Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

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Progress Against Obesity?

The obesity epidemic and what to do about it has been a major focus of this blog.   Plug in OBESTIY to the key word search tool and a large number of links show up on many elements of the obesity problem.  Except for the ideas that exercise can modulate the negative health consequences of obesity, limit the impact of obesogenic genes, and play a key role in helping real biggest losers, there is not a lot of good news on the obesity front.

However, there were reports earlier this week that childhood obesity is dropping in some cities in response to comprehensive nutrition and physical activity programs.   Here is a link to a longer report from the Robert Wood Johnson Foundation.   The report concludes:


“Growing evidence suggests that strong, far-reaching changes—those that make healthy foods available in schools and communities and integrate physical activity into people’s daily lives—are working to reduce childhood obesity rates. More efforts are needed to implement these types of sweeping changes nationwide and to address the health disparities gap that exists among underserved communities and populations.”


There are also new ideas about how social media might be able to help fight childhood obesity.  This is an important idea because evidence from the Framingham Study shows that weight gain in our friends is a critical risk factor for weight gain in us!   They followed social connections between and among about 12,000 people for over 30 years and found that:


“Discernible clusters of obese persons (BMI>30) were present in the network at all time points, and the clusters extended to three degrees of separation. These clusters did not appear to be solely attributable to the selective formation of social ties among obese persons. A person’s chances of becoming obese increased by 57% if he or she had a friend who became obese in a given interval.”


The idea is that the same social forces that make obesity “contagious” might also be used to make healthy choices and behaviors contagious.   There is also increasing evidence that food pricing strategies (e.g. sugar and fat taxes) will work to improve nutrition and combat obesity especially in low socio-economic groups.  This is important because these groups have been relatively resistant to other public health efforts directed at obesity.


When you look at the data and ideas described above and discussed previously, it seems to me we need to do the following to turn the obesity epidemic around:

  • Adopt the strategies outlined in the Robert Wood Johnson Report nationally.  Like smoking, if we stop obesity early in life it will pay off in middle age.
  • Develop comprehensive programs to promote physical activity.  Some of this is about urging people to exercise more.  Some of this is about urban design and planning to make the world friendlier to physical activity.   Most of us live in places that are car friendly but not walking or biking friendly.  This is critical because weight loss is hard and physical activity can prevent weight gain, help with weight loss, and blunt the negative health consequences of obesity.
  • Increased public education programs.
  • Interventions that increase the cost and/or reduce the portion size of obesogenic foods like sweetened beverages.   This would include so-called sin taxes.
  • Use social networking tools to define what is normal and reduce the “contagious” elements of obesity.  They could also be used to increase the contagious elements of fitness and normal body weights.


Summary:  the news on obesity is not all bad and strategies that work are beginning to emerge.   If they are applied widely over the next 20 or 30 years perhaps the obesity epidemic can be stopped.   It is a matter of both our individual and collective cultural will power.



2 Responses to “Progress Against Obesity?”

  1. December 13th, 2012 at 1:04 pm

    JustaTech says:

    I love the Framingham Study! It’s amazing the huge amount of data that study has gathered (and all the susequent ‘offspring’ studies).
    Hopefully the “contagiousness” of obesity can work both ways: you can work indirectly through your social group to spread fitness and healthy eating.

  2. December 18th, 2012 at 8:34 am

    juie says:

    I can attest to some of this. To maintain weight loss, I have to live a bit differently than I used to. Instead of happy hour, I now convince [some] friends to walk up a hill to see the sunset. We split and app and an entree at restaurants, instead of having our own. I go for Thai or VN over pizza or a burger. Dessert is very rare. I try to convince people to come over for dinner, not eat out (never been a soda drinker – restaurants/takeout are my weight regain tool). I walk/bike places instead of driving (this, as you mention, is a big deal). Obviously, not all friends are on board with this, but I spend more time with the ones who are, because it matches my lifestyle, and I don’t want to get fat again.

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