Obesity Villains Reconsidered

The word “multifactorial” has been mentioned here many times before. Thanks to life being how it is, a plethora of factors will always be at work, on us and around us, in pretty much every aspect of human existence.

Take the example of auto accidents. Distracted driving is the main cause of them, and then there’s speeding, and drunk driving. Relative to those biggies, the collective impact of deer collisions may be small — but they are still potentially fatal; along with fog, potholes, tailgating, reckless lane-hopping, and other factors that despite being not so statistically prominent, are nonetheless meaningful. Even if deer cause only a fraction of a percent of vehicle accidents, they are still a factor. If those eventualities could be eliminated as factors, so much the better.

The same is true of some of the less frequent or more unlikely-sounding reasons for what has been called the obesity epidemic. Obesity appears to follow the pattern of having not only a gigantic, pervasive cause or two but an arsenal of little tricks to bring people under its sway.

Throwing ideas out there

Inspired by the news that over a billion humans are now obese, Joe Eisenmann, Ph.D., reflects on the many contributing factors that gang up to cause the ongoing epidemic. This writer is described as (among other things) a diverse scholar-practitioner and youth sports coach, who has been on the faculty of four different universities and published 180 scientific papers.

As an academic researcher, some years ago he was included in the group of highly respected obesity scholars who, with Dr. David Allison, wrote a paper called “Ten Putative Contributors to the Obesity Epidemic.” Bearing in mind that “putative” means commonly supposed, accepted or assumed, they are…

increasing maternal age
greater fecundity among people with higher adiposity
assortative mating
sleep debt
endocrine disruptors
pharmaceutical iatrogenesis
reduction in variability of ambient temperatures
intrauterine and intergenerational effects

That entire list would certainly not be endorsed by Dr. Pretlow, but illustrates what the authors meant by saying, “Human weight, body composition and obesity, like other human traits, are part of the multi-faceted complicated human phenotype.” The general multifaceted idea is sound, although experts have different opinions about specifics. The Abstract section of the work says,

While the evidence is strong for some contributors such as pharmaceutical-induced weight gain, it is still emerging for other reviewed factors. Considering the role of such putative etiological factors of obesity may lead to comprehensive, cause specific, and effective strategies for prevention and treatment of this global epidemic.

The authors seem to suggest that, when such important answers are sought, it is important to look at everything, in order to know what should be discarded. This paper proposes that the commonly understood reasons for obesity can be generally sorted into two groups — food marketing practices and institutionally-driven reductions in physical activity — which for convenience, are called the “big two.”

The authors say,

Our purpose here is to expand upon our brief discussions elsewhere and offer a more thorough discussion of factors that may be contributing to the obesity epidemic beyond those conventionally included within the big two.

Each major category includes a large number of sub-categories, some of which are manifestly more harmful than others — but they all do their share, in the big picture. On one hand, a marketing practice that can be regulated and enforced is the inclusion of accurate labels that make full disclosure of ingredients, caloric value, sell-by date, genetic interference, allergens, etc.

But much more difficult matters come under that marketing practice heading, too — like “food deserts.” Government bureaucracies cannot force corporations to build grocery stores where they don’t want to, and that’s that. “Institutionally-driven reductions in physical activity” are not easily addressed, either. It will take more than a few bike lanes and standing desks to make an appreciable dent in obesity.

Your responses and feedback are welcome!

Source: “The 25 Top Causes of Car Accidents in the US,” SeriousAccidents.com, undated
Source: “The Obesity Epidemic — more complicated than diet and exercise,” Substack.com, 03/04/24
Source: “Joe Eisenmann, PhD,” VoltAthletics.com, undated
Source: “Ten putative contributors to the obesity epidemic,” ncbi.nlm.nih.gov, November 2009
Image by Juhan Sonin/CC BY 2.0 DEED

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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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