Where Do We Start To Overcome Obesity?

Dr. James Hill recaps his talk on Obesity from the AHA Annual Conference on Cardiovascular Disease Epidemiology and Prevention – Nutrition, Physical Activity and Metabolism (EPI NPAM) Meeting in 2014.

What We Have Learned About Obesity

Unfortunately, the last 50 years is not a success story in obesity. Obesity rates have gone up and up over past 50 years.

What have we learned? We started out looking at obesity as a problem in physiology. There was something was wrong and we wanted to fix it. What I think we learned is that the physiology is working just fine. What we need to fix is the environment.

We’ve created over the last 50 years an environment where food is plentiful, it tastes very good, it’s served in large portions and it’s inexpensive. So our biology says basically to eat when there is food available. And we do.

We have created an environment when we don’t have to be physically active. And our biology says to rest when you don’t have to be physically active. So we rest.

We now have an environment that pushes us to eat and rest and therein lies the problem.

Moving Forward

The challenge is to find the “why.” Why do people want to change that? So we talk about this environment with good tasting food and big screen tvs and automobiles. Most people aren’t lining up to say take those away. They like them. How do we tweak the environment so that we have the things we like, and yet obesity is low?

One of the ways I look at it is it’s supply and demand. You can’t make healthy choices if healthy options aren’t available. So we need to continue to do that. But we really need to do some work on the demand side. Why? Where’s the demand for healthy options?

To do that, we have to look at how we value health in the present. Right now, it’s “make these good choices and 20 years later you won’t get heart disease or diabetes.” That’s not very powerful in the moment.

Change the paradigm and look at health not as the output. Health is a result of everything else we do. Good health now becomes the input. It becomes the fuel for prosperity. Allows us as an individual, as a family, as a community or a population to achieve what we want to achieve. It’s the good fuel that allows us to do what we want to do.

where do we start to overcome obesity?

We start in schools and work sites where we relate good health to performance. It’s not about healthcare costs, its about healthy employees doing better for the bottom line. It’s not about kids being healthy as much as healthy kids learn better so kids are learning better.

So I think we start in schools and work sites. It branches out to the community. And we have to continue to provide healthy choices. We have to work hard to figure out reasons to get people to choose those healthy choices.


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