There is controversy as to the existence of effective obesity treatments, the ethical implications of promoting treatments for obesity that do not have long-term follow up data and may have contraindications, and concern that APA's proposed development of Clinical Treatment Guidelines for Obesity may contribute to the structural and institutional discrimination and stigmatization of people of higher weights.
As a concerned individual, I ask that certain considerations be made when selecting members of the APA Clinical Treatment Guideline Development Panel on Obesity, for which a call for nominations has been issued.
I recognize that the development of Clinical Treatment Guidelines related to obesity is considered by some of the organization’s governance and membership to be an uncontested step toward supporting APA’s strategic plan to “expand psychology's role in advancing health and increase recognition of psychology as a science.” However, there is controversy in the psychological and broader scientific communities as to the existence of effective obesity treatments, the ethical implications of promoting treatments for obesity that do not have long-term follow up data and may have contraindications, and concern that such guidelines may contribute to the structural and institutional discrimination and stigmatization of people of higher weights.
I am aware that in the April issue of the Monitor on Psychology, leadership of APA Divisions 38, 12 and 54 wrote in support of the Guidelines stating that “There is excellent scientific evidence that obesity can be treated successfully…. [Our understanding of biopsychosocial factors that contribute to obesity] has been instrumental in developing evidence-based treatments that effectively promote and maintain weight loss.” In the process of Guideline development, it is essential that such statements be carefully considered and critiqued from a scientific perspective.
I write in support of the letter submitted on May 22nd and signed by concerned organizations and APA members asking that, at a minimum, membership of the Panel include individuals who will a) ensure sound scientific inquiry b) provide input from affected communities with special recognition of the centrality of weight stigma as a context for people seeking help for weight loss and c) recognize and address provider bias.
Specifically, request is made for the inclusion of at least two Panel members who are knowledgeable about a weight neutral approach to health, at least one member who specializes in eating disorders, including Binge Eating Disorder, at least one member knowledgeable about issues of disability and higher weight, and at least one member who is a representative of a grassroots civil rights organization for fat people. I also note that during the process of developing the Guidelines, it is critical that the Panel proactively maintain dialogue with the communities that will be affected by the Guidelines.
In addition, to maintain APA’s high standard as a professional organization, I request strong consideration of the following in the appointment of members to the Panel:
• Full representation of experts in weight neutral approaches to health at higher weights.
• Transparency in the process of guideline development.
• Unbiased scientific reviewers without conflicts of interest, e.g., ties to the weight loss, food, bariatric surgery, health insurance, or pharmaceutical industries.
• Consideration of research spanning the full range of factors affecting health, including social stigma, economic status, access to healthcare, weight cycling, disordered eating at any size, and intersecting oppressions.
Thank you for taking responsible steps to ensure that psychologists’ responsibility for leadership in health promotion is not compromised when selecting members of APA’s Clinical Treatment Guideline Development Panel on Obesity.