Red Herrings or Promising Leads?

This picks up from the previous post about “Behavioral Research Agenda in a Multietiological Approach to Child Obesity Prevention,” which looked briefly at three accused obesity villains — infectobesity, dysbiosis, and circadian rhythms. The authors write,

In a multietiological approach, any particular child may be subject to influence by multiple etiologies simultaneously. It is not clear how each etiology interacts with each other or with a complex dynamic energy balance model (including neurological and hormonal influences).

In other words, the entire field is a hot mess, and the editorial confirms that, at this point, what we don’t know far outweighs what we do know. Etiology has to do with causation, and over 100 different factors have been suggested, tested, and sometimes confirmed as influential in the struggles of humans to control their eating and, consequently, their weight.

Add in the fact that any individual may be subject to quite a large number of disparate influences, and chaos ensues. Once the energy balance model has been demoted from omnipotence, which in many minds it has been, the multifactorial possibilities are bewildering. Figuring it all out is like piecing together the confetti from a cross-cut paper shredder. The enormous number of pieces make it difficult to prove anything.

Heroes of multifactorialism

Dr. Angelo Tremblay of Laval University, Quebec, is also holder of a Canada Research Chair in Environment and Energy Balance. His obesity research achievements include the publication of hundreds of papers (which accrued thousands of citations) on clinical medicine, biology, and biochemistry.

Journalist Gary Taubes interviewed Dr. Tremblay, who at that point had been collaborating for over 20 years with geneticist Claude Bouchard, Ph.D., as he discussed one of the phases of the Quebec Family Study:

We documented the importance of short sleep duration, dietary restraint, dietary disinhibition, low calcium intake, low participation in vigorous physical activity, low vitamin intake, high fat diet, and high alcohol consumption. To my knowledge no other study has documented the relative importance of these different environmental factors in terms of their predictability of overweight.

Or, as they phrased it in “Findings from the Quebec Family Study on the Etiology of Obesity: Genetics and Environmental Highlights”:

Obesity is a complex trait resulting from multiple interactions between genetic and behavioral factors. The identification of all putative contributors to the obesity epidemic is critical to our understanding of the conditions under which weight gain occurs…

Given all this, it may be too soon to say of any particular factor that it does or does not influence obesity, or how extensive that influence may be.

Your responses and feedback are welcome!

Source: “Behavioral Research Agenda in a Multietiological Approach to Child Obesity Prevention,”, 03/29/19
Source: “Angelo Tremblay on the Environmental Risk Factors for Obesity,”, August 2010
Source: “Environmental Highlights,” January 2014
Photo credit: See-ming Lee (SML) on Visualhunt/CC BY-SA

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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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