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This blog entry strikes me as exemplary. However, I have a couple of remarks that I believe to be of paramount importance, both concerning education.
Firstly, the education of the medical and health collective as a whole. Undoubtedly, many of us have failed, and continue to fail, to appropriately appreciate individuals living with obesity and its consequences. Despite being recognized as a disease, this diagnosis is often omitted in most patient clinical records; we frequently fail to advise any lifestyle modification (and when we do, it is done in an utterly generic manner), and ultimately, our approach is not always empathetic and only serves to increase stigmatization. As if this scenario were not of extreme significance, medical schools do not teach us to prescribe either a healthy diet or appropriate exercise. In truth, we are taught nothing—or very little—of what could be termed medicine of healthy lifestyle. Thus, it is imperative to educate healthcare personnel on this true pandemic.
Secondly, as we know, excess adiposity largely originates in our early years, placing the role of early childhood educators and teachers at the forefront. Likely, their training is also inadequate, facing considerable limitations to advise their students on the best possible lifestyle, informing them of the consequences both short-term and, especially, long-term. Such education is something educators can expand upon once they receive it. In this respect, neither doctors nor other health personnel have made a sufficient effort.
Food insecurity refers to inconsistent access to sufficient food for a healthy and active life but is also linked to the quality of the food available. Undoubtedly, it may signify the limited availability of nutritious, affordable food, and even water, due to economic hardships. However, it can also result from poor choices by individuals due to inadequate or non-existent information on the subject. In other words, within an obesogenic environment such as ours, the absence of even basic formal education in nutrition can become a pivotal factor in the onset and perpetuation of obesity.
In conclusion, education in all its dimensions, affecting all stakeholders involved (health professionals, educators, teachers, and society at large), will be crucial in halting the continuous rise in the prevalence of this disease and, gradually, reversing the obesity curve in our Western societie. Such education, which should include the concept of "social nutrition" (https://www.nature.com/articles/s43856-023-00398-3, a concept that educators can expand upon once they receive it.
Javier Crespo. Clinical and Traslational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
Thank you, Javier, for your insightful comment! I completely agree with all the points you raised. Preventing metabolic disease should begin as early as the embryonic stage and include education on healthy eating and behavior during the first 1,000 days and throughout the entire lifespan. We definitely have a lot of work to do to accomplish this aim.