How to Reverse the Trend Towards Obesity

The NEW ENGLAND JOURNAL of MEDICINE |Perspective| December 3, 2020 pp2197-2200| “Solving Population-wide Obesity-Progress and Future Prospects” by Shiriki Kumanyika Ph.D., M.P.H., and William H. Deitz, M.D., Ph.D.



image cdc.gov


Read the article for full detail, audio also available at NEJM.org


Facts

Globally, 1B adults overweight, 650M adults with obesity, and 124M children with obesity.


Globally, “obesity is responsible for 41% of uterine cancers; more than 10% of gallbladder, kidney, liver and colon cancers; 40% of cardiovascular disease; and most cases of type 2 diabetes.” Being obese also increases the likelihood of serious illness or death from COVID-19.






Obesity and COVID-19 figure from mayoclinicproceedings.com



“Obesity disproportionately affects racial and ethnic minority groups and rural and low-income populations in the United States.”


Summary of the Perspective Article

Root causes of obesity are increased food intake and reduced physical activity in cultures of food abundance and low need for physical activity.


In 2001 the “U.S. Surgeon General David Satcher…called for mobilization.” Specifically make changes in schools, workplaces and communities to “improve diets, increase physical activity and reduce health disparities.” Investments have been made subsequently. Policy changes include “standards for school-based physical activity and physical education…system-level changes in food…environments…” including…”nutrition-education information and food advertising; and approaches to addressing health disparities and achieving health equity.”


One can point to Michele Obama’s “Let’s Move” that called for healthy eating and physical activity, Healthy-Hunger-Free Kids Act of 2010 and taxing sugary drinks and “The Diabetes Prevention Program trial [that] demonstrated weight loss linked to lifestyle modification and a reduced incidence of type 21 diabetes in ethnically diverse populations with prediabetes…”


Global efforts are underway as well. International groups like the IOM and the U.K. Government Office for Science “have called for systems-level transformation…” that aims to “reimagine and reengineer systems that define modern life.” Moving away from the status quo in wealthy countries of “overabundance and the normative overconsumption of highly palatable processed and high-calorie convenience foods, motorized transportation, sedentary work and learning environments and entertainment…”. The Lancet Commission on Obesity connects-the-dots between the negatives affects of obesity on the environment. “The overproduction and overconsumption that drive obesity also increase the release greenhouse gases” ultimately capable of global warming and “catastrophic weather events” that damage crops and lead to “food insecurity” and “undernutrition” in low- and middle-income countries.”


Tackling Obesity will need effort from medicine, public health and investment from the private and public sectors.

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