Views on obesity: Difficulty changing eating habits; Huge changes in the food marketplace

Sep 20 2012

The New York Times and the Journal of the American Medical Association offer opinions on the U.S. battle against obesity.

The New York Times: Classifying Calories
Starting this week, McDonald's is posting calorie information for all items on its menus across the United States, part of a movement to improve diets and reduce obesity by providing nutritional data. New York City has mandated that chain restaurants post calories since 2008, and the federal health care law adopted in 2010 will eventually require fast-food restaurants across the United States to do so. While the alarm over obesity is fairly recent, the notion of using "scientific" knowledge to guide the dietary habits of ordinary people -; particularly the less well off -; is not. The fate of earlier campaigns suggests that it will take much more than calorie information to change food ways (Bruegel, 9/18). 

Journal of the American Medical Association: The Role of Government in Preventing Excess Calorie Consumption
As the obesity epidemic has mounted during the last few decades, Americans' genes have not changed, but the "food environment" has changed markedly. Food has become increasingly ubiquitous, convenient, calorie-dense, offered in large portion sizes, and heavily marketed. Many foods contribute to excess calorie intake, but sugary drinks have drawn particular blame because of the near-tripling of consumption since the 1970s and their association in epidemiologic studies with obesity, weight gain, diabetes, and markers of cardiovascular disease. The increase in portion sizes of these beverages is important because studies consistently show that when people are offered larger portions they simply consume more without recognizing it and without compensating for the increased consumption by decreasing intake later (Dr. Thomas A. Farley, 9/19).

Journal of the American Medical Association: The Next Generation of Obesity Research: No Time to Waste
The obesity epidemic is not the first major health crisis that the United States has faced. In recent decades, progress has been made against such daunting challenges as tobacco use, infant mortality, and HIV/AIDS. However, obesity may pose the most significant challenge yet because it involves changing approaches to 2 fundamental aspects of daily life: food consumption and physical activity (Dr. Griffin P. Rodgers and Dr. Francis S. Collins, 9/19).

Journal of the American Medical Association: FDA Approval of Obesity Drugs: A Difference in Risk-Benefit Perceptions
Given the obesity epidemic, patients and physicians are in need of safe and effective treatments. Companies are responding with significant investment in drug development. Drugs provide an important therapeutic option when lifestyle modifications are insufficient for achieving weight loss goals and when surgery is not desired or warranted. However, in the last decade, 3 obesity drugs were removed from the US market, and until last month, only 1 new obesity drug has been approved since 1999 (Elaine H. Morrato and David B. Allison, 9/19).

Journal of the American Medical Association: Progress In Obesity Research: Reasons For Optimism
Treating obesity has also proven elusive. Changing lifestyle is difficult and usually ineffective. Few drug options for weight loss exist, and bariatric surgery, while effective, is reserved for the morbidly obese. Thus, it is tempting to consider obesity an intractable problem and walk away from it. Fortunately, many dedicated researchers, clinicians, and policy makers have not given up. ... Prevention is the best treatment. Successful prevention requires disentangling the factors responsible for the obesity epidemic (Dr. Edward H. Livingston and Dr. Jody W. Zylke, 9/19).