Currently browsing posts about: Obesity

I first read about this in a Forbes article: New Study: Front-Of-Pack Warning Labels Don’t Lower Obesity Rates.

As the FDA mulls interpretive food warning labels, a Georgetown University study shows these schemes have been powerless to halt obesity trends.  In an attempt to tackle stubbornly high adult obesity rates over 40% in the US, the FDA is advancing a proposed front-of-pack (FOP) label that highlights whether a food or beverage contains low, medium or high levels of sugar, saturated fats and sodium. But a new study from Georgetown University titled Can Front-of-Pack Product Labeling Fix the Obesity Crisis says that the FDA has not learned the lessons from other countries using such interpretive food warning labels: there is no hard evidence that they have been effective in improving consumer diets or in arresting rising obesity rates.

The author of this article is Hank Cardello, executive-in-residence at Georgetown McDonough’s Business for Impact.

If you click on the link to the study, you discover than Cardullo himself is its author.

Hank Cardello, executive-in-residence at Georgetown McDonough’s Business for Impact, has published a white paper titled,“Can Front-of-Pack Product Labeling Fix the Obesity Crisis?” This paper argues that front-of-pack (FOP) food labeling has not led to meaningful improvements in public health outcomes. It evaluates data from multiple countries to test the efficacy of other FOP labeling initiatives.

Both the article and his White Papert disclose the funder: the Consumer Brands Association, formerly known as the Grocery Manufacturers of America, which represents Big Food.

Comment

I can understand why the food industry does not like warning labels or any other front-of-pack label that might reduce product sales, which studies of Latin American warning labels show they do.  So this piece is predictable.

If you want people to lose weight, they have to eat less.  Eating less is very bad for business.

What good are front-of-pack labels?  At best they alert consumers to avoid high-calorie foods formulated to get us all to eat more of them.

But that’s just a start.  To lose weight, you also have to make sure the rest of your diet does not replace the calories you just saved.

Cardullo’s suggestion is smalled portions.  Good idea.

In the meantime, warning labels could help and I hope the FDA comes up with good ones.

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Published tomorrow!  Information is here.

The White House has announced the formation of a President’s Commission on Making America Healthy Again

It will be chaired by newly confirmed HHS Secretary Robert F. Kennedy Jr, and according to the The MAHA Commission Fact Sheet “is tasked with investigating and addressing the root causes of America’s escalating health crisis, with an initial focus on childhood chronic diseases.”

The Commission will include representatives of relevant agencies.  It is to:

• Produce a Make our Children Healthy Again Assessment within 100 days.
• Submit a Make our Children Healthy Again Strategy within 180 days.

Comment

Whew.  I can’t wait to see what this Commission comes up with.  But it sounds like nothing will be done, actually, for at least six months.

Oh.  Wait!  I’m having a deja vu.   Didn’t we already do this?

Isn’t this just what Michelle Obama’s Let’s Move initiative did in 2010?

• Recall: White House Task Force on Childhood Obesity Report to the President: Solving the Problem of Childhood Obesity Within a Generation.
• Also recall: Republicans pushed back so hard on this that hardly any of it could be accomplished.
• And: President Trump opposed her initiatives as late as 2017.

Don’t get me wrong.  I am totally for doing this and hope the Commission takes its mandate seriously.

Let’s Move got pushback for trying to take on the food industry.  If RFK, Jr’s Commission can do this, it will deserve much applause.

As always, stay tuned.

I am fortunate to be on the mailing list for Nicholas Fereday’s always-worth-reading Rabobank’s RaboResearch.  This one is especially worth sharing: Talking Points: Anti-obesity medications—Will the food industry be the biggest loser?

It has been oer a year since the food industry finally woke up to the threats and opportunities of the new class of Anti-Obesity Medications (AOMs) such as Ozempic, Wegovy and Zepbound.  And gosh, what a lot has happened since then. Chiefly, both the demand and supply of these drugs have exceeded all expectations and the momentum driving the market suggests they are highly likely to become a permanent feature of the food landscape. Doubly so as scientists keep finding further benefits from taking them – the weight loss effects of these drugs might ultimately prove to be their least remarkable feature. But for now, the impact of these drugs on the food industry is real. The challenge for the food industry is to figure out how to respond to that and unlock some of the opportunities these drugs create. Here are three points to consider:

1.   The AOM market is much bigger and growing much faster than anticipated.

2.   There are good reasons to believe demand has strong momentum.

3.    Users of AOMs eat less and differently, providing a useful roadmap for food companies.

A reader, Maria Birman, alerted me to this new report in Lancet Diabetes & Endocrinology from the 56-member Commission on the Definition and Diagnosis of Clinical Obesity.  The commission recommended shifting the definition and diagnostic criteria for obesity away from the BMI and instead defining obesity in two categories based on health status.

• Clinical obesity: signs and symptoms of organ or other dysfunctions; a disease requiring effective health care treatment
• Pre-clinical obesity: high levels of body fat but no signs of dysfunction but higher risk for chronic disease, requiring support for risk reduction.

Maria writes:

I’m astonished by the full two-page “declaration of interests” (no conflict there, of course not!). Naturally Eli Lilly and Novo Nordisk are very much interested in obesity being considered a disease, and a treatable one at that. And doctors and scientists paid by these companies authored this paper which is posed to be very influential.

I took a look at the conflict-of-interest statement.  It is indeed astonishing as it goes on and on for nearly two pages in four columns.

Maria saved me from having to go through the analysis.  Here are her counts.

• Of the 56 authors, 47 declared conflicts of interest; only 9 did not.
• All 8 authors on the steering committee declare financial ties to drug companies.
• Novo Nordisk (Ozempic, Wegovy) is mentioned 60 times by 38 authors.
• Eli Lilly (Zepbound) is mentioned 39 times by 27 authors.
• Authors report financial ties to other pharmaceutical companies: AstraZeneca, Pfizer, Merck, Johnson & Johnson, Eurodrug Laboratories, Sanofi., and others.
• Authors report consulting fees, fees for educational purposes, research grants, speaker fees, co-authorship of manuscripts, medical writing assistance, and personal honoraria as a consultant and speaker, among others.
• Authors report financial ties to food companies such as Nestlé, which makes the Vital Pursuit line marketed to people on Ozempic.

Comment

No question, the BMI is an imperfect measure of the health risks of obesity, although it works pretty well as a first step.  Defining obesity as a disease may well help get treatment for people who need it.

I wish we had a health care system that could help people with obesity find out whether they have the clinical or pre-clinical form.  In the absence of  a functional health care system, we have drugs—effective and without deleterious side effects for some people, but for the great majority, highly expensive and hard to get.

This commission appears as an arm of the pharmaceutical industry.  Its findings require careful scrutiny.

I saw this on Twitter (X):

For the video, click here.

I’m for all three actions.  I’ve argued for years for getting rid of conflicts of interest and focusing resources on preventing chronic disease.

I can’t wait to find out how the new administration plans to accomplish these goals.   We all need to hold it accountable for delivering on these promises.

What started all this was this graph of obesity prevalence in the US from the Financial Times:

The most complete account of what happened next comes from Helena Bottemiller Evich in Food Fix (a must-read for anyone interested in following the food scene): “Have we passed peak obesity? New data sparks speculation.”

The Financial Times was the first to pick up on new data from the Centers for Disease Control and Prevention showing that the obesity rate for U.S. adults declined two percentage points between 2020 and 2023. The headline from across the pond was upbeat: “We may have passed peak obesity.” Soon, a couple of other news outlets followed, including Axios: “Americans are getting healthier by some key metrics.” The Washington Post editorial board jumped into the fray this week as well: “The obesity rate might have stopped growing. Here’s what could be working.”

The original data came from the CDC:

Plotted this way, the decline is not nearly so impressive (and severe obesity is increasing slightly).

As for the effect of the drugs, it’s much too early to say, says the epidemiologist Deirdre Tobias posting on Twitter (X).

The downtick occurred before the drugs were widely used.  Following her thread produces lots more data on that point.

We will have to wait a few more years to know how all this will play out.  I can’t wait!

Susan Greenhalgh. Soda Science: Making the World Safe for Coca-Cola.  University of Chicago Press, 2024.

This terrific book picks up where I left off with Soda Politics: Taking on Big Soda (and Winning) (2015) and Unsavory Truth: How the Food Industry Skews the Science of What We Eat (2018).

Susan Greenhalgh’s focus, however, is on ILSI, the International Life Sciences Institute (now renamed the Institute for the Advancement of Food and Nutrition Sciences).  ILSI is a classic industry front group,  It was created originally by Coca-Cola to make sure science promoted corporate interests.  It is funded by big food companies.  It positions itself as an independent think tank.  Hence: front group.

Soda Science documents how ILSI, working through personal connections (guanxi) at the Chinese Ministry of Health, convinced the Chinese government to target obesity prevention measures at physical activity (“move more”), rather than diet (“eat less,” or “eat better”).

The first half of the book tells the story of ILSI’s role in the Global Energy Balance Network, a group outed as funded by Coca-Cola (I wrote about this in 2015, particularly here, here, and here in The Guardian).

The second half gives an intimate, first-hand account of how science politics works in China.

Greenhalgh is a distinguished anthropologist.  She retired from Harvard as as the John King and Wilma Cannon Fairbank Research Professor of Chinese Society (she is an expert on China).  She uses social science methods—interviews and qualitative research as well as document review—to study this particular example of soda politics.

• The International Life Sciences Institute (ILSI): true colors revealed (October 3, 2019)
• ILSI tracked media responses to my book, Unsavory Truth (February 22, 2023)

The story she tells here is fascinating in its own right and a great read.

It also makes one other point: social science methods are really useful in getting information unavailable any other way.

I say this because bench scientists tend to look down on qualitative research and consider it non-research.  I disagree.  I think qualitative research is essential, and has plenty to contribute.  This book is a great example of why.

I subscribe to Pet Food Industry and greatly admire the superb quality of its reporting.

Here’s an example:

Pet obesity 2023: owners oblivious, vets scared to talk: Pet owners may be largely unaware that there is a problem, especially with their own dogs and cats, despite years of warnings.

Several items in this article got my attention.

A.  It is based on a survey by The Association for Pet Obesity (APOP).  Pet obesity is such a widespread problem that it has induced formation of a society to address it.

B.  Pet owners do not recognize that their pets are overweight.

The survey found only 28% of cat owners and 17% of dog owners to say their pets were overweight.  Instead,  84% of dog owners and 70% of cat owners said their pets’ weights were healthy.

Veterinarians say 59% of dogs and 61% of cats are overweight or obese, and percentages are rising.

C.  Veterinarians are reluctant to discuss obesity with pet owners.

Although the survey found 84% of veterinarians to report encountering “pet owners who appeared embarrassed or angry when told their pet was overweight,” only 4% of owners thought their veterinarian would be uncomfortable discussing the issue.

Comment

None of this should be surprising, as I think about it.  Doctors avoid discussing obesity with human patients (embarrassment, stigma, and lack of time, empathy, or satisfactory treatment approaches).  Obesity has become the “O” word.

An astonishing 75% of U.S. adults are overweight or obese, and children are also getting there.

We, as a society, need to prevent this kind of weight gain for ourselves, our kids, and our pets.

How to do this requires policies, and lots of them, all at once.  Policies require politics.  Politics requires advocacy.

We need all of these, and right away.

Resources

Sunday’s New York Times has an entire section on pets.

Information about my book with Malden Nesheim on pet food issues, Feed Your Pet Right, is here.