Looking at Obesity Through a Lens of Futility in Lancet

If one is in the mood to stare into the abyss of futility, the Lancet has a perspective for you on obesity today. The Global Burden of Disease project has a new analysis of obesity in the U.S. It tells us that 76% of adults 25 and older have overweight and obesity. Furthermore, that number is destined to reach 80% by 2050. The authors say this means that:

“Existing policies have failed to address overweight and obesity. Without major reform, the forecasted trends will be devastating at the individual and population level, and the associated disease burden and economic costs will continue to escalate.”

Solutions? Ask Sisyphus

The implications are plain to see, say the authors. Obesity is caused by many complex factors like “urbanisation, flawed food and agricultural systems, food insecurity, and wealth inequality.” So obviously, for overcoming obesity “a whole-of-government, Health-in-All-Policies approach is required to impose multisectoral structural changes.”

In short, with better places to live, abundant healthful food, and more equal prosperity for everyone, the problem will be solved. The next administration must focus on this “to impose multisectorial structural changes.”

Reading this, we begin think these authors actually have a wry sense of humor.

Meanwhile, Back in Reality

For the last two days at the National Academy of Sciences, we’ve been taking in wide-ranging discussions about the experiences of persons living with obesity and the economic realities of coping with this disease. We heard views from economists that were at times expressions of hope, diverging to futility at other points.

“There will never be enough money to pay for obesity medicines,” said one of the more pessimistic economists. On a brighter note, “We will soon have a broader pharmaceutical armamentarium with a broader range of prices,” said another. We are on our way to more scalable options for coping with obesity.

In the end, it is clear that progress is coming, even if it will fall short of a utopian dream. More people are getting better care for obesity. Serious scientists are working to understand the drivers of obesity in the population and with a better understanding of those drivers, more effective prevention strategies will be possible.

While we agree with the view that obesity prevention strategies have been a bust up until now, it need not be a Sisyphean exercise in futility. Caring for the people who live with this disease is rewarding work. Working toward a better understanding of what’s driving it can be quite challenging and also rewarding.

The reward for curiosity will be the discovery of effective prevention strategies.

Click here for the new paper in Lancet and here for another perspective on it.

Le Mythe de Sisyphe, painting by Serge Mazet, licensed under CC BY 4.0

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November 15, 2024