An Ounce of Prevention Is Worth a Pound of Cure

To express the thought behind yesterday’s post another way: Exercise with weight loss as your goal, and you may face disappointment. Exercise to gain dozens of contributory benefits, and for a general feeling of well-being, and you win every day.

Of course, if exercise were the answer to everything, all the time, life would be too simple. Mulling over a color-coded map embodying research from the Robert Wood Johnson Foundation, it is easy to see that in the realm of weight, other factors must be at work. Among the “Percent of adults who are physically inactive,” the most obese states are Mississippi, Oklahoma, Kentucky, Louisiana, and Alabama. It’s as if Mississippi (purple) is the epicenter, with a ring of not-quite-so-bad (red) states around it, and every one of them borders on an orange state. It really is quite visually striking, in a jagged-edged bullseye kind of way.

The blur of reality

Still, many Americans carry a stereotype in our heads about states that tend more toward the rural; a belief that they are populated by wiry farmers, mechanics, horse trainers, etc., who are at the peak of health because their everyday lives entail lots of movement. Today, the residents of those states may not even be particularly slothful, but of course, times change.

A lot of agricultural labor has been automated, so farmworkers are not necessarily doing drastic chores from dawn to dusk. Before the internal combustion engine took over, people in the country, or in semi-rural areas, used to stay fit by walking, chopping wood, and wrangling critters. But although some country folk still do hard physical labor, and get plenty of exercise, a huge number are overweight or obese. (Side note: In the face of all this, it seems paradoxical for city dwellers to blame their obesity on the “built environment.”)

Six of one, half a dozen of the other

Remember “The Bus Conductors’ Secret“? It raised the question: Do strenuous jobs make people fit, or do fit people apply for and get hired for strenuous jobs? Even the most meticulous studies can seem to contradict each other. Does living in a two-story house or an upstairs apartment increase longevity? Do out-of-shape people abandon living quarters that have stairs, or tend not to move in, in the first place? Population “epidemiology” is fraught with missing basic factors, or misinterpretation of cause and effect.

A study of children in Ecuador raised puzzling questions, which we will look at next. The only point where there is consensus is that overweight adults probably started out as overweight children. That seems to be the one truth to which we can stubbornly cling. “An ounce of prevention is worth a pound of cure.”

Your responses and feedback are welcome!

Source: “Physical Inactivity in the United States,”, 2019
Image by Kevan/CC BY 2.0

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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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