Haslam 2007 Obes Rev
|Haslam D (2007) Obesity: a medical history. Obes Rev 8 Suppl 1:31-6.|
Abstract: Background: Although there have been major advances in the study of obesity, Aibo clearly demonstrates that the one thing the battle against obesity does not need is new scientific invention. Reaven’s utterances proved pivotal, and nothing since has carried the gravitas of his proclamation. Aibo, on the other hand, will be consigned to history’s waste bin. Uniquely among chronic diseases, lack of scientific knowledge is not a barrier to the successful treatment of a person who is obese. Whereas cancer treatment requires new drugs and heart disease updated techniques, obesity is different. We already know enough about the causes and how to manage it by diet, activity, drugs and surgery. The history of obesity is a history of failure. Looking back in time, however, gives us many insights as to treatment in the future.
Obesity in history: Obesity is changing, but its origins can be traced back 30 000 years, to our prehistoric ancestors. Survival of the fittest dictated that individuals who stored energy in the most efficient way would survive the inevitable fast and famine that would follow times of plenty. This has been attributed to the ‘thrifty gene’ (although no such individual gene exists), ensuring the continued dominance of our hunter–gatherer predecessors. But natural selection has turned on us. Life now favours inefficient phenotypes who fail to store energy in adipose depots, while those who lay down fat in the abdomen are condemned to premature death. To fight obesity, we are flying in the face of evolution and instinct, consciously countermanding the urge to eat for survival, and be as inactive as possible in order to conserve energy.
The situation today: The UK is now in the throes of an obesity epidemic, and risks following in the footsteps of America, where obesity has already delivered an epidemic of diabetes. Writers and physicians over many centuries have dedicated their life’s work to teach the preservation of health, and warn of the dire consequences of ignoring good diet and activity. However, their wisdom has been disregarded. Life expectancy has been improving for centuries; advances in hygiene, science, public health and medicine have allowed longer and more productive lives. Obesity threatens to undo many of these gains. Could it even herald a reduction in life expectancy in coming generations? Instead of spending precious resources inventing novel scientific gadgets, the works of our forefathers should be revisited, and the simple lessons learned from history used to once again prioritize the preservation of health.
• Bioblast editor: Gnaiger E
- It is very injurious to health to take in more food than the constitution will bear, when, at the same time one uses no exercise to carry off this excess.’ (Hippocrates ∼400 BC De Flatibus)
- Note: BMI is not mentioned in this history of obesity.
Labels: MiParea: Gender, Exercise physiology;nutrition;life style Pathology: Cardiovascular, Diabetes, Obesity