(CNN) — If you've been paying attention to health news lately, you may have noticed a subtle but real shift in the way society discusses weight.it started about 10 years ago body positivity movement, the idea that you should love your body no matter its size. But at that time, american medical association Obesity was also classified as a disease. The medical community was divided, with some believing this classification helped reduce stigma, while others argued it pathologised the larger body.
These transformations have been accelerated by the arrival of powerful and wildly popular new drugs that are already helping many people lose weight.
we, Podcast “Chasing Life” The team believes this is the perfect time to sort out these medical and cultural threads. That's why I would like to put a spotlight on weight in the upcoming season. For listeners who love the brain as much as I do, there's a lot here for you too, because the brain and body are forever connected.
We're not going to reveal the secret to losing weight “with just one weird trick.” And I'm not even saying you necessarily need to lose weight. in fact, our first episode Investigate the real relationship between weight and health. We talk to Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital and an associate professor at Harvard Medical School, about what weight does, and doesn't, tell us about our health, and what might surprise you. We spoke to her about what she might have to say.
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Despite changing attitudes towards larger bodies, excess weight comes at a cost.
From a medical perspective, it costs the country a lot of money.According to research Published in the magazine “Lancet” in 2020, 27% of total health spending in 2016 (approximately $730.4 billion) can be attributed to “modifiable risk factors” for preventable health conditions such as cardiovascular disease. And high BMI topped the list of those risk factors. It accounted for almost a third of this amount, or $238.5 billion.
Research shows that this was eight years ago, when total health spending was $2.7 trillion.But health spending has only ballooned, increasing by more than $1 trillion. According to , the amount will reach $4.5 trillion between 2016 and 2022. National medical expense accounting. Without giving away any more numbers, I think it's safe to say that we are paying a lot of money for medical care that is ultimately caused by our excess weight.
But beyond the medical costs to society, there are real costs to individuals in terms of their physical and mental well-being that cannot be put a price tag on.
Almost 3 in 4 Americans are over 20 years old Classified as overweight or obese. However, weight stigma is widespread, and our culture is steeped in stigma and shame when it comes to weight.
It puts relentless pressure on hundreds of millions of people to slim down, exercise more, and conform to certain beauty standards that are difficult for many to approximate, let alone achieve permanently. you can't. They are advised to “get healthy,” which often means “lose weight.”
All that blood, sweat, and tears doesn't even take into account the fact that the system used to classify people is flawed in the first place: BMI.
When he was a Belgian mathematician, statistician, and astronomer Adolphe Quetelet developed a formula in the 1830s (weight in kilograms divided by height in meters squared equals BMI) to try to determine what, statistically speaking, the “average man” was. I'm talking about the average European man in the 1830s.
The Ketolet formula was renamed “BMI” by physiologist Dr. Ketolet in 1972. ansel keyand attempted to link body composition to health, disease, and survival, although not without some controversy.
This formula was not intended to be used as a diagnosis, as Quetelet imagined. It was not intended to apply to the rest of the world. It does not take into account general health, muscle vs. bone vs. fat, gender, age, subcutaneous vs. visceral fat, or other considerations. Additionally, categories (“underweight,” “normal,” “overweight,” and “obese”) have arbitrary cutoff values.
“You can't judge a book by its cover and assume that someone is reading it. [who] People who are big are unhealthy and people who are thin are healthy. ” Stanford told me: Refers to a person's size and BMI. “That's what people assume. I call it practicing street medicine.”
She says she looks below the surface to assess an individual's health using things like blood tests and functional capacity, adding: “Thin people can be very unhealthy, and their weight… “Heavier people may be healthier.”
Stanford University's approach represents a new way for doctors to think about weight. It parallels body-positive and body-neutral movements, appreciating what your body is capable of. These cultural shifts seem to encourage us all to embrace larger bodies without changing them, as long as they are physiologically and functionally healthy.
Then, a development occurred that led to the widespread availability of a new class of powerful and effective drugs originally developed to treat type 2 diabetes. These drugs include semaglutide (sold as Ozempic, Rybelsus, Wegovy) and tirzepatide (sold as Mounjaro and Zepbound), as well as the older liraglutide (sold as Victoza and Saxenda). It's difficult to overestimate the effects of popular culture, and the physical effects of those who consume it.
As of September, 1.7% of US population Semaglutide is prescribed for diabetes or weight loss, and that number is expected to increase.a projection JPMorgan analysts say that by 2030, 9% of the country's population will be taking these drugs. That's 30 million Americans. And pharmaceutical companies are working hard to synthesize even more powerful drugs.
These drugs work by mimicking certain hormones that your body releases when you eat. When these hormones, or drugs that mimic them, bind to receptors in the body, they can do things like stimulate the production of insulin or send signals to the brain that you're full or full and can stop eating. , are believed to have a variety of functions. Also in her GLP-1, which is one of her hormones. slow digestion Therefore, you will feel full for a long time.
For anyone who has tried dieting, it's a pretty big deal, especially when it comes to feeling full for longer and telling your brain that your body has finished eating.
By many accounts, these new drugs reduce “food noise” or “brain chatter,” or intrusive thoughts about food, the next meal, or that peach ice cream in the freezer. For many people, the noise of food essentially creates a 24/7 need to exert willpower, an exhausting battle similar to walking around every day with a backpack full of rocks. (These drugs are so effective at quieting brain chatter that they are also being studied for other compulsive behaviors, such as: Substance abuse, alcohol use disordersmoking and gambling addiction).
As someone who has been covering medical news for over 20 years, I can tell you that the introduction of these drugs feels different. Like Prozac in the late 1980s and Viagra in his late 1990s, the arrival of these drugs appears to be pivotal, perhaps even revolutionary. Seems safe, in most cases. This does not mean that some people do not have unpleasant side effects; in some cases, something very serious. Furthermore, when the drug is discontinued, weight comes back wellmaking these drugs that will probably last a lifetime.
We are also in the midst of what could be called a paradigm shift in the way we think about the “disease” of obesity.
Although we don't have all the data yet, there is a new idea that there are different types of obesity. Soon, these various subtypes may be considered separate diseases, just as breast cancer is no longer considered one disease but multiple diseases. These subtypes of obesity do not all have the same underlying biology or causes, nor do they necessarily respond to the same types of treatments.
That's natural. We are not all built the same, so we need to take that into account. I know this from experience. Last year, my wife and I each wore blood sugar monitors for several weeks to track our blood sugar levels. During that period, we both ate the same diet and found that certain foods caused blood sugar spikes and others did not. But it was different for each of us. I was sad to learn that one of the staples that made me a favorite (not Rebecca's) was this Indian flatbread that my mom makes. It's me and my dad's favorite. (I shared this with his type 2 diabetic father, who laughed and said he already knew because his blood sugar monitor was also warning him.)
success and shame
Although this country seems to be entering a new phase in thinking about weight and weight loss, thanks to changing attitudes and new medications, there is still significant shame and stigma around weight. They come in two types.
Otherwise the first form will be displayed Use these new drugs and continue to stay in a larger body than is culturally acceptable. And to be clear, many people don't have access to drugs, many people can't afford them, others can't tolerate them, and some people don't lose as much weight as they expected. .
The second form of shame occurs when we use it. Because very few people are willing to talk about it openly.That's rare among celebrities. be upfront about doing so. That's the same as admitting that you lack the willpower to do this yourself, or that you're taking the easy way out.
We don't have the same shame for people who take medications for high cholesterol or high blood pressure. So why do we do this using weight loss drugs, especially since most of us know from experience how difficult it is to lose weight and keep it off?
(In episode 2 of this season, we talk to Harvard University paleoanthropologist Dr. Daniel Lieberman as he explores the power of evolution: Why our bodies are built to hold all those fat cells. (I will explain why.)
That's why I was really impressed when Oprah came out and said she was taking medication to lose weight and keep it off. She has always been ahead of her time when it comes to weight loss. Not only did she share her literal ups and downs on the scale, she honestly admitted that she struggles with her own weight in the first place. This is something that most people, famous or not, are not willing to do.
So where is the inflection point? When will these drugs be seen as tools rather than signs of failure? And when will we be able to lose weight without shame or accept ourselves for who we are?
There are no easy answers, but these are just some of the topics we'll be touching on and the conversations we'll have during our sessions. This season of Chasing Life. We hope you'll join us as we search for answers.
