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Public perceptions clash with scientific reality on obesity
A recent study in The Lancet revealed that 80% of people in the UK, Australia, New Zealand, and the US believe obesity can be entirely prevented through lifestyle choices alone. Yet experts argue this view oversimplifies a complex, chronic condition influenced by genetics, biology, and environment.
The limits of willpower
Bini Suresh, a dietitian with two decades of experience, describes how highly motivated patients often struggle despite consistent efforts. "Terms like 'willpower' and 'self-control' are misleading," she says. "Obesity is not a failure of character."
Dr. Kim Boyd of WeightWatchers echoes this sentiment, noting that decades of advice to "eat less and move more" have failed to address the root causes. "Obesity is far more complex than personal discipline," she states.
Genetics and biology play a key role
Prof. Sadaf Farooqi, a consultant endocrinologist at Cambridge University, explains that genes significantly influence hunger, fullness, and metabolism. Variants in genes like MC4R, carried by roughly 20% of the global population, increase hunger and reduce satiety. "Some people gain more weight from the same amount of food or burn fewer calories during exercise," she adds.
Andrew Jenkinson, a bariatric surgeon, introduces the concept of the "set weight point," a biologically determined range the body strives to maintain. "If weight drops below this point, hunger surges and metabolism slows," he says, comparing it to a thermostat. Leptin, a hormone produced by fat cells, plays a crucial role in regulating this set point, but its signals can be disrupted by high insulin levels in Western diets.
The obesogenic environment
The UK government's latest measure-banning junk food ads on TV before 9 PM and online-aims to curb obesity, but experts argue it's only a partial solution. Public health director Alice Wiseman highlights the ubiquity of high-calorie foods: "You can't go to school or work without passing a food place. Visibility matters."
The UK's fast-food industry, worth over £23 billion annually, thrives on aggressive marketing. Healthier foods are more than twice as expensive per calorie as less nutritious options, according to a The Food Foundation report. "In families where money is tight, eating healthily is difficult," Wiseman notes.
Debating responsibility and solutions
While some experts advocate for regulation, others push back. Gareth Lyon of Policy Exchange argues, "You can't legislate people into shape." Christopher Snowdon of the Institute of Economic Affairs calls obesity an "individual problem," not a public health issue. "It's bizarre to suggest the government should make people slimmer," he says.
Prof. Keith Frayn acknowledges environmental changes but warns against dismissing willpower entirely. "Large databases show people can lose weight and keep it off," he says, citing the U.S. National Weight Control Registry. "They describe it as hard-very hard."
Rethinking willpower
Psychologist Dr. Eleanor Bryant distinguishes between rigid and flexible willpower. "Rigid thinkers see lapses as failure, while flexible thinkers recover quickly," she explains. "Flexibility leads to better outcomes."
Suresh emphasizes education as the first step. "When patients understand their struggle is biological, not a lack of discipline, their relationship with food improves," she says. Structured support-nutrition, psychology, and realistic goals-proves more effective than blame.
A complex path forward
With over 60% of UK adults now classified as overweight or obese, the debate continues. While genetics and biology set the stage, the modern environment-cheap, ultra-processed foods, sedentary lifestyles, and relentless marketing-amplifies the challenge. "We're living in an environment engineered for overconsumption," Suresh concludes. "Willpower alone isn't enough."
