Globesity – How Bad Can It Get?

GlobesIt is a challenge to find a source that has a good word to say about the future of globesity. Mostly, the prognosis is grim and the predictions are dire. The World Obesity Federation predicts that by the year 2025, one billion of Earth’s grownups will be obese. According to projections made by the McKinsey Global Institute (MGI):

If the prevalence of obesity continues on its current trajectory, almost half of the world’s adult population will be overweight or obese by 2030.

The Institute’s discussion paper, “Overcoming obesity: An initial economic analysis,” is described as presenting “an independent view on the components of a potential strategy” based on information gathered about 74 different interventions that are being either talked about or tried, somewhere in the world. The highlights of the report are not encouraging. If we look at the evidence, “no single intervention is likely to have a significant overall impact.”

The report also points out that while education and personal responsibility mean a lot, they don’t mean everything. They are necessary but not sufficient conditions. The new understanding is that lifestyle modification is not the whole picture. The Obesity Society, for instance, says:

We must ensure that appropriate attention is paid to the many factors that influence weight and health.

Or as the MGI phrased it:

Obesity is a complex, systemic issue with no single or simple solution.

Earlier this year, a series in the journal Lancet examined public health programs that exist in different parts of the world. In avoiding obesity, it is important to have fresh natural fruits and vegetables, and to expend an appropriate number of calories. But the international anti-obesity establishment has moved beyond the energy in/energy out paradigm.

In The Atlantic, Olga Khazan told readers about a study from York University in Toronto, which was published by Obesity Research & Clinical Practice:

It’s harder for adults today to maintain the same weight as those 20 to 30 years ago did, even at the same levels of food intake and exercise…In other words, people today are about 10 percent heavier than people were in the 1980s, even if they follow the exact same diet and exercise plans.

How can this seemingly inexplicable condition exist? Think of the implications. A lot of the “personal responsibility” rhetoric goes out the window. Being obese is not necessarily a person’s fault, or even a person’s mother’s fault.

What are the factors other than diet and exercise? Professor of kinesiology and health science
Jennifer Kuk offered three hypotheses. One of them is that chemicals in the environment change our hormones in ways that induce weight gain. People take in a lot of antibiotics and hormones indirectly. It’s like second-hand smoke, and very difficult to avoid in this modern world. Artificial sweeteners are probably an obesity villain—although it is one that could be avoided if people really wanted to pay attention and limit their menu choices a lot.

Also, millions of people are taking prescription antidepressant meds, whose propensity to cause weight gain is now beyond doubt. The third suspect Prof. Kuk mentions is the controversial microbiome. The world of gut bacteria has just begun to reveal its secrets, and once the optimal balance of populations can be understood, it can be manipulated for benign purposes. So it may be too pessimistic to assert that Americans’ BMIs are “influenced by factors beyond their control.” That particular inner universe appears to be amenable to an extensive amount of control.

The World Obesity Federation’s main candidate for obesity villain, by the way, is Big Food, the conglomeration of international food corporations that sell untrustworthy products and advertise shamelessly to children. Indeed, there is plenty of blame to go around.

It has become impossible to deny that the puzzle has many levels. It isn’t tic-tac-toe, it’s three-dimensional chess. Like quantum physics, the obesity puzzle contains some mind-boggling discoveries that continually demand further research, because some things just don’t seem to make sense. On the other hand, as MGI says, “while investment in research should continue, society should also engage in trial and error, particularly where risks are low.”

Your responses and feedback are welcome!

Source: “Global obesity rise puts UN goals on diet-related diseases ‘beyond reach’ ,”, 10/09/15
Source: “How the world could better fight obesity,”, November 2014
Source: “A Broader, Global Approach to Obesity Treatment and Prevention,”, 02/20/15
Source: “Why It Was Easier to Be Skinny in the 1980s,”, 09/30/15
Image by Paul L Dineen

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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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