Is There Hope For Obesity and Diabetes Prevention?

Prof. Paul Zimmet, Melbourne

This morning, at the World Congress on Diabetes, I attended a talk by Paul Zimmet, professor emeritus from Melbourne’s Baker Institute, on ‘diabesity’ as a global threat to health and economies.

Zimmet reminded us that in 2030 almost 500 million people will be living with type 2 diabetes, two-thirds of these in the developing world. This increase, largely driven by increasing obesity rates, is almost directly proportional to economic development in these countries.

So while it there is no doubt that this burden of disease will significantly impact global health and economies, Zimmet also spoke out against the often proposed ‘simplistic’ notions that simply banning or taxing sugar soft drinks or imposing bans on food advertising, which are unlikely to have major impacts on these numbers.

As Zimmet points out, even a cursory glance at the Foresight map should make it immediately evident that such simplistic (and populistic?) approaches discount the remarkably interconnected ‘tangled’ complexity of the problem.

Indeed, there are unfortunately currently no ‘proven’ population approaches to preventing or reducing obesity – a real challenge for ‘public’ health efforts.

Thus, although there is general acceptance that prevention is better than treatment – there is no consensus or hard evidence that any such approaches are actually effective beyond rather rare instances of isolated ‘anecdotal’ examples in communities or populations, that are generally not transferable or scalable enough to impact a relevant proportion of the global at-risk population. There is also very limited evidence on the long-term impact of such ‘successful’ interventions.

This, of course poses a major dilemma for a prevention approaches to obesity or diabetes. Especially, when, as Zimmet points out, we consider the role of biological drivers of the epidemic (such as epigenetic modification), it is not really clear how this global ‘diabesity’ epidemic could indeed be reversed in the foreseeable future.

So while in the end, one certainly will require population- or societal-wide prevention efforts, where exactly these should begin and how effective these will be remains anyone’s guess.

Certainly not a happy or optimistic picture of the future of global health.

AMS
Dubai, UAE

Certainly a lot of food for thought (pun intended) – but no immediately obvious solutions to the problem.