else goes into weight loss (such as stress management & tolerance, therapy, energy balance, behavior change, and mental health), but to using chemical interventions because it’s easier. They dismiss the adverse symptoms.
Conclusion:
The media does little to properly inform and a lot to fear-monger and push agendas. The topic of obesity is so complex to render it to 6 minutes of questionable doctors hoping to promote a drug is dishonorable. The fact that some people can “diet” and exercise without results highlights the complexity of energy balance, it doesn’t indicate inefficacy of nutrition and exercise in managing obesity. The unsubstantiated claim that obesity is mostly genetic and therefore untreatable without pharmaceutical intervention is laughable.
Health and wellness is a multi-faceted topic and weight/body composition is one small part of that. Instead of investing money into pharmaceuticals, please invest in professionals that actually want you to get healthier.
So much more work must be done to improve societal knowledge on the topic of health and wellness. A drug will not do it. As we have seen countless times, messing with the body’s chemistry is much less desirable than achieving health through enhanced understanding of the body. Barring curable infectious disease, one should be highly apprehensive of doctors pushing pills for conditions that can be managed, prevented, or cured with lifestyle interventions, behavior change, mental health strategies, and social support. The problem with weight loss methods doesn’t lie in naturopathic inefficacy, but in the segregation of health professions and the egotistical gatekeeping of health interventions across the health & wellness industry.
-Nikki
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Additional Notes:
Obesity has increased worldwide, what about our genetics has changed?
https://www.webmd.com/diet/obesity/features/are-you-fated-be-fat (2015)
Multiple doctors offer contradicting viewpoints. The article below cites multiple research studies that note as little as 14% of BMI can be attributed to genetics.
https://www.livestrong.com/article/13724421-genetics-and-weight-obesity/
