Obesity: The Elephant in the Room
Obesity is an epidemic that is often, well, the elephant in the room, and its impact on public health is hard to ignore. As my career in nursing is still in its beginning stages, I feel that it’s more common than not to care for someone struggling with their weight. Unfortunately, this issue is often overlooked or inadequately addressed. When it does come up, people commonly respond with comments like, “I know I need to eat better” or “I should cut this food out,” but genuine action is rare. The path to weight loss is complex and often requires significant behavioral changes—much like overcoming an addiction.
And yes, I think obesity is a form of addiction. Recognizing it as such is crucial if we ever hope to effectively address and manage it. But how do you help someone who is addicted to something they need to survive—food? The complexity of food addiction makes it distinct from other substance dependencies, yet the underlying mechanisms share commonalities. I’m tired of seeing people dismiss obesity as laziness or weakness, resorting to fat-shaming as a way to push the problem aside. The reality is that many individuals struggling with obesity are battling life stressors on multiple fronts, sometimes while caring for others or juggling demanding roles. Addressing obesity in a 15-minute appointment feels almost impossible.
Understanding the Root Cause
What we often overlook is that obesity is not just about weight—it’s a sign of deeper behavioral and neurological patterns. The idea of “rewiring” the brain is key here. Many patients have developed an emotional and psychological dependence on food, using it as a coping mechanism for stress or trauma. This behavior is not something that can be changed with a quick fix or a stern lecture. Telling someone to “just eat healthier” is like telling an alcoholic to “just stop drinking” without any support system or program in place. Sustainable change takes time, education, and, most importantly, a shift in mindset.
In my experience as a nurse, I’ve noticed that obesity is often placed on the back burner during patient visits—not because it isn’t important, but because the multiple comorbidities that accompany it require immediate management. Obesity is rarely addressed head-on, yet it’s a major contributor to preventable diseases. For instance, if we could help a patient lose weight, we might see a significant improvement in their diabetes, hypertension, and even chronic pain levels. But focusing solely on weight without understanding the emotional and psychological underpinnings sets up both patient and provider for failure.
Obesity as a Cause, Not Just a Consequence
While genetic components can predispose some people to obesity, lifestyle factors often play a more significant role in its development. Obesity is a driver of numerous chronic diseases—heart disease, type 2 diabetes, fatty liver disease, and more. But does it cause these diseases outright? Or does it make existing conditions more severe and difficult to manage? I would argue that it’s both. By tackling obesity head-on, we could either eliminate some of these diseases entirely or at least make them significantly more manageable.
Yet the struggle remains: people find themselves unable to stop harmful eating habits, even when they are aware of the risks. This is where the comparison to addiction becomes critical. Obesity is associated with a state of chronic inflammation and is damaging to the body in ways that are similar to drug or alcohol abuse. If we could normalize the fact that obesity is a form of addiction, we might finally be able to develop interventions that get to the heart of the issue.
Addressing obesity requires more than surface-level conversations and generalized advice. It demands empathy, a deeper understanding of the underlying behaviors, and a commitment to individualized support. By confronting the issue openly and providing resources that address both physical and psychological components, we can better guide patients toward healthier lifestyles. Ultimately, recognizing obesity as a complex health condition rather than a personal failing is essential to creating effective strategies for lasting change.
