We have a great privilege this week to spend time in Canberra (and Sydney), delivering two invited presentations and finally meeting up with quite a number of people we have known only virtually. Now in person. The occasion is the annual meeting of ANZMOSS – the Australian and New Zealand Metabolic and Obesity Surgery Society. Today, we spoke to the integrated health professionals of ANZMOSS about the pernicious, pervasive binary thinking about obesity that fosters bias and gets in the way of progress.
We have all seen it. False dichotomies that trap us in stupid debates. Which is more important? Diet or physical activity? Treatment or prevention? Obesity or eating disorders? The list is long.
A “Habit of Mind”
Writing in Social Science Review, Professor Emerita Sharon Berlin tells us that this binary thinking is common and often useful:
“Organizing aspects of our realities into dichotomous or bipolar categories is a pervasive, ordinary, and often useful habit of mind.
“However, when coupled with a search for certainty, this mode of understanding highlights extremes, superimposes a value hierarchy, neglects nuances of meaning, and leaves us with limited possibilities for understanding and action.”
Neglecting nuance becomes a huge problem when we try to wrap our heads around the complex, chronic disease of obesity. Without understanding the nuanced complexity of obesity, we find ourselves at a loss to move forward.
Overcoming Binary Thinking
This pernicious habit need not encumber us in efforts. Six basic strategies can be a big help for overcoming the traps that binary thinking sets for us in obesity:
1. Reject bias and stigma
2. Stick to the facts
3. Recognize and dispel false dichotomies
4. Foster understanding of obesity science
5. Seek effective approaches for obesity prevention
6. Build systems to deliver better care.
Yes, there is much for all of us to do here. But if we can begin to be alert to pernicious, pervasive binary thinking in obesity, the work might get easier. Progress might come faster.
Click here for our presentation on this at ANZMOSS and here for further perspective.
The Ancient of Days, painting by William Blake / Wikipedia
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
August 06, 2025 at 8:11 am, John DiTraglia said:
The most important binary about obesity, I think, is the environment vs genes one. That is to say your fault and not your fault.
It should be dealt with by saying that your fault is less than 10% and trying to push your weight some of that 10% is reasonable and beneficial to your health. But a cosmetic and even more healthful treatment requires surgery or the new medicines,
Period.
It’s actually not so complex after all except for cost. But a wise philosopher said any problem you can solve with money is not that serious.