Finding the solution to obesity

In an editorial in Obesity, Corkey discusses the many different theories explaining why obesity continues to increase despite best efforts at controlling weight gain in this environment, including increased availability and marketing of high-calorie and high-glycemic-index foods and drinks, larger food portions, leisure time physical activities being replaced with sedentary activities such as watching television and use of electronic devices, inadequate sleep, and the use of medications that increase weight.

According to Corkey, all of these purported explanations assume an environmental cause that is detrimental to the organism involved, (humans). "However, if we use the principle of symbiosis and Darwin's theory of evolution, perhaps we can understand obesity prevalence as an interim stage in the evolution of man reacting to his environment in order to gain long-term survival and ultimate longevity," says corresponding author Corkey, professor emeritus of medicine and biochemistry at Boston University Chobanian & Avedisian School of Medicine.

Humans have developed a method to feed the billions of people on the planet, by developing processed foods with preservatives and other chemicals that can make food last longer and can be made cheaply to increase calorie density in small packages. Corkey points out that those who develop obesity store body fat in response to excess calories. "Therefore the cause of obesity has as much to do as the human reaction to overfeeding as it does the production of foods that are being overfed," she states.

Corkey notes that key developments in the obesity/diabetes field include bariatric surgery as well as multiple agents (drugs) with different mechanisms of action to treat obesity and prevent weight regain. "Novel drug combinations are beginning to close the gap with bariatric surgery and appear to be very powerful new tools to treat obesity as a disease."

Corkey believes recognition of obesity as a disease and earlier diagnosis of diabetes and other consequences of obesity will support early and more effective treatment and prevention. "Importantly, disease recognition will help to support insurance coverage of effective obesity treatments," she adds.

Lastly, Corkey examines culinary medicine as an emerging evidence-based field that brings together nutrition and culinary knowledge and skills to assist patients in maintaining health and preventing and treating food-related disease by choosing high-quality, healthy food in conjunction with appropriate medical care. "Culinary medicine has the advantage of being an intervention that can be implemented at the earliest time point in the development of obesity with no negative side effects," says Corkey.