Roundtable on Obesity Solutions 10th Anniversary: Looking Back, Moving Forward: Proceedings of a Symposium (2025)
Chapter: 8 New Opportunities and the Next 10 Years for the Roundtable
8
New Opportunities and the Next 10 Years for the Roundtable
In the final session of the symposium, Pronk moderated a conversation about the next 10 years of the roundtable, asking panelists to identify new opportunities, discuss challenges, and think critically about what is ahead. Pronk began by sharing his own thoughts on the symposium and asking panelists to share theirs. One thing that stood out, said Pronk, was the conversation about helping people live their best lives. Rather than focusing on the condition or disease, how can we support people in living their best life? What does that mean? What is the roundtable’s role in supporting people while tackling obesity?
Relatedly, Pronk observed that Dietz said that half of obesity begins in childhood. What can we do about this? How can we set kids up for their best life? Pronk suggested that there may be opportunities to make a difference in the first 100 to 1,000 days of a child’s life, as this is when a significant amount of brain development occurs. Pronk’s final thought on the symposium was on the importance of the systems approach. Taking this approach has given the roundtable the opportunity to use a broader perspective and to go further upstream. However, the world is dynamic, and things change over time. “We can’t just keep looking back and admiring the map we created,” said Pronk; we need to keep the map moving and growing.
Patricia Nece, Obesity Action Coalition, said that her mind was “spinning with ideas.” For her, the symposium emphasized how quickly things change in the obesity space. Things that were not possible before are possible now, she said, and this dynamic nature needs to be kept in mind as the roundtable moves forward. Ihuoma Eneli, University of Colorado Anschutz
Medical Campus and vice chair of the Roundtable on Obesity Solutions, said that it is an exciting time in the obesity space. There is renewed energy to address obesity, and this is the right time to look forward at what is ahead.
Kristal Hartman, Obesity Action Coalition, said that what stood out to her was that the solution is not prevention or treatment; it is both. To care for an entire population, we will need both of these approaches, and we need them together. Using herself and her family as an example, Hartman shared that she has struggled with obesity for most of her life and will have obesity for the rest of her life no matter what the scale says. Her children are now out of the prevention phase and into the treatment phase. As a family, prevention and early intervention would have been beneficial if it were possible. Hartman said that she foresees a future where families will have better options at an earlier time. “We have the opportunity, we have the knowledge, and now we have an obligation to make an impact on this in the next 10 years,” she said.
NEXT STEPS
Pronk asked panelists to reflect on what the next steps of the roundtable should be. What would be the most meaningful topic, action, or focus area for the roundtable to take on? Nece replied that there needs to be a continued focus on the lived experience, bias, and stigma. The phrase coined by disability activists “Nothing about us without us” applies to obesity as well. Bias and stigma are keeping people with obesity from getting the care they need, said Nece. She made an analogy to cancer treatment. If there were a drug that cured cancer in 25 percent of cases, health systems would be eager to adopt it, yet there is resistance to using effective drugs to fight obesity. Nece suggested that this is because of bias and stigma and said that the roundtable can play an important role in educating the public, health professions students, and health professionals about obesity as a disease rather than a personal failing. There could be a role for the roundtable in employment discrimination as well, she said, noting that a person’s employment status is a structural determinant of health.
Finally, Nece said that there is a need for the roundtable to add more diverse voices when hearing about lived experience, in particular people living at lower economic levels. She noted that while her own experience with obesity is valid, it does not encompass the range of experiences; she has always had employment and health insurance, has never suffered racism, and has always had access to healthy foods. She said that bringing in economically challenged people may require the support of an institution to compensate them for their participation (e.g., to cover economic loss or child care costs).
“We have to stop the madness of people having to get really sick before they are treated,” said Hartman. Obesity is the only disease where people have to get sicker before they can get treatment, she said, giving the example of her insurer refusing to pay for GLP-1 medication unless she develops diabetes. The roundtable has the opportunity to make recommendations on how people living with obesity are treated, both in clinical care and in research. Hartman noted that people with obesity are often excluded from clinical trials because of their body weight or comorbidities, which then leaves them without appropriate information with which to make treatment decisions. In general, there is a need for earlier intervention and primary prevention in obesity. Children and parents need support rather than blame and shame for a disease that runs in families, said Hartman.
Eneli said that choosing one part of the obesity agenda to focus on is difficult; in some ways, “We have to do it all and do it at the same time,” she said. Instead of focusing on specific leverage points, Eneli argued that the roundtable’s charge for the next 10 years will be to bring it all together and find ways to create change across the system. In addition, the roundtable can create a space for talking about sensitive or difficult issues, as well as disagreement and debate. She noted that it is important that the roundtable not become an echo chamber.
CLOSING REMARKS
Before offering his closing thoughts, Pronk asked panelists to use two words to summarize the past 10 years of the roundtable and to look ahead to the next 10. Nece said “fabulous start,” Hartman said “lived experience,” and Eneli said “exceptional impact.”
The roundtable is a very unique place, said Pronk, and is one of a kind in the field of obesity. It brings together multisector perspectives, uses an evidence-informed path, and explicitly includes the lived experience of those with obesity. Such a convening has tremendous opportunity for breakthrough thinking, he said. The first 10 years of the roundtable have made an impact, but much work remains to be done. The priorities identified on the systems map remain important but challenging; the issues of equity, health literacy, and stigma remain high on the agenda.
Current projections for the impact of obesity and the burden of illness are “catastrophic” in terms of health and well-being, economics, and even national security. Clinical care is challenging, with prices outpacing reimbursements and increasing pressures on health care workers. To address all of these challenges, policy levers will need to be considered, said Pronk. We need to reach over half of the population, and “You cannot do that with merely a good idea alone.” Policies that are linked to regional cultures across different parts of our country will be necessary to make
the necessary changes to the social, physical, and economic environments, which will in turn influence the behavior of people. The roundtable is on the right trajectory with the systems map, said Pronk, but the work is far from done.
In the United States, said Pronk, “We pay too much, we live too short, and we die too long.… This needs to change, and that is what the Roundtable on Obesity Solutions should be about.”
