OCW2022: Getting Real About Obesity Prevention

For decades now, lots of talk about preventing obesity has been easy to find in public health circles. For the most part, that talk has focused on educating, urging, nudging, or taxing people to adopt healthy eating and active living as a pattern for their lives. But despite all that talk, the prevalence and the health impact of obesity has only gone up. That’s not OK. Because for those of us who care about OCW2022, real, effective obesity prevention is critically important.

That means on prevention, now more than ever, it’s time to act.

Chasing Bad Food and Sedentary Lifestyles

The eat healthy, move more theory of obesity prevention has had public health going after junk food and sedentary lifestyles since the 1980s in an effort to bend the curve on obesity. Maybe you remember legwarmers and aerobics from the 1980s. Throughout the 1980s and 1990s, low-fat everything was supposed to protect us from weight gain. It didn’t.

With the new millennium, the definition of junk food shifted toward demonizing carbs instead of fat. Then the proclamation came that sugar is toxic. Now plant-based nutrition will make us healthy and save the planet all at once. Even with all these wonderful ideas and lots of encouragement to “eat healthy” and lead an active life, obesity prevalence kept ticking up without a pause. The sugar-is-toxic messaging worked. Per capita sugar consumption has been going down in the U.S. now for two decades. But the upward trend in obesity is unperturbed.

Despite abundant confidence that “we know what works” to prevent obesity, the outcomes for population health tell a very different story. In a recent commentary, Ann Peters pointed to new numbers from CDC and said:

“Not surprisingly, the data have only shown that we get worse over time.”

We Need a Fresh Start

There’s no way around this. We need a fresh start for obesity prevention. Simply continuing to pursue variations on a theme of healthy eating and active living seems unlikely to yield anything better than the depressing results of the last four decades.

So we need a big dose of objectivity about the limited evidence for improved population health outcomes from current strategies. Then we need to apply some serious scientific curiosity to the search for strategies that will work to yield better outcomes. Not just changes in behavior, but changes in actual health outcomes. We need to figure out how to change the interaction between human physiology and our current environment to produce less obesity. Because right now, that interaction is yielding ever more of it.

The time to act is now. For obesity prevention, action starts with a quest for strategies that will work better than the same old prescriptions to eat healthy and get moving.

Click here for the new OCW2022 fact sheet on obesity prevention and here for the Peters commentary.

Aeneas Saving His Father through the Flames of Troy, painting by Emmanuel Zairis / WikiArt

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March 3, 2022