Can’t Get Enough of That Flaky Fringe

Kid Playing in the water

In desperation, people have come up with all kinds of ideas to end childhood obesity. One alarming headline went like this:

Use law enforcement to get people to change eating habits, says UCLA panel…

Yikes! That point of view is far from mainstream, and does in fact qualify as fringe. Who says a thing like that? Sarah Rothbard does, via a website called Zócalo Public Square. The subtitle of the piece is “How Health Propaganda Will Play Out In the Years Ahead,” and the main question is, what will cause people to change their ways?

Two things, concluded the UCLA panel — time, and engagement on several fronts. Jonathan Fielding, who is Director of Public Health for Los Angeles County, offered a very quotable analysis:

Policy is not a dirty word. Public health works by successive redefinition of the unacceptable.

Health economist Frederick J. Zimmerman frames the debate in terms of freedom, power, and personal responsibility. The freedom angle is worth attention, Zimmerman believes, because if people become aware of how they are being manipulated by advertising, their sense of autonomy will kick in and they will refuse to be the passive, unwilling tool of the food industry any longer.

There is also a general feeling that awareness of societal problems, cultivated by the media, is not enough. Only when policies and incentives are combined with awareness, does change occur. Some policymakers are in favor of “nudges” or what the recovery community calls “baby steps.” One panelist talked about the increase in vegetable consumption achieved when a school cafeteria replaced the serving spoon with a larger one.

What changes people?

Sometimes the weirdest or most objectionable concepts turn out to be astonishingly viable in the real world, where emotions run rampant and take control of people, and chocolate-covered bacon is available at every major intersection. But a difference in behavior can result from just making the acquisition of a snack a bit more of a chore.

This is why some people favor the seemingly silly rules like limiting the size of soda pop containers. If the customer starts out with a smaller cup, maybe going back for a refill will just be too much trouble, and a few hundred calories will be avoided.

Neurobiologist Stephen Guyenet, author of Seduced by Food — Obesity and the Human Brain, doesn’t buy the idea that common obesity is mainly caused by elevated insulin level due to carbohydrate consumption, and periodically updates his key post on the subject, which apparently is so controversial that it has attracted more than 500 comments. Among other things, it says:

Carbohydrate consumption per se is not behind the obesity epidemic. However, once overweight or obesity is established, carbohydrate restriction can aid fat loss in some people. The mechanism by which this occurs is not totally clear, but there is no evidence that insulin plays a causal role in this process…

The brain is the primary homeostatic regulator of fat mass, just as it homeostatically regulates blood pressure, breathing rate, and body temperature… To understand obesity, we have to understand what causes increased food intake, and that factor is not insulin.

All of which goes to show that the answers are far from determined. Furthermore, for all we know, some of them might lie in the regions now thought of as far-out and science-fictional.

Your responses and feedback are welcome!

Source: “We’re Going To Attack Your Donut Eating On All Fronts,”, 02/27/13
Source: “The Carbohydrate Hypothesis of Obesity: a Critical Examination,” Whole Health Source, 08/11/11
Image by Beatrice Murch.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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