Why is the world getting fatter (and what we can do about it)

Barbara Corkey, PhD, has been the editor in chief of the journal Obesity for the past 20 years, so you can trust that she’s immersed in research of the causes, consequences and treatment of obesity. 

In these 20 years obesity rates in the US increased from 30 to 42 percent, and the rates of extreme obesity doubled (rising from 4.7 to 9.2 percent). Diseases for which obesity is a risk factor – such as type 2 diabetes, heart disease, stroke and some cancers – are correlated with the severity and duration of diabetes, therefore the appearance of obesity at younger and younger ages suggest a tsunami of these chronic diseases.

Corkey writes, in a recent editorial, that we humans “have developed a method to feed the billions of people on the planet, by developing processing of food with preservatives and other chemicals that can make food last longer and make it cheaper to increase calorie density in small packages.”

The cause of obesity, according to the editorial, is the foods that we make, and society overfeeding on them. 

The most consumed foods in the US are highly processed foods, topping the list are things like grain-based desserts (cakes, cookies, donuts, granola bars), chicken dishes, soda and other sugary drinks, pizza, alcoholic beverages, pasta, and beef dishes. Notably missing are fruits and vegetables and whole, unprocessed foods.

We’re now fighting for our health in a world that we humans have changed.

Surgery, drugs and the promise of culinary medicine

What does medicine offer to treat obesity? Key developments, according to Corkey, include bariatric surgery, which according to a recent study in the New England Journal of Medicine increases life expectancy by 3 years compared to the control group – but it's still 5.5 years shorter than the general population's. As to medications, there’s hope: “Novel drug combinations are beginning to close the gap with bariatric surgery and they appear to be very powerful new tools to treat obesity as a disease.”

The great hope, however: Culinary medicine. This is a new evidence based field, that combines nutrition and cooking know-how, in order to help people prevent disease and maintain health by promoting good eating habits. Culinary medicine has been added to the curricula of more than 55 medical schools, residency programs and nursing schools. The advantage of these kinds of interventions is that they can – and should – be started early, really early, before obesity sets in, and not just when illness manifests itself, and that there are no negative side effects.

Health meets food

Turning to your doctor to address obesity and diet-related afflictions is of course just one of the options at hand. 

Physicians used to get only rudimentary nutrition education as part of their training, and if they do have culinary skills it’s due to personal interests and pursuits, and not their medical education or the hospital lifestyle. Culinary skills can be gained in any number of ways: from friends and relatives, from videos and TV, from books and websites. The only way to get food that’s inexpensive, and that’s healthy for humans and for the planet is by getting cooking and preparing meals.

Much like in dentistry, where a visit with the clinician includes guidance on how to brush, floss, and strengthen your teeth, the visit with health professionals should include wellness counseling, especially nutrition education.

And cooking can also provide comfort and lots of joy. There are too many barriers to simple home food preparation, but to reverse the trend we're on, we'll have to overcome those.

Dr. Ayala