Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How can we really stop obesity?

Albert Do, MD, MPH
Conditions
February 6, 2019
Share
Tweet
Share

I met a young man in my clinic recently, who came for treatment of obesity.

He was only 26, yet suffered from obesity throughout his life — now reaching a debilitating 420 pounds. His explanation for how he developed obesity was a reflection of the issues surrounding nutrition health policy in the U.S. He said that “it would have been easier to not put the weight on to begin with,” that he was “too poor to eat healthy,” and that he “wished there were programs that help with this.” Despite the perception that obesity is a personal failing, there are social and political reasons for the current obesity epidemic, which need to be treated from a health policy intervention.

The most effective way to treat obesity is through prevention. The most effective way to prevent obesity is through factors leading to unhealthy dietary intake. Changing the food environment — the physical, social, economic, cultural and political factors that make impact accessibility, availability and adequacy of food — is the way reverse the course of obesity.

It is well-known that obesity is seen more commonly in those with the highest poverty and the lowest education rates. Poverty leads to less food security: limited or uncertain availability of nutritionally adequate and safe foods. This has been linked to increased risk of obesity, irrespective of whether one experiences hunger. The source of the obesity epidemic is complex and involves genetic, psychological, environmental, social and economic factors. However, obesity’s rise is in-part driven by high-fat, high-salt and high-sugar foods available at low cost. This clearly afflicts those already in most need. Higher obesity rates are seen in areas with fast food restaurants and convenience stores, and I have heard stories from those who eat fast food or junk food attributed to limited financial means and the need to “be responsible and efficient” in their finances.

Policy interventions for obesity should play a role in combating obesity and would have dramatic public health direct and spillover effects, given the estimated 250 complications from obesity. This approach would represent an upstream-based intervention which potential for deeper and expansive effects as diseases are prevented, leading to societal improvement and reduced costs. Food access and security have been argued as a socioeconomic issue and, thus, a health policy issue. Making policy-based solutions to increase food security may modify the economic incentives to eat healthier, especially among low-income households. Poverty has undeniable harms effects on health and disproportionately affects ethnic minorities. There have been reports of a so-called “food insecurity-obesity paradox,” where there is an observed association between the food insecurity and higher obesity prevalence in the presence or absence of hunger. This irony results in two separate effects: the burden of food insecurity and limited nutritional choice discretion, as well as the adverse outcomes associated with excess weight and obesity.

Legislation can target both healthy food access and affordability given the potential cost of fresh foods, an oft-cited reason for fast-food consumption in lower-income regions. For example, food assistance program expansion through numerous programs — like Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), among others — may increase equity through improvement for a broad age group. However, although increasing individual means may play a role, further research in the effects and solutions for food deserts (areas without fresh fruit, vegetables, and other healthful whole foods) and interventions are essential to allow for affordable, healthy food options. Another consideration would be providing incentives for the opening of supermarkets, to increase food access. Obesity prevention through modification of the built environment and improved food access will likely benefit all members of a given household. Given the worrisome patterns of obesity in both the adult and pediatric populations, this intervention serves to potentially benefit members of all ages of a household in contrast to school-based or workplace-based interventions.

Although it may seem paradoxical to propose improving food access to combat obesity in the U.S., there is some truth to the idea that unhealthy foods are less expensive. Think about that fried chicken family dinner or the burger combo at the fast food drive-thru. We are currently living in a time of widespread nutrition access at low costs. In the U.S., we are in a time of “feast-rather-than-famine,” coupled with technological capability to create nutritionally-dense foods and our evolutionary biological skill in storing excess calories. These factors would naturally result in obesity.

As a society, we are in dire need to transition to a healthy lifestyle and diet. We must take healthy food access seriously if we are to effectively prevent and treat obesity as it continues to worsen. Despite the difficulty with measuring weight gain that was prevented, we must accept this challenge and the faith required in knowing that in the future. We can understand the policy measures set in place leading to reduction in weight gain in the industrialized world, only after we have set the laws in place to treat it. We know obesity burdens society through costs and immeasurable effects, and only swift action now will stop it.

Albert Do is a gastroenterologist.

Image credit: Shutterstock.com

Prev

How an insurance company auditor tried to destroy a physician's career

February 6, 2019 Kevin 54
…
Next

How to say "no" to kids

February 6, 2019 Kevin 0
…

Tagged as: Obesity

Post navigation

< Previous Post
How an insurance company auditor tried to destroy a physician's career
Next Post >
How to say "no" to kids

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Albert Do, MD, MPH

  • Call obesity what it is: a disease

    Albert Do, MD, MPH

Related Posts

  • Why do we think obesity is caused by lack of exercise and not junk food?

    Martha Rosenberg
  • Who’s really to blame for the obesity epidemic?

    Peter Ubel, MD
  • Beware of food sensitivity tests on Facebook

    Roy Benaroch, MD
  • What if people were only allowed to use food assistance dollars to buy healthy food?

    Peter Ubel, MD
  • When celebrities attack children with food allergies

    Lianne Mandelbaum, PT
  • Food allergies are frightening, not funny

    Lianne Mandelbaum, PT

More in Conditions

  • How kindness in disguise is holding women back in academic medicine

    Sylk Sotto, EdD, MPS, MBA
  • Measles is back: Why vaccination is more vital than ever

    American College of Physicians
  • Hope is the lifeline: a deeper look into transplant care

    Judith Eguzoikpe, MD, MPH
  • From hospital bed to harsh truths: a writer’s unexpected journey

    Raymond Abbott
  • Bird flu’s deadly return: Are we flying blind into the next pandemic?

    Tista S. Ghosh, MD, MPH
  • “The medical board doesn’t know I exist. That’s the point.”

    Jenny Shields, PhD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician
    • Reimagining Type 2 diabetes care with nutrition for remission [PODCAST]

      The Podcast by KevinMD | Podcast
    • How AI is revolutionizing health care through real-world data

      Sujay Jadhav, MBA | Tech
    • Ambient AI: When health monitoring leaves the screen behind

      Harvey Castro, MD, MBA | Tech
    • How kindness in disguise is holding women back in academic medicine

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why physician voices matter in the fight against anti-LGBTQ+ laws

      BJ Ferguson | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician
    • Reimagining Type 2 diabetes care with nutrition for remission [PODCAST]

      The Podcast by KevinMD | Podcast
    • How AI is revolutionizing health care through real-world data

      Sujay Jadhav, MBA | Tech
    • Ambient AI: When health monitoring leaves the screen behind

      Harvey Castro, MD, MBA | Tech
    • How kindness in disguise is holding women back in academic medicine

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why physician voices matter in the fight against anti-LGBTQ+ laws

      BJ Ferguson | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How can we really stop obesity?
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...