OBESITY RESEARCH

HISTORY/EXISTING CONDITION:

Historically, obesity researchers have sought an answer to the question, "How can we make fat people thin?" and have spent a half-century and billions of dollars in an unsuccessful attempt to find permanent behavioral, dietary, pharmaceutical, and surgical treatments for fatness. The underlying assumptions in such a pursuit are that thinness is more desirable than fatness, that fatness increases health risks, that permanent weight loss is possible, and that weight loss mitigates morbidity factors and increases longevity.

These assumptions run contrary to the experience of most fat people, which is that permanent weight loss is impossible to achieve, that dieting makes them fatter, that many of them are healthy, and that valuing thinness over fatness is a cultural bias.

Obesity researchers' hypotheses often incorporate personal or cultural biases against fat people. Unproven assumptions about fatness frequently invalidate the basic premise of research studies. For example, obesity researchers often use data from studies of very-low-calorie diets (which demonstrate initial weight loss, followed by weight regain, and then by early death) to "prove" that being fat is unhealthy, rather than interpreting the data to mean that very-low-calorie diets are unhealthy. Conversely, mainstream obesity researchers never study alternatives to weight loss (such as exercise) in improving co-morbidity factors.

In addition, the obesity research community has refused to see that fatness is not only a health issue, but a psychological, cultural, and political issue. When they do acknowledge the social stigma involved in fatness, they see the solution as changing body size rather than eradicating the stigma. Some researchers (such as Dr. John Foreyt) have advocated increasing the social stigma against fat people in order to motivate them to lose weight.

Most obesity researchers experience a profound economic conflict of interest. According to journalistic investigative reports on file at the NAAFA office, there is a connection between the evolution of the idea that obesity is a disease needing treatment and the economic interests of major players in the field. For example, the 1985 National Institutes of Health (NIH) consensus conference which proclaimed obesity a "killer disease" also arbitrarily redefined obesity in such a way as to affect millions more Americans. This redefinition and the call for treatment translated into billions of additional dollars of research money, commercial weight loss industry profits, and physicians' revenues.

At this consensus conference, leading obesity researchers had an enormous economic stake in seeing expanded forms of obesity treatment applied to more Americans. Theodore Van Itallie, M.D., the chair of the NIH consensus conference planning committee and a researcher at Columbia University, was a paid consultant to United Weight Control. George Blackburn, M.D., and Thomas Wadden, M.D., considered to be leading authorities in obesity research, were both paid consultants to Sandoz, the makers of Optifast.

These conflicts of interest continue to be faced today by researchers who are variously in the NIH task force on the prevention and treatment of obesity, Shape Up America, the American Obesity Association, and the Weight Risk Investigation Study Council. For example, Xavier Pi-Sunyer, who is a researcher and has a weight loss clinic at St. Luke's-Roosevelt Hospital, sits on the advisory council of the American Obesity Association. (The AOA touts itself as a consumer advocacy group, but its primary goal is to lobby Congress to pass legislation mandating that insurance companies pay for weight loss attempts.) Pi-Sunyer is also a member of the Weight Risk Investigation Study Council, which was created by Knoll Pharmaceuticals to provide research grants. He also sits on the advisory board of American Home Products, Wyeth-Ayerst Labs and Knoll Pharmaceuticals. He was also a consultant to Hoffman-LaRoche, Knoll, Genentech, Eli Lilly, and Weight Watchers International.

In his book Lifespan, Thomas Moore writes, "Most leading obesity researchers are either consultants to diet or pharmaceutical companies, conduct research for these companies, presenting their results at conferences sponsored by these companies, or sometimes all three."

These researchers often review research proposals that receive government funding, and provide peer reviews for weight-related articles in scientific journals. Due to their economic interests and bias, a suppression of research antithetical to the diet industry's position exists. Research not supporting weight loss isn't funded and isn't published.

While members of other disenfranchised groups (such as African Americans, Latinos, and women) are usually consulted when research is conducted and public health policy is developed for those populations, advocates for the fat community are virtually never consulted by the National Institutes of Health or by researchers prior to investigating obesity-related issues, despite repeated offers of assistance.

NAAFA'S OFFICIAL POSITION:

The National Association to Advance Fat Acceptance asserts that the primary goal of obesity research should be to improve the health and well being of fat people rather than on weight loss. In addition, NAAFA condemns those obesity researchers who use their position as public health policymakers to further their own economic interest. Further, NAAFA demands that the NIH fund new investigators and studies which focus on non-dieting alternatives to improving the health and well-being of fat people. Finally, NAAFA demands that fat people have a voice in the types of weight-related issues being researched, and in the development of public health policy about fatness.

NAAFA ADVOCATES:

That the National Institutes of Health, the Food and Drug Administration, and other federal, state, and local agencies which develop public health policy about fatness consult with NAAFA in order to incorporate the viewpoint of the affected population.

That the National Institutes of Health discontinue funding investigations into dietary, pharmaceutical, and surgical treatments for fatness.

That the National Institutes of Health fund investigations which seek to improve the health status of fat people independent of weight loss.

That obesity researchers reveal all sources of current and previous research funding and affiliations with the weight loss and pharmaceutical industries when publishing or presenting their research.

That obesity researchers study cultural bias against fat people and ways to reduce that bias.

NAAFA RESOLVES TO:

Advocate on behalf of the fat population before the National Institutes of Health, the Food and Drug Administration, and other federal, state, and local agencies which develop public health policy about fatness.

Educate its members, the public, and the media about the actual or potential conflicts of interest of obesity researchers.

Carefully evaluate any researcher's goals and methods before inviting NAAFA members to consider participating as research subjects or as control group participants in any obesity research study.

Denounce any research which could be harmful or dangerous, either physically or psychologically.

Evaluate and disseminate information about the latest developments in obesity research.

First Issued: 8/13/98

Last Revised: 8/13/98

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