Earlier this year, JAMA reported that obesity rates among children decreased among 2-5 year olds, researchers at the University of North Carolina contradicted that finding. In an effort to reassure us, on May 4th, Emanuel and Steinmetz stated that we have a reason to be optimistic about the obesity rates because we are moving much faster against obesity than we did in our efforts against tobacco.
I do not think there is a particular reason to be optimistic, especially with their insight that if current trends continue, by 2030, the incidence of obesity related medical conditions could be 20 times what it is today. This will cost the American economy up to an additional $580 billion annually. I am not sure how I can maintain optimistic given these facts.
Tobacco and obesity are two distinct issues but because they both detrimentally impact health they are often compared to each other and attempts at eradicating these epidemics are approached in the same way. This is a huge oversight. The overarching distinction is that we do not “need” to smoke but we do “need” to eat in order to sustain ourselves. We have the idea that if we working toward eradicating the issue of obesity as we have done with tobacco that we can expect similar results.
We feel like we are a step ahead because we are “moving faster.” Moving faster does not really matter if we are going about it the wrong way and are not open to seeing these epidemics as two distinct issues requiring the implementation of different treatment modalities. We are proud of the fact that we worked toward imposing additional taxes on sodas and sugary drinks, banned advertising, posted calorie counts on menus, restricted schools from carrying it in their vending machines and forged campaigns that advocate for healthier eating and engaging in physical fitness. This is similar to how we handled tobacco, excise taxes were raised, advertising was banned, warning labels were posted, smoking on airplanes, in government buildings, restaurants, bars, etc. were banned, and campaigns that advocated for healthier lifestyles, therefore reducing the rate of Cancer were forged.
Although all of these measures are helpful ones it does not get to the crux of the issue surrounding obesity that is not effectively being addressed. That being the psychological barriers that get in the way of individuals having the knowledge of what to do and the actual doing. With obesity we expect a quick and easy solution which we are readily able to implement easily and with little sustained effort. Using nicotine replacement therapy, medications such as varenicline, electronic cigarettes, and participating in smoking cessation treatments have been effective methods with tobacco. With quitting smoking we know the triggers and cravings decrease overtime and it is more than possible to avoid being around or exposed to smoking. With food it is not as easy or nearly as possible.
Seeking out the “right” diet, medication, or treatment is not enough, either is temporarily restricting it, taxing it or talking about it. Fundamental change needs to take place at the core, starting with the way we view this issue and methods to process and practice it, as well as the psychological barriers that get in the way of taking effective action, despite the plethora of resources we have available to us need further attention. I will be more optimistic when real permanent sustained change is considered and implemented, until then, I do not see anything to be optimistic about.
