We need to do a better job of educating people about healthful diets, including the calorie content of common foods, without promoting fetishes. Encouraging lifelong, regular exercise in children may well have the greatest effect in terms of preventing obesity, as well as numerous other benefits. If the time children now spend in front of the television eating junk food and watching advertisements for more junk food was instead spent in physical activity, leanness would be virtually ensured. Healthful eating habits and regular exercise become even more critical in young adulthood, when a tendency toward obesity typically appears. Although we are still uncertain whether overweight is a direct cause of the illnesses associated with it and whether reductions in weight are beneficial, few would claim that becoming obese is consistent with optimal health.
Physicians can have their most important role in counseling patients about how to prevent obesity.
Because the causes of obesity are highly heterogeneous, doctors need to tailor their advice to each patient. Many overweight persons are happy and in reasonably good health, some overeat because they are depressed, and still others are depressed because they are overweight. In other situations, doctors should be cautious about exhorting patients to lose weight, especially when they are only mildly obese. Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition. Finally, doctors should do their part to help end discrimination against overweight people in schools and workplaces.