Obesity prevention: what on earth are we waiting for?

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Please allow me to start with a little name dropping here (sorry): my PhD opponent was professor Steven Blair from the Cooper institute in Dallas, notably of fitness/fatness fame, and his really groundbreaking research on fitness and numerous health outcomes. I am sure Steve’s work has helped to save countless lives and will continue to do so. Anyway, one of the things I clearly remember Steve saying was how we (in medical science) have all been led to worship at the shrine of the randomized controlled trial. And if your research is not founded on a randomized controlled trial then work is so flawed, so biased, that you may as well quit and do something else entirely.

His point was very clear: it is far too easy to discredit sound studies that do not use a randomized design. Most people who critique or even completely discard science have never done any science themselves, let alone a randomized controlled trial, and are employed as full time bureaucrats, or work for big pharma, and so they lack the understanding that such evidence is often utopian and oftentimes makes very little sense. In other words, good science is many times discredited for very petty reasons.

But here is my point: we can easily become very stupid if we insist on scientifically proving everything that we want to do. Not only is it utopian for many reasons such as cost and time, it’s often completely unnecessary. We don’t need, for example, a randomized trial to prove beyond any meaningful doubt, that certain things are either good or bad for us such as exercise, junk food or stress.

So far there are very few examples of obesity prevention programs that have been scientifically proven to be effective. That does not mean that we should refrain from very commendable initiatives such as building more parks and bike lanes, taxing junk food much more severely, banning junk food marketing, reducing harmful chemicals from our food such as steroids, preservatives and antibiotics, etc. There is no need to validate all these preventative measures in a gargantuan randomized controlled trial that will take years, if not a decade, to design, fund, carry out, analyze and publish.

The burocrats can always find things to nitpick at if they so wish (they usually do) and use this as an excuse for their inertia. Everyone should know, however, that science is never perfect. We have to trust and use our common sense when it comes to tackling the epidemic, just as much as we have to let good science guide us when we design programs that reduce obesity.

So what are we waiting for? Why is there so little action to prevent obesity? The numbers are getting worse by the day it seems, partly because we are in fact allowing the epidemic to run around more or less unchecked. It’s time to get serious about prevention, and do all these things that can start to slow it down, and don’t sit around waiting for the perfect study to show us exactly what to do, because that could be decades. We can’t afford to sit around any longer hoping that someone else is going to solve this for us.

Erik Hemmingsson

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