I’ve had so many patients, friends and colleagues ask me this simple question: “Why, with the obesity epidemic running wild, are we so unsuccessful at finding solutions for it, and preventing it or solving it? Can it really be that it’s just our fault as humans, and this is all just about fallibility and lack of personal responsibility?”

I always have to take a big deep breath and say, “No, it is not about personal responsibility and lack of discipline,” although clearly that plays a small role, as it has done throughout time.

But if one backs up and has a wider lens to look at the epidemic of obesity and diabetes, we realize that it’s negatively impacting life expectancy and quality of life across the globe, and that the underlying propensity of humans to lack willpower or discipline has not changed over the decades or centuries.

So, What Has Changed?

What has changed dramatically in these recent decades that correlates closely with the obesity and diabetes epidemics is the environment, and the inputs that are directly intersecting with our genetic makeup. Those would include several things, but of course the number one factor would be the changes in the food supply.

There is a great deal of research describing the change in the genomes of many food staples, including wheat, soy, rice, and corn, in ways that we don’t truly understand and have not fully examined. There may be beneficial effects of some of these changes, some of which came about from hybridization techniques and some from GMO techniques.

I’m not offering blanket opposition to GMO techniques or improvements in agriculture, but it’s clear that key properties of food have changed that are intersecting with our biology, causing unintended consequences of runaway obesity and type two diabetes. And we’ve yet to have a well-organized, galvanized research effort to understand exactly what the mechanisms are that have led to those changes.

My hunch is that the genomic properties of the key food supply ingredients are driving the epidemic, but food science-driven manipulations of our brain chemistry with fantastic flavors, food engineering, advertising, calorie density, and portions likely also contribute to the problem.

There may be many other culprits too. The antibiotics that are used in agriculture and in human and animal treatment are also associated with obesity. There are other factors involved in the food supply, such as the chemicals in pesticides, and our cultural changes, such as more screen time and less outdoor exercise.

My reading of the best research is that screen time is contributing a minority amount compared to the more profound changes of food supply, plant genetics and biochemistry.

Identifying the Real Problem

What’s sorely lacking is a Manhattan project effort at trying to understand why millions of people are suffering and dying unnecessarily from an epidemic that ought to be understandable, solvable, and preventable.

With effort, real science, scholarship, laboratory investigation, and dedicated scientists together with people who can help frame the questions, we ought to be able to get to the bottom of this problem. We need to understand what the precise environmental changes are that are causing runaway obesity, among not just adults and people who are thought to be lacking the necessary willpower, but kids and young adults too.

Certainly, this problem is not a result of humans lacking personal responsibility. This is a problem of environmental biology interacting with our genetic biology through a rapidly changing environment, producing very negative effects in terms of obesity and diabetes.

We don’t hear about it. It’s not a big priority among the major governmental institutions and research arms to understand the number one problem causing death and disease in the US. We have much, much larger research efforts organized at diseases that are affecting a tiny fraction of the humans afflicted with morbid obesity.

That is in part due to the poor understanding and the tremendous bias against people with obesity. The view of those people that it is their fault, and they are the ones who brought this on themselves. It’s a total lack of awareness by most scientists and policy makers.

But when it happens to an entire population, you can’t blame the individuals anymore. You have to begin to look at the factors that are causing it to the whole population.

Taking Responsibility

So, yes, we all need to take greater responsibility. Yes, we all need to eat better. Yes, we all need to exercise more. And we need to do so much more now that there’s a dreadful threat and a new environmental assault on human biology that’s causing obesity and diabetes.

But we also must have a much more organized, much more effective research endeavor to understand the factors causing this terrible epidemic amongst the people in this country and abroad. Everyone deserves better.

That’s my answer when someone asks me that question. It’s a mouthful; I usually lose them somewhere in there when I assert it is a classic environmental disease.

What I hope is that with greater outreach and understanding we will create the public space and resources for a more organized research effort to tackle the number one health problem in this country and around the world. I hope that adding my voice will make some small difference.

Do you think obesity comes from a person’s own behavior? Is each of us responsible for our own weight? Do you think factors such as changes in the environment and food technology may be causing obesity? What’s your take on this global issue?