Stretching Into the Light

Light at the End of the Obesity Tunnel?

Obesity has many complications, but here’s one that’s entirely unnecessary – whiplash. Health reporters routinely take the public through wild gyrations of hope and despair in describing obesity trends. This week we have another round of such reporting on a new study and commentary in the New England Journal of Medicine. Spoiler alert: the light at the end of the obesity tunnel is an illusion.

Scientists and clinicians are learning phenomenal things about obesity every day. But we’re not even close to understanding the problem, let alone knowing how to solve it.

Describing the Global Pandemic of Obesity

The new study in NEJM this week does a fine job of fully describing the global pandemic of obesity.  That’s right. It’s no longer an epidemic. It’s a pandemic – prevalent around the world.

More than 108 million children and 608 million adults have obesity. The numbers have doubled in more than 70 countries since 1980, and have grown steadily in most of the others. Medical care for the complications of obesity is getting better, so people are living longer with it and getting more complications. In turn, adults with untreated obesity are having more and more children with obesity.

Yet in the midst of this pandemic, Edward Gregg and Jonathan Shaw claim that “actual successes in prevention . . . may finally be under way.” They make that claim in an editorial that accompanies this report.

Optimism Bias Meets the Realities of a Pandemic

For folks who devote their careers to obesity prevention, a desirability bias is not surprising. So the belief that childhood obesity is coming under our control has grown rapidly after a few reports of a possible decline in prevalence among toddlers. But we suspect these declarations of success are premature.

And in any event, their claim of a “plateau” in U.S. obesity prevalence is clearly false. The most recent, reliable statistics indicate that the ongoing trend for obesity in both adults and youth is up. Not plateauing, not declining.

No doubt, the rate will plateau, even if current efforts are totally ineffective. A significant portion of the population is immune to obesity. (Not because of virtue, but because of biology.)

But it’s time to stop looking for light at the end of the obesity tunnel. This is a pandemic. It will take time and good research to overcome it. We need to put our energy into looking for real, scientific insights. Such insights will lead to real solutions with real, measurable effects.

Click here for the study and here for the editorial. For a thoughtful examination of how to interpret trends in obesity, read this report from the National Academies.

Stretching Into the Light, photograph © That Guy Who’s Going Places / flickr

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June 15, 2017

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