WALL•E and a scary, obese future

But we can take action now to address an obesity epidemic

Pixar’s new animation film WALL•E bravely tackles two global issues. It takes on the environmental issue, and audiences are sure to appreciate that. But it also makes a statement about fitness and the obesity crisis, and I wonder how comfortable – or uncomfortable -- moviegoers will feel about the mirror this film holds up to ourselves.

(Modest spoiler for the next two paragraphs!)

Viewers will see mankind portrayed as so grossly overweight and unfit, that they’re unable to walk or care for themselves. Our descendants move about in automated chairs, continuously chatting, surfing and entertaining themselves through chair-mounted video screens.

And, as a symbol of how humankind got to their enormous girth, is the ever-present super-sized drink -- always near by, always ready to be gulped.

(OK, spoilers are finished.)

This cautionary tale of what mankind’s future could be like is, of course, an exaggeration, but there is serious concern that our environment has become so “obesogenic,” that the natural outcome of going with the flow results in continuous weight gain, and deteriorating health.

Weight loss and overweight prevention

As we all know, there are countless ways to treat overweight conditions and obesity. In fact, a new diet -- with the same promise -- seems to be invented every moment.

While the best way to lose weight and keep the weight off is still debated, what is very clear is that the treatment of obesity (with a goal of weight loss) is very challenging, and sustaining a lower weight is a continuous lifetime undertaking.

Much less research and emphasis is placed on weight gain prevention. I was therefore excited to read the American Heart Association recently published a scientific statement in Circulation (a weekly, peer-reviewed publication) in which it calls for a comprehensive, population-based strategy for obesity prevention.

The statement says population-based initiatives targeting eating and physical activity, geared toward prevention of weight gain in adults and children, are “essential.” By treating the population at large, and modifying the environment to one that facilitates healthier choices weight gain prevention should be easier, and individuals will be less prone to weight gain even if they’re not highly motivated and actively trying to control their weight.

An editorial by Dr. Reginald L. Washington titled “Prehab versus Rehab: The Winner Is Clear”, accompanies the paper and explains:

“Perhaps prehabilitation would be more successful in decreasing obesity in populations. This is primarily because there are two components to the obesity epidemic: individual participation and population factors that cannot be controlled by individuals. These population issues need to be addressed before an individual becomes obese, and this prevention can be viewed as prehab.

Citizens live in an obesogenic environment. This is a toxic environment in which there are multiple factors promoting obesity at the same time. Not unless and until all of these factors are simultaneously addressed and reduced will the obesity epidemic decrease.

The majority, but not all, of these obesogenic factors are out of the individual's control. An example would be the convenience and availability of fast foods. Individuals may try to eliminate or decrease the consumption of fast food in their diet. However, they are bombarded with fast food commercials in the media.

Additionally, the convenience, taste, and cost of fast food often make these items irresistible, particularly to people who have limited financial resources. The prevalence of fast food restaurants in lower socioeconomic environments adds to the problem. It is very difficult in these environments to find affordable and presentable fresh fruit. On the other hand, it is extremely easy to find affordable, convenient, and tasty fast foods. There are few supermarkets and healthy restaurants in these neighborhoods. These are examples of population issues and individual issues acting together to prevent the decrease of obesity.”

I truly believe we need to do something about changing our food and activity environment. We can all start with our own home, and make our pantry one that has mostly or only healthy choices, and develop a routine that gives us plenty of physical activity.

We can then move on to the larger circle of influencing the food environment in our kids’ schools, summer camps and extra- curricular activities (is it, for example, really necessary to give out snacks and sugary drinks after every soccer game?).

The bigger changes we need are admittedly harder -- legislation and policy changes interventions, as well as infrastructure investment in walkable and bikable neighborhoods, are indeed daunting tasks.

But unlike our future selves portrayed so chillingly in WALL•E, we have to get motivated about obesity prevention, because treating obesity and its health consequences is so much more difficult and costly.

What steps do you suggest for making our environment healthier?

Dr. Ayala