Storm Brewing

Three Bad Assumptions About the Perfect Storm of Obesity

Bad assumptions make bad policy. And at the heart of policies to address obesity for three decades has been a wobbly understanding of what exactly is causing the perfect storm of obesity. That storm continues to rage despite best efforts to prevent its impact on health around the world.

Why, exactly, has the obesity’s prevalence grown so quickly? Today in Obesity, eight of the world’s best experts present some of the best thinking you will find anywhere on this subject.

1. Too Much Fat or Sugar

At the top of everyone’s list of suspects is the food we eat. NIH’s Kevin Hall points out that focusing on a singular nutritional villain is a mistake:

Individual dietary macronutrients have each been theorized to be the prime culprit for population obesity, but these explanations are unlikely.

More plausible explanations invoke complex changes in the overall food environment and the associated alterations in normative eating behaviors.

Too much sugar or too much fat might be part of the problem. But it’s the whole food environment that’s causing the problem. Not just one or two little pieces of it.

2. Regular Exercise

Fitness facilities are thriving these days. But Timothy Church and Corby Martin say that the real problem is not recreational exercise. That has actually changed very little. It’s physical activity at work and school that’s lacking. And that deficit, they say, interacts with the food environment:

We propose that the current very low levels of occupation-related physical activity have pushed the majority of Americans into the unregulated zone of Mayer’s curve. And this, combined with the modern food environment, has created a toxic interaction responsible for the current obesity epidemic.

No doubt, all the people running down to the gym or yoga studio get a health benefit. But they’re not going to turn obesity trends around.

3. Simple Answers

But perhaps the most naive assumption is the most common. “We know what to do to reduce obesity,” says public health professor Simon Chapman. On Twitter, General Healthy asks us, “What’s left to research?” The Robert Wood Johnson Foundation tells us “we’ve turned the corner on this obesity epidemic.”

Rachel Davis, Eric Plaisance, and David Allison say no. It’s not that simple:

A combination of factors, rather than only one factor, is responsible for the increased rates of obesity. Additionally, these factors are ever changing, requiring a multifactorial approach to reducing population obesity levels and presenting exciting opportunities for new discovery.

Simple nostrums have failed. Let’s Move! might be an inspiring catchphrase. But it’s not the answer to the perfect storm of obesity creating a tidal wave of chronic diseases. We must get real and get curious about this complex problem. Only then will we be in position to put real solutions into action.

Click here, here, here, and here to read these perspectives published today in Obesity.

Storm Brewing, photograph © Linda Tanner / flickr

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December 20, 2017

5 Responses to “Three Bad Assumptions About the Perfect Storm of Obesity”

  1. December 20, 2017 at 8:14 am, Allen Browne said:

    Leave me here, Scotty. There is intelligent life down here.

  2. December 20, 2017 at 8:26 am, David Brown said:

    Quote from “Food for Nought: The Decline in Nutrition” by Ross Hume Hall, PhD, 1976.

    “A highly individual system of growing and marketing food has been transformed into a gigantic, highly integrated service system in which the object is not to nourish or even to feed, but to force an ever-increasing consumption of fabricated products …Man can never be more than what he eats, and one would expect that a phenomenon with such profound effects on health and wellbeing as a radically changed system of supplying nourishment would be thoroughly documented and assessed by the scientific community. Such is not the case … Failure to monitor and to appreciate the results of rapidly moving technology produces a brutal effect … ”
    https://books.google.com/books?id=a1gknQEACAAJ&dq=editions:ISBN0061410780

  3. December 21, 2017 at 4:51 pm, David Stone said:

    .”A combination of factors, rather than only one factor, is responsible for the increased rates of obesity.”

    Ted, a welter of secondary factors, yes, and they are well worth researching; a no-side-effects appetite-killer may one day work wonders. But meanwhile, let’s not forget that there is indeed a single primary underlying factor responsible for increasing rates of obesity: energy imbalance — more Cals consumed than burned until enough weight is gained to be appropriate for the energy intake, thus restoring energy balance.
    We know that merely understanding the concept of energy balance doesn’t automatically result in people adjusting their intake/output to achieve a healthy weight, esp. in cultures which value obesity, but I worry that failure to reinforce the concept in those who wish to lose weight will tend to promote denial of its importance; and we need to try to counter the claims that “Calories don’t matter”: https://tinyurl.com/yc59smm5

  4. December 21, 2017 at 5:00 pm, Ted said:

    Thanks, David, for sharing your thoughts and for illustrating an important point. I witness many pointless arguments based on an utterly false dichotomy. Does energy balance matter? Of course it does. However, energy balance exists within a complex, adaptive system. It is not so simple as calories consumed versus calories expended in voluntary physical activity. Energy balance is far more complex.

  5. December 21, 2017 at 7:52 pm, David Stone said:

    Ted, yes, total output is certainly more than just Cals consumed in voluntary activity, esp. in our low-active society, and of course I was referring to total energy expenditure, including that component and including any adaptation (to conserve or to waste) that may be occurring.