The National Collective of Obese Associations (CNAO) is campaigning for World Obesity Day, which takes place from March 4-6. The theme chosen for this 2024 edition is the fight against stigma. CNAO made a video whose key message is: “Fatness is not a choice”. See without moderation.
“I would like people to look at me normally, to consider me like everyone else. So my weight would not be an obstacle to employment…”, says Magloire, radio and television host, actor, whose career has made him a victim of grossophobia. It’s an understatement to say that he knows what he’s talking about when he calls us to put an end to prejudices about the disease of obesity, at the end of the video he made National Collective of Obese Associations (CNAO), on the occasion of World Obesity Days (March 4-6). A video with a title that aims to put a few falsehoods or clichés in their place: “Fat is not a choice”.
Colossi with feet of clay
There are an estimated 8.5 million obese people in France, the majority of whom are men. However, as this site reminds us, many obstacles remain in front of them: getting clothes, finding a job and even optimizing their care pathway. Because if prejudices are still widespread, especially about the causes of obesity, they are still too often reduced to a lack of will, even health professionals are not educated on the specifics of care for people suffering from obesity, with a high risk of them withdrawing from the health system. Embracing body diversity would improve healthcare delivery, reports Anne-Sophie Joly, founder and president of CNAO. “Not to mention chemotherapy or anesthetic doses, which must be higher, or difficulties in finding veins, for injection or blood analysis, due to fatty tissue, not all doctors are equipped, far from it, with an appropriate scale or blood pressure monitor. Measuring blood pressure is still one of the recommendations of the High Institute of Health, just like gaining weight, she notes. However, we, obesity patients, are giants with feet of clay, exposed to the risk of multiple pathologies. » In fact, obesity is associated with numerous comorbidities and high mortality. Thus, it increases the risk of cardiovascular diseases, diabetes, disorders of the musculoskeletal system and many types of cancer – endometrial, breast, ovarian, prostate, liver, gall bladder, kidney and colon. And recently, recalls Anne-Sophie Joly, the Covid pandemic cruelly highlighted the high price paid by people suffering from obesity, who accounted for 47% of intensive care hospitalizations and 40% of deaths.
For this category of the population, HNAO calls for the organization of more intensive monitoring, along with the establishment of special counseling centers. “The World Health Organization (WHO) has recognized obesity as a disease since 1997, but not France. And until that is the case, it will be difficult for us to change the way we look at this chronic disease of adipose tissue that will become fibrotic.”, specifies Anne-Sophie Joly. Multifactorial, obesity is at the intersection of several factors, including epigenetics, pollution, cesarean births, with a negative impact on the richness of the newborn’s microbiota, sedentary lifestyle, ultra-processed diet and stress. Let’s add that obesity is overrepresented in the poorest families – it is 4 times more common there – and in some regions even more than in others.
Need for assessment and strong measures
According to the World Health Organization, 29% of people in France will be obese by 2030 – compared to the current 17%. However, obesity today costs almost 11 billion euros in annual spending healthcare system. Measures have been taken, such as the establishment of the National Food Council in 1985, the launch of the National Healthy Eating Program (PNNS) in 2001, or even in 2016 the use of NutriScore, this 5-color food logo intended to enlighten consumers in their purchases, but it is not mandatory. But it is clear that these useful prevention tools have not stopped the progression of obesity. The president of the CNAO calls for a precise list of the epidemiological and health situation of obese people: ” There the latest survey conducted in 2020 by the League Against Obesity, but on a small sample of individuals and in a short time, which does not reflect reality, explains our interlocutor. If we want to be effective, we are looking for a ten-year inter-ministerial plan, renewable, cross-party, based on the model of cancer plans, with a dedicated institute, like INCa, which will be able to work 360°. “
In addition to preventive measures related to lifestyle, especially physical activity and diet, the French themselves demand it, judging by the results a study by the Harris Interactive Institute for France’s Assos Santé, published last February, support for people suffering from obesity also includes multidisciplinary and tailored care, which also integrates drug and surgical treatments, however, as a last resort, the High Health Authority (HAS) pointed out on February 28, during the presentation of the good practice recommendation for facilitating the care pathway for adults suffering from obesity. This point was also an opportunity to emphasize the need for health professionals to demonstrate “with benevolent neutrality”, in the words of Professor Pierre-Louis Druais, general practitioner and vice president of the Commission for Recommendations, Relevance, Paths and Indicators (CRPPI) of HAS. And this reminder is clearly neither redundant nor exaggerated, if the CNAO video is to be believed, which, although short, less than thirty seconds, is no less eloquent, even impressive: “I am most moved by the weight of your words, they are the thoughts of my colleagues, doctors, my family or strangers. Obesity is a disease, but the disease that isolates me and prevents me from being treated is fat phobia…”
Furthermore : I didn’t choose to be fat.Anne-Sophie Joly and Richard Zarzavatdjian, eds Solarni (February 2024)