Obesity Australia, If You Are Listening...

At LONG LAST I am pleased to present Part 2 of our deep dive into the murky underworld of "Big O" - Australia's obesity organisations, and their links to Big Pharma. Join me and fearless anti-diet dietitian Mandy-Lee Noble as we reveal the disturbing progress which Novo Nordisk is making, steadily infiltrating our universities, academics, health professionals, consumer groups, and news media with one goal: to make larger bodied Aussies believe that they are diseased and need urgent treatment! And in spite of the obesity organisations repeatedly claiming to be 'transparent' about their funding sources, we keep discovering that NOTHING is what it seems! Smoke, mirrors and deflections abound, and there is SO much money being thrown at so many different groups, our heads are spinning. AND they're using weight stigma as a weapon to push their drugs and surgeries! It's diabolical double speak and it needs to be stopped. This is an episode NOT to be missed !

 

Show Notes

What’s firing up my wonderful anti-diet dietitian guest Mandy-Lee Noble? Since our last podcast, (Ep #55 - Inside The Obesity Collective), there have been some new developments on the Big Pharma front, particularly in how they are trying to shape hysteria around weight - driving people into treatment and portraying higher weight as being a health issue in and of itself. What has really spiked Mandy’s frustration is that at the start of 2020 the esteemed journal Nature (in their medical journal ‘Nature Medicine’) released a “Consensus statement” about obesity stigma. CONTENT WARNING - we’ll be using the stigmatising ‘o’ word (obese) throughout this podcast because of how the groups we’re talking about use it. But we HATE IT because it is implicitly stigmatising! So this group released a joint international consensus statement for the ending of stigma of the ‘o’ word (with that stigmatising word in the title!) We thought … maybe they’re starting to do the right thing? But … no. Upon reading, it reveals itself as just another push to get people into treatment simply because they are in a larger body. And what might be influencing this paper? Let’s check how many times Novo Nordisk is mentioned in this statement as a ‘conflict of interest’ … it’s in the double digits. 20 times, out of 40 authors.  Novo Nordisk isn’t the only conflict of interest. The major supporters of this paper were pushing surgical devices for bariatric surgery (Ethicon).  Mandy has issues about the use of the word ‘stigma’ here. Weight stigma is when you’re treated poorly just due to your weight, which we know is an epidemic and happening all the time and leading to poor health outcomes and disengagement from healthcare. When these industry groups use that word, they consider it a barrier to people using treatment! It’s all just dollar-signs to them. In the spirit of transparency - let’s go through the conflicts of interest for Louise and Mandy. Hope you’ve got some time …. (Louise played a cricket sound). ;) Basically fuck all, right? We’re not getting paid. We’re here for love, not money - not for the vested interest of corporations or even of ourselves. This kind of ‘investigative journalism’ research has an impact on our mental health, for sure! Mandy arcs up at the assumption that people at higher weights need treatment for disease - the stigma is there in the assumption. Let’s reflect on what happened after the last podcast. There were unexpected ripples from that episode. The powers that be at Obesity Australia were listening … either that or there were some totally weird coincidences. Some of the coincidences: the fact sheets disappeared! The fact sheets telling people that chips were lethal and to drink Diet Coke to put off their hunger, all of the magic 1920’s weight loss tips have vanished. The whole oldy-worldy Obesity Australia website has vanished and replaced with a trendy new Obesity Collective website. This all happened within 2 weeks of our last podcast with Mandy. There was a bit of an MIA issued in the last podcast for the Weight Issues Network - a consumer group that just didn’t seem to exist, until it magically appeared very soon after the podcast aired.  We wondered, where are they getting the money from? Mandy sent them a Facebook message asking, and was told that the director would be in touch. Tiffany Petrie, director of The Obesity Collective, did reach out and offered to meet us for a coffee, which we accepted. We then learned Petrie would be bringing some friends to the coffee (some backup?). Immediately before the coffee date, they … pulled out! Petrie said she would be too busy for months to meet. The offer is still open from Mandy and Louise! On the types of articles that are being reposted on the WIN Facebook page, which has a huge following - at the moment there’s 100 people following, which includes Louise and Mandy. It’s funny that this group that’s meant to be addressing weight stigma reposts so many stigmatising articles. Things about the ‘war on childhood obesity’, and other articles that make Mandy go “wow”. Overall though, there isn’t too much action happening on that page.  Mandy was contacted by some journalists to comment on the funding that Obesity Australia receives, and was pleased to see the table she provided was reproduced entirely in one of the articles (but without acknowledgement). The Medical Republic released a podcast and media article, which Louise came away from a bit disappointed - the title of the article was framed as ‘why is this being battled out between skinny people’, as if HAES Australia is battling in the ‘war on obesity’. HAES Australia is a body without industry funding to support people who want to provide weight-neutral care. Whereas the WIN is a ‘patient’ group which frames obesity as a disease. Completely different agendas. Mandy wanted the title of this podcast to be “Obesity Australia, if you are listening” - a reference to Russia and Trump, and how Obesity Australia seemed to be listening to the last podcast. Obesity Australia, if you ARE listening and if you REALLY are serious and want to end weight stigma, DO THESE THREE THINGS WE’LL TALK ABOUT HERE.  Number 1: Advocate for medical professionals to disclose industry funding when they are talking to the media and/or their patients. It’s about informed consent! What is behind the advice that someone is receiving? If it’s money, that’s important information to know.  A good example recently from Channel 9 News in a short segment called ‘Study hoped to decrease obesity stigma’.  It’s just a minute or two long. We’ve seen all the ‘war on obesity’ stories, and this is a new take - obesity stigma?! But when you watch the story, it’s nothing new at all. The story is tremendously stigmatising with all the same language about ‘battling’ weight and obesity, framing it as the enemy. It also uses ‘headless fatty’ images, of people in larger bodies with their heads not shown, carrying their fast food lunches around as it was probably filmed on a lunch break. The program banged on about rates of overweight and obesity as if they were the rates of people who were unwell - as if everyone in those groups is diseased. Life expectancy, however, continues to rise (shh). The study mentioned in the story was QUITE hard to get hold of. It’s not even a new study, it was published in February 2019. At least, we think this is the study because they haven’t referenced it adequately in the story. Our statistics match up with theirs, so we think it’s the same one. And the study itself has NOTHING to do with stigma. The title is “Gaps to bridge: misalignment between perception, reality and action in obesity”. But the gap is ‘how to get people to treatment’ - why aren’t more fat people asking for help from their doctors? That’s basically the only question asked in the study, and ‘weight stigma’ doesn’t appear in the study. None of the researchers are weight stigma researchers. Dr Georgia Regis gives an expert opinion as an ‘obesity physician and researcher’ that people in larger bodies need to seek medical help. She’s using the big assumption that everyone in a larger body requires treatment. And was this opinion out of the goodness of her heart? Or … perhaps because she has some vested interest that isn’t declared in this piece?  Dr Regis actually has several conflicts of interest to declare, which we see on the research articles we read - but people seeing her speak on the news don’t get that declaration of conflict of interest. Dr Regis actually received $43,000 over three years from Novo Nordisk, a company that produces weight loss drugs. And that’s not the only treatment industry that she’s accepted fees from - there are other payments here from companies that make products and treatments for bariatric surgery. Dr Regis may of course be giving unbiased and evidence-based opinions. Either way though, just as she is required to do in research, she should be declaring these conflicts of interest to the media she speaks to and TO HER PATIENTS. Transparency! It’s even in the Obesity Australia principles! Fun fact: Novo Nordisk (you’ll never guess) actually completely funded this research paper. They also have made other payments to the authors on the paper, and this is on top of paying for the researcher’s travel expenses to attend ‘author meetings’ about this paper. Where would they need to go !?? Let’s talk privilege, because it’s necessary when talking about stigma. Mandy and Louise have the privilege of being educated, having access to research, and being health professionals. When Mandy and Louise read this research, conflicts of interest have to be declared - but it’s not necessary at the moment that these conflicts are declared to media or to patients. Obesity Australia, if you’re listening - advocate for health professionals to declare conflicts of interest. Number 2: If you’re listening, Obesity Australia, be transparent about industry funded consumer groups. This includes WIN, the Weight Issues Network. WIN does say on their website (in their ‘transparency statement’) that they receive some funding from Obesity Australia, ANZOS and ANZMOS (groups with ties back to Novo Nordisk).  WIN has six principles - transparency is one of them, another is about being ‘safe and empowering’ - providing “information, support, and a place to have a voice”. So, what we’re asking from them is definitely in lines with what they say they’re going to provide. One of our planned ‘coffee questions’ was about where they got their money from - and at first we were told the money was donated. Since then we’ve learned that Obesity Australia gave WIN $5,000 to start them off. We haven’t had a response about how much money they received from ANZOS and ANZMOS. It’s interesting that when we email them we get responses back from Tiffany, who is not actually part of WIN … it’s all very incestuous.  On the WIN page, we learn that funding has come from the Obesity Collective, which is basically the same as Obesity Australia. The other thing is that WIN has now set themselves up as a separate charity, which means people can donate directly to them and get (possible) tax exemptions.  Some other issues we have with transparency - they claim they’re getting pro bono support. We generally understand that as people providing work for free. This pro bono work is coming from PricewaterhouseCoopers. They have a long term business relationship with Novo Nordisk, having been their auditors for years.  WIN has a board - some with lived experience, a clinician, a researcher and some others including a bariatric surgeon (we think some of the people in WIN are this surgeon’s patients). Who we mainly hear from is Lynne Keppler, who has done some media and spoken at obesity conferences. What is missing from the board is people who are not treatment-seeking. All of them describe themselves as a patient or someone living with a condition of ill health.  The WIN also receive some training, some webinars that we’ve seen that come from Dr Arya Sharma, a Canadian bariatric physician and bigwig in Obesity Inc. Who paid for that!? Novo Nordisk paid to fly Dr Sharma in for seminars and meetings - his expertise here is helping people tell their stories and stay on track with their key messages, all of which perfectly align with Novo Nordisk. It’s pretty clear in these webinars that the key messages he wants people to stay on are that obesity is a disease, and that weight stigma is a barrier for larger bodied people seeking weight treatment such as surgery and drugs.  So, what we have is a consumer group that has claimed that they are transparent, when they’re really receiving training from people who are heavily funded by Novo Nordisk and being supported by groups that are supported by Novo Nordisk and other pharma groups and bariatric supplies manufacturers.  It’s hard to see how this is a transparent consumer group that is free of conflicts of interest because it’s all being funded by weight loss treatment industries. That’s our concern. What we’d like Obesity Australia to do, if they’re listening, is encourage WIN to be transparent. For example, where is the source funding coming from for events such as the one run by Dr Sharma?  On their website and Facebook group, WIN encourages people to share their stories. Louise has the question ‘what for?’. Is it so their stories can be packaged up and used to further the agenda (lobbying the government to increase obesity services?). It’s a misuse of the word ‘stigma’. Talking about the stigma you’ve faced takes a toll - and then that lived experience gets media trained and packaged so you continue talking to the media and government groups about how much you need these interventions … it feels really dark. They’re not really asking people for stories about weight stigma, but about stories of treatment seeking.  Number 3: If you’re listening, Obesity Australia, we’d like you to be transparent about the industry funding that health professional groups get. Health professional groups are another way to lobby for change, lobby governments, etc. It would be really good if we could see those entities also be transparent. An example: NACOS, the National Association of Clinical Obesity Services. Louise had never heard of this group before! It’s quite new, having only dropped in September 2019, after WIN dropped in August 2019. Louise read through a NACOS financial report, wondering who they are and how they came to be. Clinical Obesity Services are units in hospitals involving teams of health professionals offering weight loss services. Evan Atlantis, NACOS President,  in his financial report for NACOS wrote that they are committed to improving health services and clinical services for patients with obesity, with considerable  support and grant funding from … Novo Nordisk.  After the NACOS formed, the Novo Nordisk money paid for Price Waterhouse Coopers (PWC) to write up a report outlining just how dire obesity is and how urgently services are needed (you guessed it, completely the same as the other Novo Nordisk reports written by PWC). PWC wrote 4 out of the 5 “obesity is dreadful” reports produced by Obesity Australia. Guess who is the secretary general of NACOS? Dr Nick … the bariatric surgeon who is also on the board of WIN. If you’re listening, Obesity Australia, here are those three things we want you to advocate for if you’re really serious about addressing weight stigma. NUMBER 1: Advocate for medical professionals to be transparent and disclose industry funding with media, general public and patients. NUMBER 2: Consumer groups that are industry funded be more transparent about all funding, in-kind support and training. NUMBER 3: That health professional groups be more transparent about their funding sources. Is there something that All Fired Up! listeners could possibly think about as you move through media and accessing healthcare? We might look at all this stuff and think “bloody hell, I’m just one person! What can I do?!”. If you’re talking to anyone medical who is trying to sell or advise you on weight loss drugs or procedures, ask them to disclose if they are receiving any payments or training from these groups … and how much. You need to know if your health professional is being potentially influenced by industry funding. Research shows that for the majority of health professionals who are inviting people to use these drugs or surgeries, their training about them has come completely from these groups that make money from them. And ask about the long term side effects! We hope this has been helpful and insightful, and rounded out our journey down the rabbit hole that we started over a year ago. Why is Novo Nordisk, a HUGE pharmaceutical company, so interested in little old Australia? Actually, this is happening globally - and that will be the subject of the next podcast. You won’t believe the size of this octopus.  An update on Professor Simpson, executive director of Obesity Australia who had a grant from Novo Nordisk … we found out how much it was. Let’s remember that the research that Novo Nordisk were funding was NOT about weight stigma, but about cricket sperm. Hmm. And that grant amount for research that has nothing to do with weight stigma? 13 MILLION DOLLARS. The head of Obesity Australia, an organisation which pretends to be all about weight stigma, is being funded to the tune of $13 MILLION by Novo Nordisk in order to research cricket sperm. If people are really feeling they’re providing unbiased advice, they’d be happy to provide their conflicts of interest. When we hear messages from the head of Obesity Australia, think about it, are we really hearing the messages of Novo Nordisk? To be continued! This story isn’t over.

 

Resources Mentioned

Find out more about my amazing guest Mandy-Lee Noble here

The Joint International Consensus Statement for Ending Stigma of Obesity

The Weight Issues Network website (checkout the logo!)

The Medical Republic article “Why is the war on obesity being fought by skinny folks”?

The Channel 9 news piece which wasn’t really about weight stigma

The study that the Channel 9 news piece was talking about, which also has nothing to do with weight stigma

The Novo Nordisk funded National Association of Clinical Obesity Services (NACOS)