Americans keep dieting to lose weight, but bariatric surgery is the most effective tool out there.

There’s a surprisingly big disconnect between how obesity researchers think about the causes of and treatments for obesity and how the American public does.

Researchers think some people have genetic and hormonal traits that make them more susceptible to obesity. They think it’s a complex, chronic disease, like cancer, with many causes and sub-types. They’re also losing faith in dieting and exercise, neither of which is very helpful for weight loss in the long term.

The public, on the other hand, generally believes obesity is caused by a lack of willpower, and that it can be fixed with gym memberships and trendy diets. In one 2016 survey of more than 1,500 Americans, 60 percent of the participants said dieting and exercise were even more effective than surgery for long-term weight loss.

Here’s the absurd fact, though: Weight loss surgery is far and away medicine’s best treatment for obesity.

The medical case for bariatric surgery has grown much stronger in recent years. High-quality studies on the long-term health outcomes of people with obesity who got surgery show, on average, that they’re able to lose dramatic amounts of weight, and even reverse their obesity-related health conditions, like diabetes and high cholesterol, as a new study out in JAMA Surgery demonstrated once again. Medicaid now covers the procedure in 46 states, and so do national health systems in countries as diverse as Israel, Brazil, and Canada.

Yet out of the 20 million people who are eligible in the US, fewer than 1 percent get a bariatric surgery for weight loss, according to the Obesity Society.

Why? Polling data shows that many Americans still think it’s dangerous and ineffective.

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