Tuesday, October 31, 2006

War on Obesity

There is a humourous and somewhat sad article in the New York Times last Sunday on the stigmatization of the obese. The article points out a recent research article that calculates that because of American's increasing girth, a billion extra gallons of gasoline (petrol for you Europeans) are burned each year. That means an extra 3.8 million tons of carbon dioxide. So, yes, obesity is now linked to climate change.

There is a lot of talk these days about the obesity epidemic and what to do about it. Many people still believe it is a lifestyle choice. The molecular biologists in the field believe that it is a genetic problem and can only be solved pharmaceutically. Not surprisingly, those most vocal about the magic pill fix also seem to have the most patents and biotech ventures on the side. While both of these points of view are probably true in some sense, they both kind of miss the point. I think that the main reason people are gaining weight is that for our current environment, it is the natural thing to do.

We live in a world where food is extremely cheap and plentiful and exercise is optional. The most logical thing to do it seems is to gain weight and plenty of it. The health consequences of this extra fat will likely not affect most people for many years. Although the incidence of insulin resistance and diabetes is increasing, it is still not clear if moderate weight gain is really all that bad. To quote Katherine Flegal of the Centers for disease Control and Prevention from the Times article: "Yes, obesity is to blame for all the evils of modern life, except somehow, weirdly, it is not killing people enough. In fact that's why there are all these fat people around. They just won't die.”

So what should we do about it? After, three years in this field, I've come to the conclusion that there really isn't much we can do about it on the individual level. Our metabolic systems are so geared to acquiring calories that I believe any pharmaceutical option will likely not be effective in the long run and/or have many side effects. From studies our lab has done on food records, it is quite clear that people generally have no idea how much they eat. I doubt people can will themselves to lose weight. I think the only thing that would work is a wholesale change of our society that would increase the cost or reduce the availability of food and motorized transportation. This is definitely not going to happen by choice or design. So barring a great depression or massive crop failure (which could happen), I think we're just going to have to live with all the extra weight.


Daniel said...

You are probably right about the possibility of a pill "fixing" obesity. One question that I am curious about is whether humans will evolutionarily adapt to this new condition. Which actually opens up the whole bag of human sociology and evolutionary pressure, so I will stop there.

Carson Chow said...

Given that obesity isn't that lethal, I doubt it will have very much evolutionary pressure on its own. However, if thin people tend to marry thin people while overweight people marry overweight people, then that could lead to a separation in the populations. However, it would probably take a minimum of 100 or so generations to notice anything. I would presume that the environment would drastically change before this happened.

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