Why are we not doing more to prevent obesity?

In many ways, obesity is a very complex disease, and it’s likely to remain so for many years. You can always go deeper down the rabbit hole, regardless of whether you are researching fat cells, metabolism, eating psychology or socioeconomics. Researchers are usually very happy to do this, it’s what we trained for.

There comes a point, however, when new studies do not add very much to what is needed in order to bring about a certain outcome, such as prevention of obesity. It’s true that we need much more research, for example on obesity etiology, but do we really need more evidence to tell us that junk food and inequality/poverty (this latter risk factor only applies to countries that have already made the nutrition transition from natural food to junk food, such as Europe and North America) are major causal factors? I think not.

Our diet is the simplest & most profound evidence of the failure of public health & its leaders. #APHA14 pic.twitter.com/BxFTzyFmkd

— General Healthy (@GeneralHealthy) November 15, 2014

Indeed, we can and should act now to reduce both, and in so doing, we would very likely help to prevent new cases of obesity and probably many other diseases that are also linked to both risk factors, such as depression, arthritis, diabetes and heart disease.

Apart from getting rid of junk food and lowering rates of poverty, we should also be promoting healthy nutrition across the lifespan, where the food contains minimal quantities of pesticides, preservatives, sugar, salt, unhealthy fats, steroids, and antibiotics – just plain natural food, it’s simple. We should also be doing things like promoting physically active transport, and reducing sitting time at work and at home. Healthy eating and regular physical activity will not get rid of obesity, but they can probably go some way in lowering the obesity incidence rates at the very least.

And while messages to promote healthy eating and physical activity can be helpful, we have to be much more comprehensive in how we change the environment. Indeed, the food environment has become so toxic that it feels like we almost have to completely rethink how we produce food. Junk food simply has no place in a society where we value and place emphasis on prevention on chronic disease. Reducing poverty will also require much more than pretty messages, it requires major political decisions and pressure from voters. Bear in mind that the difference between the rich and the poor is at its widest in over 7 decades.

In America, the top 0.1% hold 22% of America's wealth, almost the same share as the bottom 90% http://t.co/xMSLMmIyAg pic.twitter.com/dXAV3fslmu

— The Economist (@TheEconomist) November 8, 2014

There will always be times when we have to do more research in order to understand more about a particular disease or problem, but if we are talking about obesity prevention, this is probably not that time. This is the time for action, like what is happening in Mexico (see my previous post), where they are successfully working to reduce their more or less catastrophic childhood obesity rates, for example by taxing soda, during very challenging conditions.

Actually, if there is one thing that we should do more research on, it would be to find out why we are not implementing much more serious obesity prevention programs and why we have let mega food corporations take over close to our entire food supply. And while we try to find answers to those two question, there is nothing stopping us from implementing healthy nutrition and physical activity habits for everyone, especially for children in socioeconomically challenged areas.

If you have an answer as to why we are not doing more to prevent obesity, I would love to hear from you. Please share.

Erik Hemmingsson

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We have been divided and conquered by Big Food

Let’s face it: we have been divided and conquered by the food and beverage industry. It’s not pretty. In fact, they have been running circles around us, more or less unopposed on their way to almost gaining 100% control of what we eat and obviously making mega profits along the way. Most people probably never realized there was a match on. Sometime in the future, I am sure we will ask ourselves how we could let them get away with so much, just like we today are asking ourselves how we failed to control Big Tobacco.

http://authoritynutrition.com/big-food-is-much-worse-than-big-tobacco/

Here are some of the things they have been getting away with:

– loading our food with toxins, chemicals, preservatives, pesticides, antibiotics and steroids

– adding sugar, salt and fat to pretty much everything to make it more palatable and cover up any bad tastes

– specifically targeting children in their advertising

– increasingly producing “food” in factories without any natural ingredients or nutrients

– saying they want to be part of the solution, for example by reducing calories, but then doing the complete opposite

Coke targeting nations that don't have an #Obesity epidemic…yet http://t.co/5mmuwGw6Gv via @HuffPostBiz

— Chris Jarratt (@chrissjarratt) October 30, 2014

All of these changes have been very gradual so that no one would notice. Historically, we have been suckers for these slow changes. As an example of just how toxic our food environment has become, picture yourself time-travelling from the 1950:s, just before the rise of the junk/fast food industry, to today. You would be stunned at the amount of junk food on offer, and the brash and cynical marketing that accompanies it (think toys to children from the latest children’s movie, for example).

Now, thankfully, the tide appears to be turning. More and more people are waking up and not liking what they are being served or how mega food companies operate, and are starting to find more healthy and sustainable food sources or even growing their own. Crucially, consumers are also getting more and more connected and organized in fighting back, particularly in the US. This is where the fighting appears to be at its most fierce, since this is also where the food environment is worst.

We have to be mindful, however, of not falling for more of their classic divide and conquer tactics. One such example is when we as researchers try to link a particular junk food or beverage to a particular health outcome, such as obesity or depression. By just focusing on one adverse health outcome, and endlessly debating this, we are shooting ourselves in the foot and not getting anywhere. What we have to do is to analyze the total cost of junk food, including all known health problems and the negative effects on the environment (which are massive).

I doubt that we can count on politicians to solve this for us, this needs to come from the bottom up, i.e. consumer power. And once enough people get fired up and organized, then we will start to see real change happening, i.e. real food, packed with nutrition and grown in a truly sustainable way, available to everyone.

Obesity prevention: what on earth are we waiting for?

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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Gutless and disloyal “revolving door” politicians/lobbyists perpetuate the obesity epidemic

Let me be clear here from the outset: I don’t particularly like most politicians, and I certainly don’t trust them, especially those higher up in office. They usually say one thing and then do something completely opposite, and they generally don’t act as their voters would like them to act.

Quite frankly, their lack of voter loyalty is nothing short of mind boggling, just look at the US congress. Marion Nestle’s recent post on “revolving door” politicians outlines this very nicely:

http://www.foodpolitics.com/2014/09/the-infamous-revolving-door-two-recent-examples/

Too many politicians are only too happy to go straight to well paid industry jobs, usually as lobbyists or consultants for big tobacco, big pharma, big oil, or any other “big” you can think of, once they end their time as elected officials or civil servants. The many mega junk food corporations have certainly been very well served by this group of politicians/salesmen/lobbyists, at the expense of the wishes of ordinary people.

Given the wealth of scientific evidence conclusively showing that junk food is very detrimental to our health, it’s a scandal that it’s not countered more than it is, including rules for their very aggressive marketing. Most of that marketing is aimed at children to boot. This lack of action certainly serves to perpetuate the stays quo and indeed ever increasing waistlines, see this recent report in JAMA (this report is also a wake up call for all those who think that the obesity epidemic has plateaued):

http://jama.jamanetwork.com/article.aspx?articleid=1904816

Obesity rates (and rates of many forms of cancer, diabetes, depression, etc) could certainly be slowed down and possibly reduced by our elected officials through banning and taxing junk food much more severely. So why don’t they? If you ask me, there are too many revolving doors, too many corporate loyalties, and too many gutless politicians who dare not rock the boat.

The price for all this corruption at the hands of all those who should be serving the public interests first are ever increasing rates of obesity and other non-communicable diseases. This will certainly please big pharma but very few others. How much longer should we tolerate this?

 

Erik Hemmingsson

Please share this information so that more and more can become aware of how we can stop obesity, thank you. 

Polarity abounds and why it’s time for a new way of doing things

It appears to be a human condition to react very slowly, if at all, to adverse changes that happen very gradually (think the obesity epidemic). If bad things happen very quickly, then we have no problem mobilizing at all, such as what happened during the SARS outbreak just over a decade ago. Moreover, the factors that are feeding the obesity epidemic, such as processed junk food, stress, and socioeconomic adversity, have changed steadily but very gradually as well, making for one gigantic slippery slope that we have apparent problems reacting to.

It seems as if many things in society, including the drivers of the obesity epidemic, are now reaching some kind of peak polarity, i.e. you are either very poor or very rich, you either eat only nutritious organic food or only junk food, and you either exercise 7 times per week according to the latest hype, or you refuse to exercise at all. In terms of socioeconomics the middle class is disappearing fast, and the 1% seemingly flourishes at the expense of the rest of society.

Polarities abound in the present time, and this makes it very difficult to make any inroads into creating the conditions we need in order to produce successful obesity prevention and treatment programs. In short, it is very difficult to separate the fortunes of the individual from the rest of society, and society is not in a happy place right now.

http://www.motherjones.com/politics/2011/02/income-inequality-in-america-chart-graph

 

Politically, there is much current upheaval in the world, possibly with some kind of peak fear with war in the middle east, ebola outbreaks, water shortages, extreme weather, and an economy in tailspin – can it get any worse?

The good news is that more and more people are waking up to the fact that the current systems, i.e. politics, finance, food environment, lifestyles, etc, are obviously in need of major reform. Maybe we are even getting close to some kind of breaking point for the current dysfunctional way of doing things. I thick that we are, and when enough people wake up to this reality, that is when we can create the conditions we need for preventing obesity globally.

Do we, for example, want to keep eating junk food when it is abundantly clear that such food is very harmful to our health, do we want to keep the current financial system that only seems to work for the 1%, and do we want politicians that are heavily influenced by corporate interests. Or do we want something better? It’s not as utopian as many people think that it is.

 

Erik Hemmingsson

 

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