What’s the Point of Obesity Prevention?

Obesity prevention is something that easily enjoys broad support. People instinctively accept that an ounce of prevention is worth a pound of cure. Sounds good. But what, exactly is the goal of our efforts and how will we know if we’ve met them?

Sometimes the goal is expressed as crudely as “obesity is prevented and eliminated.” This is the vision recently proposed for one of many distinguished groups seeking solutions to the obesity epidemic. Clearly, such a goal is not grounded in reality.

Sometimes the goal is expressed more precisely as aiming  “to reduce the childhood obesity rate to just five percent by 2030 – the same rate before childhood obesity first began to rise in the late 1970s.” This goal came from the White House Task Force on Childhood Obesity in their 2010 report to the President.

More precise thinking is clearly needed, along with more rigor in evaluating progress toward well-defined goals. Goals need to take into account and respect the diversity in body size that has existed throughout human history. The earliest images of humans depicted people with obesity. So a campaign to “eliminate obesity” might only serve to further stigmatize people with the condition. And indeed, such talk inflames people committed to a health-at-every-size agenda. The point should be to prevent the suffering and disease that results from obesity, not to eliminate people with obesity.

Obesity strategies also must reflect an understanding that prevention cannot succeed unless paired with evidence-based treatment. Adults with obesity produce children with obesity. So family-based interventions are increasingly favored for childhood obesity.

Some policymakers justify an emphasis on prevention over treatment because obesity is such a difficult chronic disease to treat. But our experience over the last few decades of trying to prevent obesity would suggest that prevention is hardly an easier task.

Understanding and treating obesity in adults and children is essential for preventing an excess of obesity in the next generation. We need both an ounce of prevention and a pound of cure.

Click here to read more about the failure to measure the results of obesity prevention efforts. Click here to read more about the connection between obesity prevention and treatment.

An Ounce of Prevention, Philip Morris cigarette advertisement, 1945

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