Marion Nestle

Personal, Corporate, and Public Responsibility for Obesity

For most of the first 30 years of the obesity epidemic, the response has been simple. Address it as a failure of personal responsibility. But that hasn’t worked out so well. Marion Nestle explained this in her keynote address for the Obesity Medicine Association Fall Summit yesterday in Boston.

Today’s food environment makes it socially acceptable to eat highly caloric junk foods everywhere. In large portions, at all times of day. This obesogenic environment results from food company business imperatives. They must sell as much food as possible, to as many people as possible, to maximize shareholder value.

Thus, she says, responsibility for obesity lies with the food industry. The paradigm of personal responsibility and nutrition education has failed because the food environment is so unhealthy. The rise of calories in the food supply mirrors the rise in obesity, she says. In her narrative, this correlation equals causation.

Putting Sugar on Vegetables

According to Nestle, the food industry has gone through something like the stages of grief in dealing with obesity. First came shock at the unfolding events. Then, denial. It couldn’t be their fault. Next came bargaining, with the companies reformulating products. We suffered through a decade of low-fat (high sugar) cookies and other snack foods. Finally, they settled into the acceptance phase. In this phase, industry fights back with a playbook to sell as much of their unhealthy products as possible.

It’s a very pleasant conspiracy theory. You can’t really blame them because they have shareholders to please. They’ll do whatever it takes, even distorting the science, to meet their goals. She offered the concept of putting sugar on vegetables to illustrate. Maybe that way, kids will eat them. That was the theory promoted by agents for industry, she said.

To show how industry distorts science, she pointed to a 2011 study of the correlation of candy consumption with health for kids and teens. In this example, correlation equals causation. Just like her correlation of calorie trends with obesity. But in this case, it’s the food industry playbook at work.

In Nestle’s telling, corporate responsibility has a simple meaning. The food business is responsible for obesity. It’s a tale of corporate irresponsibility.

Public Responsibility

It’s tough to swallow the conspiracy theory Nestle is selling. Certainly, industry has bad actors that should be constrained. But it’s worth noting that bias distorts everyone’s thinking about obesity. She was selling quite an array of books in her talk. There’s nothing wrong with that. A robust marketplace for ideas is a good thing. Even if we become wedded to the ideas we’re selling. It’s only human.

Nonetheless, we agree that the ultimate answer is public responsibility. It’s imperative to fix market flaws that are driving an unhealthy food supply. Our only quibble would be that we need to focus on more than simply finding the bad guys. We need a greater focus on curiosity and objectivity about the ways in which which this marketplace is broken.

And of course, factors other than food are also contributing to obesity.

To solve a problem, we have to understand it well. In the case of obesity, we do not. Doubt is neither a heresy nor the product of an industry cabal. It’s the fuel for curiosity.

Click here for more from Marion Nestle. She has quite a few good ideas to offer.

Marion Nestle Speaks at the Fall 2019 OMA Summit, photograph © Ted Kyle / flickr

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October 5, 2019