Scientists from around the world investigating obesity recently gathered in the golden rooms of the Royal Society, the academy of sciences of Isaac Newton and Charles Darwin, where ideas like gravity and evolution were once debated.
While they debated the triggers for obesity, which affects more than 40% of American adults and costs the health system about $173 billion a year. In the closing session of the meeting, biologist John Speakman offered this conclusion on the subject: “There is no consensus on what the cause is.”
This does not mean that scientists did not agree on anything. The 3-day meeting was suffused with an implicit understanding of what obesity is not: a personal failure. No speaker explained that all human beings ran out of willpower by the 1980s, when obesity rates skyrocketed, first in high-income countries and then in most of the rest of the world. Not a single scientist said that our genes changed in that short period. There was no talk of laziness, gluttony and idleness as coadjuvants of obesity. Unlike the prevailing social view of obesity, which assumes that people have full control over their body size, they did not blame individuals for their condition, just as we do not blame people suffering from malnutrition, but rather restrictions and waste.
Instead, the scientists stated that obesity was a chronic and complex disease, and that they had met to come to a conclusion as to why humans, as a whole, have become thicker in the last 50 years. To that end, they shared a range of mechanisms that could explain the global boom in obesity. And their theories, while diverse, made one thing clear: as long as we treat obesity as a personal responsibility issue, its prevalence is unlikely to decrease.
An endocrinologist discussed the scientific model behind the low-carb approach, suggesting that high-carb eating patterns drive fat in a unique way. A nutritional biologist advanced the idea that all the carbohydrates and fats in today’s foods dilute the protein our bodies need, prompting us to eat more calories to make up the discrepancy, while an evolutionary anthropologist argued that many hunting societies— Lean foragers ate a lot of carbohydrates, with a particular affinity for honey.
Others stipulated that convenience foods, ultra-processed and packaged foods, make up more than half of the calories Americans consume. A physiologist shared his randomized controlled trial showing that people consume more calories and gain more weight on diets of ultra-processed foods than on whole-grain diets of the same nutrient composition. But he said it’s not yet known why these foods motivate people to eat more.
The mystery could be explained by the thousands of toxins that ultra-processed foods can include in the form of fertilizers, insecticides, plastics and additives, argued a biochemist. His research on cells has shown that these chemicals interfere with metabolism.
However, others believe that the problem has less to do with what we eat and more to do with what we don’t eat. An ethologist shared her work on the link between food insecurity and obesity in birds. When food is scarce, animals eat fewer calories but gain more weight. Human studies have also shown a “robust” association between food insecurity and obesity, known as the hunger-obesity paradox.
The scientists stated that obesity cannot be considered a disease. They explained rare cases caused by mutations or disorders of a single gene; most commonly, obesity arises from still uncertain genetic-environmental interactions. Maybe they should have talked about obesity all the time.
In a very short period of time, the scientists, including many in the room, had learned a great deal. By the end of the conference, attendees were far from having arrived at a unifying theory to explain the worldwide rise in obesity, a disease that has been with humanity at least since Hippocrates but has only become widespread since the advent of MTV.
They distinguished more than a thousand variants and genes that increase a person’s risk of being obese. They found that body fat is much more than a storehouse of energy and that not all obese people develop its associated complications, including type 2 diabetes, cancer, heart attacks, high blood pressure, stroke and premature death. They have come a long way in identifying how the brain organizes eating and adapts to different diets, altering food preferences. But the researchers couldn’t agree on what changed in current history to affect the complexity of these biological systems.
There was no scientific input on the so-called cures that diet books and store shelves are full of right now, except for the debate over carbohydrates. There was no serious dialogue about cleanses, dieting apps, or intermittent fasting. No one suggested that supplements could help people lose weight or that it was necessary to boost metabolism. The only presenter on the gut microbiome explained that human trials on obesity to date have been mostly disappointing.
Despite the incredible advances in medicine in treating obese patients, effective drugs and surgeries have not been talked about as solutions to end the public health crisis. In other words, there were no quick cures or magic tricks in that London meeting room.
Asking researchers how to deal with obesity, given the uncertainty, they pointed to policies that would alter or regulate our environment, such as banning junk food marketing to children, banning vending machines in schools, and making neighborhoods more walkable. They clarified about changing the food system in such a way that it also addresses climate change: related crises once met with public policy inertia that have now gained global momentum. But when it comes to obesity, governments continue to be accused of being overprotective states if they try to intervene with regulations.
This partly explains the fact that, instead of seeing obesity as a social challenge, the bias that it is an individual decision prevails. Guilt and misunderstanding prevail and can be seen everywhere. People are being told to just eat more vegetables and exercise, which is the same as us tackling global warming by saying just take fewer planes or recycle. Diet gurus and companies rake in billions with food and fitness fads that end up flopping.
People often blame themselves when they can’t control their own body weight. For example, recently a man who, following a brain tumor, developed severe obesity, a common side effect of his disease. The tumor went undiagnosed for months as doctors told her to go on a diet and exercise more. But even today, the tumor just seemed like “another excuse” for her lifelong struggle with weight, so she doesn’t talk about it to anyone.
Shame is also brought by others. Shaming others about their weight is a real solution to obesity, it is harmful to people because they consent to weight gain. Quite the opposite: Researchers have found time and again that weight shaming causes people to gain more weight and is harmful. It is believed that at least some of the negative health consequences of obesity are motivated by stigma and discrimination, which translates into poorer medical care.
As long as we don’t see obesity as something that has been socially imposed, and not as something that individuals choose, we will continue to discriminate against people because of their weight and magic cures and bad policies will continue. As long as we don’t stop blaming ourselves and others and start focusing on environments and systems, the global obesity rate will continue to rise, a trend that no country has substantially reversed, even in children.
Published by The Tampa Herald, news and information agency.