Population-Based Prevention of Obesity

Almost one month ago, in the July 22 issue of Circulation, the magazine of the American Heart Association, sick care, at least this segment of it, surrendered to the overweight/obesity epidemic and raised the white flag.

Though it did not have the courage to say so publicly, the AHA Scientific Statement included the following. They are but a sampling of the admissions contained in the article. I added the emphasis and some comments after each quote. The comments are in italics.

You decide if these are the words of people who either know what they are doing or those whom you want to have as your leaders. If you think that I went cherry-picking, follow the link in the title and check it out for yourself.

The proportion of adults and children who are obese has reached epidemic proportions, moving steadily away from the Healthy People 2010 goals of 15% prevalence of obesity in adults and 5% prevalence in children. These goals may be beyond our reach for several decades to come.

A clear admission of failure and the protracted nature of the overweight/obesity problem, despite years of sick care involvement.

However, even those overweight people who are able to lose weight are often unable to maintain their weight at that level, and no clear guidance currently exists on definitive strategies to achieve long-term weight loss in the population at large.

There is no maintenance strategy, so even if some people lose weight, the sick care establishment has no plan on how people can keep it off.

Besides the limited long-term success of most obesity treatments, another factor is the limited ability to deliver enough treatment to enough people. We are already unable to deliver obesity treatment services to those who need such services, while the numbers needing treatment are rising.

Success of so-called treatments is limited, i.e., not very good, and these bad treatments cannot, thankfully IMHO, be directly inflicted on more people.

For treatment of obesity, a large reduction in caloric intake of about 500 to 1000 kcal per day, along with increased physical activity, can produce a loss of approximately 8% to 10% of body weight over the relatively short period of about 6 months.

Read here, here, here and here on how this is the IMHO path to nutritional homicide.

The analogy is used to make the point that the clinical approaches in which we are so well trained and perhaps confident can never be sufficient to solve widespread population health problems unless broad-based population strategies are also applied.

Clearly "clinical approaches," i.e., sick care, "can never be sufficient to solve widespread population health problems." If overweight/obesity were truly sick care problems, then the tools of sick care would be sufficient. Think about certain illnesses, i.e., real medical problems. We do not hear of a need to apply a broad-based population strategy for strep throat. Or gallstones. We do not hear of a a broad-based population strategy needed to prevent or treat them.

In contrast to the extensive database available on obesity treatment, research to identify specific interventions to prevent obesity is still at a relatively early stage.

Despite all the decades of talk about diet and exercise, they claim the truth is "research to identify specific interventions to prevent obesity is still at a relatively early stage," i.e., they do not know what to do or what works. Nor will they ever so long as they ignore the controlling fact that overweight/obesity is not a medical problem and is not amenable to the tools of medicine.

Given that the ultimate determinants of obesity are individual eating and physical activity behaviors, the perception that one can solve the problem by refining the ability to help individuals to change their behaviors will persist.

This is a certain admission that no matter what is done in the name of genetic "cure," infectious "cure," hormonal "cure" or any other "cure," none of it matters. Only more Calories in than out does. So why is a single stinking penny being spent on these other non-causes and why isn't the AHA calling for a moratorium on that garbage? If any of these other "interventions" made a difference, "individual eating and physical activity" would not be the "ultimate determinants" of overweight/obesity. Further you cannot overcome any "ultimate determinants" by any other means except changing those behaviors. Period. End.

Although the picture of how to intervene is far from complete, guidance and research recommendations developed by various expert panels, working groups, and systematic reviews have led to an increase in obesity prevention research.

Despite the incompleteness of the picture, the AHA claims there are experts, groups and reviews that have done no better than to increase "research" not solutions. How would they know that they are experts? Maybe what it incomplete in their picture makes them nothing more than idiots on a Quixotic quest. It is not a maybe. And they want to be compensated handsomely for their misguided efforts based on their incomplete "picture of how to intervene."

But what is arguably most damning of all, if you read the article, is the complete abdication of any responsibility to act according to the law and save the children.

These IMHO lawbreakers, cite illness after illness and social/emotional problem after social/emotional problem kids develop from the nutritional child abuse they see and don't once step up to their responsibilities under CAPTA or call for responsible behavior from their colleagues under CAPTA.

They do however, offer ways for them to still profit from the problem they cannot and will never be able to solve.

Call for an end to the duplicity and lawless behavior of the sick care establishment.