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](~/AAAAAQA~/RgRo0Tp6P4QzAWh0dHBzOi8vbWVzc2FnaW5nLWN1c3RvbS1uZXdzbGV0dGVycy5ueXRpbWVzLmNvbS9keW5hbWljL3JlbmRlcj9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDkyMSZpbnN0YW5jZV9pZD0xMzQ4NDkmaXNWaWV3SW5Ccm93c2VyPXRydWUmbmw9b3Bpbmlvbi10b2RheSZwYWlkX3JlZ2k9MCZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTc4NDQxJnRlPTEmdXJpPW55dDovL25ld3NsZXR0ZXIvM2MxM2YxMGQtODMyNi01MjgwLWE0YTktYzU0OWUzMTBmNTNmJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD)|[nytimes.com](~/AAAAAQA~/RgRo0Tp6P0SxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwOTIxJmluc3RhbmNlX2lkPTEzNDg0OSZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNzg0NDEmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmbserXuZoaLHZpSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) [Ad](~/AAAAAQA~/RgRo0Tp6P0SlaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9MTYyMTM5JmxpPVRZJm09YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDcmcD1UWV8yMDI0MDkyMSZzdHBlPWRlZmF1bHQmdGU9MSZubD1vcGluaW9uLXRvZGF5JmVtYz1lZGl0X3R5XzIwMjQwOTIxVwNueXRCCmbserXuZoaLHZpSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) [Opinion Today](~/AAAAAQA~/RgRo0Tp6P0TAaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vc2VjdGlvbi9vcGluaW9uP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwOTIxJmluc3RhbmNlX2lkPTEzNDg0OSZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNzg0NDEmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmbserXuZoaLHZpSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) September 21, 2024 [Ad](~/AAAAAQA~/RgRo0Tp6P0SmaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9MTA4MDgzOSZsaT1UWSZtPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3JnA9VFlfMjAyNDA5MjEmc3RwZT1kZWZhdWx0JnRlPTEmbmw9b3Bpbmlvbi10b2RheSZlbWM9ZWRpdF90eV8yMDI0MDkyMVcDbnl0Qgpm7Hq17maGix2aUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) [A photo of different sized and shaped balloons tied together around the middle with a string.] 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](~/AAAAAQA~/RgRo0Tp6P0S1aHR0cHM6Ly93d3cuanVsaWFiZWxsdXouY29tLz9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDkyMSZpbnN0YW5jZV9pZD0xMzQ4NDkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTc4NDQxJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpm7Hq17maGix2aUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) 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](~/AAAAAQA~/RgRo0Tp6P0TsaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOS9vcGluaW9uL29iZXNpdHktZGlzZWFzZS1vemVtcGljLXdlaWdodC1sb3NzLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) 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 [A photo of different sized and shaped balloons tied together around the middle with a string.](~/AAAAAQA~/RgRo0Tp6P0TsaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOS9vcGluaW9uL29iZXNpdHktZGlzZWFzZS1vemVtcGljLXdlaWdodC1sb3NzLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD)[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](~/AAAAAQA~/RgRo0Tp6P0TsaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOS9vcGluaW9uL29iZXNpdHktZGlzZWFzZS1vemVtcGljLXdlaWdodC1sb3NzLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [Ad] [Ad](~/AAAAAQA~/RgRo0Tp6P0SkaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjQwOTIxJnN0cGU9ZGVmYXVsdCZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyNDA5MjFXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [Ad](~/AAAAAQA~/RgRo0Tp6P0SkaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjQwOTIxJnN0cGU9ZGVmYXVsdCZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyNDA5MjFXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) THE WEEK IN BIG IDEAS [[A photograph of Co-op City in the Bronx.] Kyle Johnson for The New York Times](~/AAAAAQA~/RgRo0Tp6P0TfaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOC9vcGluaW9uL2FvYy10aW5hLXNtaXRoLWhvdXNpbmcuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDkyMSZpbnN0YW5jZV9pZD0xMzQ4NDkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTc4NDQxJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpm7Hq17maGix2aUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) [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. 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A person sits on a bench, petting a dog, while another person looks out a first-floor window.] Alëna Skarina](~/AAAAAQA~/RgRo0Tp6P0TjaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOS9vcGluaW9uL2hlYWx0aC1haXItbW9uZXktcG9sbHV0aW9uLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [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. 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So why have we forgotten about it? By David Wallace-Wells](~/AAAAAQA~/RgRo0Tp6P0TiaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8xOC9vcGluaW9uL3dhci1vbi10ZXJyb3ItdXMtbWlsaXRhcnkuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDkyMSZpbnN0YW5jZV9pZD0xMzQ4NDkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTc4NDQxJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpm7Hq17maGix2aUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) [[Article Image] The New York Times](~/AAAAAQA~/RgRo0Tp6P0TpaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8yMC9vcGluaW9uL2V6cmEta2xlaW4tcG9kY2FzdC1kYXZpZC1yZW1uaWNrLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [The Ezra Klein Show Israel vs. Hamas, Hezbollah, Iran — and Itself David Remnick discusses Israel’s overlapping conflicts after nearly a year of war.](~/AAAAAQA~/RgRo0Tp6P0TpaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wOS8yMC9vcGluaW9uL2V6cmEta2xlaW4tcG9kY2FzdC1kYXZpZC1yZW1uaWNrLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA5MjEmaW5zdGFuY2VfaWQ9MTM0ODQ5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE3ODQ0MSZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZux6te5mhosdmlIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [play button] 1 HR 16 MIN LISTEN We hope you’ve enjoyed this newsletter, which is made possible through subscriber support. 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