INFLUENCES ON OVERFATNESS OND OBESITY

Summary of main points.

• The treatment of obesity has had only limited success and attempts at prevention have been a total failure.

• The traditional models for understanding obesity using simple energy balance may be partially responsible for these poor success rates.

• Scientific thinking in this area has evolved from simple physics, to biological and physiological ways of explaining the obesity.

• A new Ideological paradigm is needed to incorporate the influences of biology, the environment and individual behaviour.

• The inclusion of physiological adjustment to changing energy stores in the model is also a key factor in understanding the dynamics of changing body fatness.

• The mediators through which the influences and moderators work are fat intake and fat utilisation in the body.

In spite of the huge personal expenditure on weight control, the burgeoning weight control industry, and the vast media attention given to the problem, it is obvious that all countries in the western world are losing the battle of the bulge. One possible reason for this is that the issue may have been inadequately conceptualized in scientific terms. The failure to even stabilise the growth rate of obesity at the population level has led some health experts to suggest a paradigm shift in thinking about weight control. It has been claimed that all science progresses through ‘paradigm shifts’ in thinking where a paradigm is defined as ‘. . . the collective set of attitudes, values, procedures, techniques etc., that form the generally accepted perspective of a particular discipline at a particular time’. In light of this, it is interesting to consider the evolution of thinking that has occurred in this area and to come up with a possible alternative, more all-encompassing approach on which better program planning—both prevention and treatment—can be based.