The Curious Woman

A Flicker of Curiosity About Obesity

“The etiology of obesity is multifactorial. However, the root cause is energy imbalance: more calories consumed than expended.” This was the explanation for obesity that Dariush Mozaffarian offered in 2008. Today, he writes in AJCN that obesity is “an unexplained epidemic.” We count this as a flicker of curiosity about obesity. If it spreads, perhaps we can make some real progress to understand and overcome obesity.

Curiosity is the first step.

All About Food?

Admittedly, this flicker of curiosity about obesity only goes so far. In this newly published commentary, Mozaffarian focuses mostly on food processing as the culprit. He writes:

“Growing evidence suggests complex, interrelated biologic interactions between food processing (including acellular nutrients, depleted prebiotics, additives), gut microbial composition and function, host metabolic expenditure, and inter-generational transmission of risk (including epigenetics, noncoding RNAs, microbial species).”

Though he understands that evidence is lacking to pinpoint the cause of excess obesity, he’s not averse to taking action. He has numerous publications advocating for action to cut back on the availability of bad foods (e.g. refined starches, added sugars, and processed meats). At the same time, he wants to dial up the good foods that are minimally processed and rich in phytonutrients.

Coming Around to Real Curiosity

Environmental Obesity DriversThe truth is that food is likely an important part of the problem with our excess of obesity. But it’s clearly not the whole story. A host of other environmental factors come into play. Most of the world, including Mozaffarian, seems stuck on presumptions about food. Nonetheless, we take heart when he writes:

“We don’t have a clear explanation for the obesity epidemic – and it’s time to acknowledge, and to correct, this regrettable truth.”

For too long, the dominant thinking has been that obesity is too hard to treat. So we must invest in primary prevention. But it’s tough to prevent something that you don’t understand. And it’s tough to prevent something that’s already progressing in about three quarters of the population.

So we need to get curious about really understanding obesity and set aside the many presumptions that have proven wrong. A flicker of curiosity is a good start.

Click here for the new commentary by Mozaffarian. For a broader perspective, click here.

The Curious Woman, painting by Silvestro Lega / WikiArt

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April 26, 2022