The Wicked Problem of Obesity Across Generations

The wicked problem of obesity across generations confounds even the brightest souls who have tried to tackle it. In series of five papers newly published in the Lancet Diabetes & Endocrinology, a distinguished group of clinicians and scientists describe the daunting scope of this problem.

With an overview commentary, Mark Hanson, Peter Gluckman, and Flavia Bustreo build upon the call of the World Health Organization for “concerted and sustained action, not only in childhood but also earlier in the life course—ie, in the mother (and father) both before and during pregnancy.”

Somehow this series manages to be encouraging and disheartening at the same time. On one hand, the series provides a remarkably clear description of obesity stretching across generations. The series focuses upon prevention. But it does not ignore the need for interventions as a means to prevent obesity in future generations.

But the series is also disheartening because of a nearly exclusive focus on the behavioral and dietary aspects of obesity. Hanson and colleagues used the schematic on the right to describe what is needed to improve preconception health for women affected by obesity. The critical path is spelled out graphically. It’s “behavior change.”

In the overview, Hanson, Gluckman, and Bustreo reveal their underlying bias even more directly saying:

If at present many young people do not seem to care about their health or view it as a low priority, perhaps they have not been given clear information about what they can do to optimise their health for themselves and their children.

Obesity has many causes. Health behaviors are important, but they are not the whole story.

Sadly, even thoughtful, learned people persist in the belief that people affected by obesity don’t care about their own health. When founded upon such bias, efforts to “end childhood obesity” will accomplish nothing.

Click here, here, here, here, and here for each of the articles in this series.

Spooky Pumpkins, photograph © hjl / flickr

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October 15, 2016