Cutting the Fat: The New Scientific Narrative of Obesity

US readers: Before heading into Thanksgiving dinner tomorrow, you might want to read science writer Julia Belluz’s new piece on what science has discovered doesn’t cause obesity.

In a word: You.

Just don’t expect Uncle Chester to understand.

Rates of obesity have risen sharply across the world over the last four decades. Why? Science has a million theories, but no answer, as Belluz found out when she attended a recent scientific conference at the Royal Academy in London titled “Causes of obesity: theories, conjectures and evidence.”

Conference papers blamed everything from a surfeit of dietary fats and carbohydrates to ultraprocessed foods, fertilizers, insecticides, plastics, additives, genetic mutations and disorders, and the hunger-obesity paradox. As the biologist John Speakman (quoted by Belluz) summed up the proceedings: “There’s no consensus whatsoever about what the cause of it is.”

But, as Belluz reports, “the three-day meeting was infused with an implicit understanding of what obesity is not: a personal failing”:

No presenter argued that humans collectively lost willpower around the 1980s, when obesity rates took off, first in high-income countries‌, then in much of the rest of the world. Not a single scientist said our genes changed in that short time. Laziness, gluttony‌‌ and sloth were not referred to as obesity’s helpers. In stark contrast to a prevailing societal view of obesity, which assumes people have full control over their body size, they didn’t blame individuals for their condition, the same way we don’t blame people suffering from undernutrition challenges, like stunting and wasting.

The researchers instead referred to obesity as a complex, chronic condition, and they were meeting to get to the bottom of why humans have, collectively, grown larger over the past half century. To that end, they shared a range of mechanisms that might explain the global obesity surge. And their theories, however diverse, made one thing obvious: As long as we treat obesity as a personal responsibility issue, its prevalence is unlikely to decline.

Belluz is fascinated by the disjunction between a) how science views the obesity epidemic (as a condition imposed on society by environments and systems, as she puts it) and b) how culture sees obesity: as a problem of individual choice. With obesity rates in 53 countries exceeding 25% of the adult population, there aren’t too many scientific problems for which a solution — or even for which a shift in framing what the problem really is — would have bigger public impact.

Of course, there is currently no real disjunction between a) and b), because in the mind of everyone except scientists (and that includes the media, the medical community and Uncle Chester), the only true narrative about obesity is a). Belluz discovered what I’ll call this new scientific narrative of obesity — that obesity is structural, for reasons yet to be determined, and individual attempts to avoid it a rigged game — because the narrative needed the conference to crystallize it.

What fascinates me is that we’re at the very beginning of launching this new scientific narrative — and it’s hard to imagine who or what would be up to that monumental task. Certainly not science and science communications — that would be the quintessential knife brought to a firefight. How many decades of papers would it take to turn the tide in public prejudice, if ever? (The Royal Society will eventually publish the conference proceedings.) Who would be the brave crusading public experts and celebrities? Which foundations or billionaires would fund the public education campaign? (Sarcasm font.)

One of the underexamined questions in the wake of climate science’s failures over the better part of two decades to sway public opinion through conventional science communications remains: How do we set it up better next time? Because that question matters to any big issue for which the prevailing science needs to overcome cultural bias and stigma. (To understand this bias, read Belluz on a patient whose brain tumor caused him to become obese — not an uncommon occurrence with brain tumors. Even now, though, she says, he’s reluctant to attribute his obesity to the tumor, because it “just felt like ‘another excuse’ for longtime weight struggles.” Now imagine a campaign that could cut through stigma that thick and pervasive.)

Happy Thanksgiving, and I hope Belluz’s piece helps you reach for that second piece of pie if you want it, even if Uncle Chester’s giving you the stink eye.