The Times’ obituary for Dr. Albert J. (“Mickey”) Stunkard, who died last week at the age of 92, describes his work on the genetics of obesity and quotes Dr. Walter Willett’s comment that genetics accounts for only a small part of the “legions of the obese.”
Stunkard was writing about the lifestyle and environmental determinants of weight gain, long before most of us had a clue.
I learned this in 2000 when Michael Jacobson and I were writing a paper on public health policy approaches to obesity prevention.[i] We were arguing that policies aimed at preventing weight gain focused almost entirely on personal behavior but needed to focus on fixing the environment of food choice.
A peer reviewer scolded us for missing Stunkard’s work.
At last, we discovered Stunkard’s groundbreaking work. In the published paper, we wrote:
The most notable exception [to the focus on personal responsibility] was the report of a 1977 conference organized by the National Institutes of Health (NIH) to review research and develop recommendations for obesity prevention and management.
In one paper, A.J. Stunkard thoroughly reviewed social and environmental influences on obesity.[ii] As a result, the conference report included an extraordinarily broad list of proposals for federal, community, and private actions to foster dietary improvements and more active lifestyles.
These ranged from coordinated health education and model school programs to changes in regulations for grades of meat, advertising, taxes, and insurance premiums. Some of the proposals cut right to the core of the matter: “Propose that any national health insurance program…recognize obesity as a disease and include within its benefits coverage for the treatment of it.” “Make nutrition counseling reimbursable under Medicare.” And “Fund demonstration projects at the worksite.”[iii]
He was far ahead of his time and will be greatly missed.
[i] Nestle M, Jacobson MF. Halting the obesity epidemic: A public health policy approach. Public Health Reports 2000;115:12-24.
[ii] Stunkard AJ. Obesity and the social environment: current status, future
prospects. In: Bray GA, editor. Obesity in America. Washington:
Department of Health, Education, and Welfare (US); 1979. NIH Pub.
[iii] Stunkard A. The social environment and the control of obesity. In:
Stunkard AJ, editor. Obesity. Philadelphia: WB Saunders; 1980. p. 438-