Scientists Don’t Agree on What Causes Obesity, but They Know What Doesn’t

By the end of the conference, the attendees were no closer to a unifying theory for the global rise in obesity — a condition that’s been with humans since at least Hippocrates but started to become widespread only after the debut of MTV. Yet in that short period, scientists, including many in the room, ‌‌have learned a lot.

They’ve identified more than a thousand genes and ‌‌variants that increase a person’s obesity risk. They’ve figured out that body fat is much more than a storage depot for energy and that not everyone with obesity ‌goes on to develop its associated complications, which include cancer, Type 2 diabetes, high blood pressure, heart attack, stroke and premature death. They’ve made remarkable progress mapping out how the brain orchestrates feeding and adapts to different diets, altering food preferences along the way. But ‌precisely what changed in recent‌ history to affect these complex biological systems, the scientists couldn’t concur.

Since the meeting, I’ve been struck by the profound gap between the talks I heard and the weight conversation happening in our culture. No scientist spoke of any of the supposed fixes that fill diet books and store shelves‌‌, with the exception of the carbohydrate discussion. There wasn’t serious dialogue about cleanses, diet apps‌‌ or intermittent fasting. No one suggested that supplements could help people lose weight or that metabolisms need boosting. The sole presenter on the gut microbiome argued that the human trials in obesity to date have mostly disappointed.

In other words, there were no quick fixes or magic hacks in that London meeting room. And while there was excitement about medicine’s incredible strides in treating patients with obesity, the effective drugs and surgeries weren’t talked about as end-all solutions for the public health crisis.

When I asked many of the researchers how they’d tackle obesity, given the uncertainties, they pointed to policies that would alter or regulate our environment, like outlawing junk food marketing to kids, banning vending machines in schools and making neighborhoods more walkable. They talked about changing the food system in ways that also address climate change — a related crisis once met with policy inertia that now has international momentum. But when it comes to obesity, governments are still accused of being nanny states if they try to intervene with regulation.

This is in part because instead of viewing obesity as a societal challenge, the individual choice bias dominates. It’s steeped with misunderstanding and blame, and it’s everywhere. People are simply told to eat more vegetables and exercise — the equivalent of tackling global warming by asking the public only to fly less or recycle. Diet gurus and companies mint billions off food and exercise fads that will ultimately fail.

When people can’t control their body weight, they often blame themselves. I recently interviewed a man who, after a brain tumor, developed severe obesity — a common side effect of his condition. The tumor went undiagnosed for months as doctors told him to diet and exercise more. But even today, he told me, the tumor just felt like “another excuse” for longtime weight struggles, so he doesn’t talk about it with anyone.

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