Opinion Today: Are we thinking about obesity all wrong?

In the age of Ozempic, there is an urgent need to clarify our understanding of this illness.

View in browser|nytimes.com September 21, 2024 Daniel Forero Because of technical issues, you might have received the Opinion Today newsletter multiple times yesterday. We apologize for the error. By Julia Belluz Ms. Belluz is a health journalist based in Paris. She is co-writing a book about nutrition and health. I became interested in the science of obesity when I started reporting on bariatric surgery nearly a decade ago. It wasn't the surgery itself that captivated me; it was the fact that, at the time, altering the stomach and rerouting the intestines was far and away the most effective intervention for significant weight loss. The evidence was and is clear. And yet only about 1 percent of people who were eligible got the surgery. Instead, people mostly continued to buy into diets, exercise routines and other products of the diet culture that too often fail. There seemed to be a huge disconnect between how researchers who studied obesity thought about effective treatments and where the public turned for help. I've followed these gaps between science and public understanding in my reporting on obesity ever since, most recently turning my attention to a question that now permeates the discussion about the new class of obesity medications, the first real rivals to bariatric surgery: Does obesity constitute a disease? As I write in my guest essay for Times Opinion this week, the American Medical Association declared obesity a disease in 2013, against the advice of its own scientific council. The idea has gained more acceptance since drugs like Wegovy and Ozempic exploded in popularity. But when I dug a little, I learned that other countries haven't followed the United State — including Denmark, home to Novo Nordisk, the maker of Ozempic and Wegovy. In my essay, I explain why obesity's classification as a disease has been so controversial in both medicine and public discourse. The reasons are different but the root cause is the same. It has to do with the myth that obesity is a choice, and a surprising lack of consensus about how to properly define and diagnose it. This murkiness has arguably set health care and policy back decades. As new obesity drugs emerge, it has become only more urgent to clarify what, exactly, this illness is and who is sick. READ THE FULL ESSAY HERE Guest Essay Are We Thinking About Obesity All Wrong? Experts are rushing to redefine obesity amid soaring demand for new weight loss drugs. By Julia Belluz THE WEEK IN BIG IDEAS Kyle Johnson for The New York Times Guest Essay Alexandria Ocasio-Cortez and Tina Smith: Our Solution to the Housing Crisis Instead of treating real estate as a commodity, we can underwrite the construction of millions of permanently affordable homes and apartments. By Alexandria Ocasio-Cortez and Tina Smith Alëna Skarina Guest Essay One of the World's Biggest Health Risks Is a Philanthropic Blind Spot Money to monitor air quality in some of the most polluted places in the world can lead to cleaner air and healthier populations. By Christa Hasenkopf Ibrahim Rayintakath David Wallace-Wells When We Try to Explain the Rise of Trump, We Don't Look Back Far Enough The global war on terror changed the course of American history. So why have we forgotten about it? By David Wallace-Wells The New York Times The Ezra Klein Show Israel vs. Hamas, Hezbollah, Iran — and Itself David Remnick discusses Israel's overlapping conflicts after nearly a year of war. 1 HR 16 MIN LISTEN We hope you've enjoyed this newsletter, which is made possible through subscriber support. Subscribe to The New York Times. Games Here are today's Mini Crossword, Wordle and Spelling Bee. If you're in the mood to play more, find all our games here. Forward this newsletter to friends to share ideas and perspectives that will help inform their lives. They can sign up here. Do you have feedback? Email us at opiniontoday@nytimes.com. If you have questions about your Times account, delivery problems or other issues, visit our Help Page or contact The Times. Need help? Review our newsletter help page or contact us for assistance. You received this email because you signed up for the Opinion Today newsletter from The New York Times. To stop receiving Opinion Today, unsubscribe. To opt out of other promotional emails from The Times, including those regarding The Athletic, manage your email settings. To opt out of updates and offers sent from The Athletic, submit a request. Subscribe to The TimesGet The New York Times app Connect with us on: Change Your EmailPrivacy PolicyContact UsCalifornia Notices The New York Times Company. 620 Eighth Avenue New York, NY 10018