One size does not fit all – can we curb obesity by capturing its complexity?
In 2011, the Red Cross reported that globally there are more people dying from overweight than from starvation. In most countries obesity rates have kept on rising since. On the one hand, the cause of so-called diet-induced obesity is simple: If you ingest more calories than you expend, than you will gain weight and eventually become obese. From this perspective the solution is simple: just eat less or burn more calories.
On the other hand, most experts agree that obesity poses a complex and multi-factorial problem with serious impact on individual health and health care systems. Undeniably, the complex interactions between our biology (genes, physiology) and (food) environment render a large proportion of the world’s population overweight or obese or at risk for that. Thus, there are no simple solutions. Despite the complexity of the obesity problem most studies compare average responses between normal-weight versus obese individuals, or study the association of one or a handful of features with body mass index (BMI). Given the complexity of the problem this approach, although useful, can only scratch the surface of the problem.
How can we go beyond BMI and and capture the complexity of the obesity problem? In I.Family, a diverse set of measures is obtained from children and their parents. This includes measures as diverse as genetics, neuropsychological profile, physical activity, eating behaviour and taste perception. Together with data on the same individuals from the preceding IDEFICS project this has yielded a dataset with unique potential for examining a variety of factors associated with obesity in concert. Moreover, neuroimaging data on how healthy food choices are made in the brain are being collected. We aim to use this to establish more sophisticated risk profiles. These may help to steer prevention and treatment of obesity, which should be evidence-based and ‘personalized’.
In my opinion, stronger government control is necessary as telling people to eat healthy is not effective. We need to make healthy eating the norm, and create a (food) environment that promotes healthy behaviours. This means better health education in schools, more responsible parents and even banning or taxing energy-dense fast foods. It’s either that or the obesity problem will keep on growing…
By Dr. Paul Smeets, Associate Professor, University Medical Center Utrecht, The Netherlands