The Persistent Irritant of Implicit Ignorance About Obesity

Warning: this is a bit of a rant, albeit a good-natured one. The persistent irritant of implicit ignorance about obesity confronts us in virtually every dialogue we have about obesity. Sometimes it gets to be too much.

Specifically, it is the presumption woven into almost every conversation about obesity, that obesity is all about bad diets. For instance, Alex Henney and colleagues recently wrote in Obesity Reviews:

“Given that poor diet quality is known to increase mortality from chronic disease, it is imperative and timely to review trends in UPF consumption in the United Kingdom and how they are associated with poorer health on a biological, epidemiological, and sociological level, to inform future clinical and political decisions aiming to improve the public health of the United Kingdom.”

Focusing on One-Fourth of the Story

On the surface, there’s nothing wrong with what Henney et al are writing. Poor diet quality is a problem that merits attention. The pursuit of strategies to improve nutrition across the population of the UK or the entire world is, of course, worthwhile.

But dietary patterns do not exist in a vacuum and obesity does not arise strictly because of poor dietary choices. Our physical environment, chemical exposures, and stressful lives all play a role. Focusing on diet alone is short-sighted.

Physical Environment

We have rising obesity because of physical environments, technology, and lives that lead to less routine physical exertion. We sit in front of screens for work, learning, and enrichment. Cars and other vehicles take the place of walking. We even have moving sidewalks and escalators to spare us from the effort of moving our feet. Machines do manual tasks that our bodies once did.

Brief trips to the gym do not cancel out the metabolic effects of the inactive lives we have engineered for ourselves.

Stress and Stressors

Moreover, stress and stressors have profound effects on our metabolic status. Economic, social, and traumatic stress are triggers for eating patterns that don’t go away because we know we should be eating our veggies. Too little sleep can be a trigger for weight gain. Time poverty means that many people do not have the luxury of cooking with whole foods from scratch. In that context, inexpensive ultra-processed foods meet a real human need.

Drug and Chemical Exposures

And then, finally, we are constantly exposed to endocrine disrupting chemicals and drugs that prompt weight gain. Nearly a quarter of adults are taking medicines that will cause them to gain weight – regardless of what they choose to eat. Pollution bathes us in BPA, PFAS, microplastics, and other chemical entities that prompt our bodies to store more fat.

So, yes, the presumption that obesity is merely the result of bad diets is irritating. Because people with good intentions presume that we can overcome obesity simply by “fixing” our diets. Decades of such narrow efforts have proven this presumption to be false.

Click here for perspective on the complex nature of obesity’s causes. For more on systems science to overcome biased mental models of obesity, click here.

Black Pearl and Shell, photograph by Brocken Inaglory, licensed under CC BY-SA 3.0

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August 4, 2024