Why Should Anyone Care About Obesity Science?

A comment last week at the National Academy of Sciences from a well-known obesity expert stopped us cold:

“I don’t think the science of obesity is going to get us any closer
to reducing the burden of obesity in the near term.”

Dismissing Science

Oh my. We are in deep trouble indeed. Hearing the value of science dismissed is no surprise on twitter. But to hear that dismissal so crisply stated at the National Academy of Sciences was a shock.

In obesity, policymakers implicitly dismiss science all the time. Simple solutions rule the day, even if they are utterly ineffective. The kneejerk reaction to Americans getting fatter was to cut fat out of the American diet. The science did not support that move, but it took decades for people to admit it.

Opportunities for Better Translation

Seeking solace, we consulted Lee Kaplan, Director of the Obesity, Metabolism, and  Nutrition Institute at Massachusetts General Hospital and an Associate Professor of Medicine at Harvard. He told us:

From the perspective of someone who both studies obesity and treats patients, I think that better understanding of the science will dramatically accelerate the search for better therapies. In turn, the better understanding of what is effective therapy will facilitate the development of more targeted and effective preventive strategies.

He pointed out that people who study the science of obesity are often divorced from the clinicians who treat patients with it. As great – or perhaps greater – is the disconnect between obesity scientists and public health professionals.

The result? Translation of science into effective solutions is far less effective in obesity than in most other fields.

Think about the phenomenal progress in cancer. Public health scientists translated papillomavirus research into evidence-based vaccination programs. Around the world, results are becoming evident. Likewise, clinical care for cancer has dramatically improved. Basic research in genetics and immunology is yielding more tailored and effective treatment for a wide range of cancers.

Learning from Bariatric Surgery

For an example of the possibilities in obesity, Kaplan points to bariatric surgery. Right now, surgery is the most effective tool we have for treating obesity. It’s also quite effective for putting type 2 diabetes into remission for people who suffer from both diseases.

Now obviously, bariatric surgery is a tool for individual healthcare, not for population health. But it provides a window into the physiology of obesity. It points to a fact that many people working on obesity miss, as Kaplan explains:

Surgery works through alteration of physiology rather than mechanical restriction or malabsorption of ingested calories. It shows that obesity itself does not result from the simple addition of calories to the diet. Effective interventions are not merely a matter of voluntarily adjusting the calorie balance sheet.

Progress in reducing the impact of obesity on health has been pathetic for the last 30 years. Translating science into clinical and public health practice can turn the tide. But scientists, clinicians, and public health professionals will have to collaborate before it will happen.

Click here for more on translational models of public health research and here for perspective on the next generation of obesity research.

The Attributes of the Sciences, painting by Jean-Baptiste-Simeon Chardin / WikiArt

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

April 10, 2017