Put The Fork Down...It Aint Genetics

A recent article in the British Medical Journal argues that the obesity epidemic is not secondary to a genetic condition that wasn't obvious for hundreds of years, but that obesity is caused by our eating habits and lifestyles.

A follow up from Art Caplan, from the Division of Medical Ethics at the NYU Langone Medical Center, notes that in a thirteen mile stretch of rural Pennsylvania he was driving he counted "19 kings, arches, colonels, and so on."

His point was that while genetics may have an influence on body size, more likely it is lack of discipline and the wide nature of choices we have...everywhere.

The study was clear that those most exposed to fast food were likely to have higher body mass indexes.  Again, I consider myself a foodie and love to eat.  Do I eat to excess?  Probably.  Do I blame it on genetics though?  No.  My family weight issues (to the extent they exist) have everything to do with excuse making and lack of willingness to get off the couch.  I feel lucky I have pretty active kids who want to play baseball with me or who want to run around the block.

For me though, Caplan's piece is equally important as the original study as it comes from the perspective of a medical ethicist.  We need to stop making "easy way out" excuses for our patients.  I know in EMS I have heard way too many partners who provide the excuse to the patient who wants a cigarette.  I have seen a 32 year old woman who I transported for open heart surgery two weeks earlier buying her cigarettes at the local pharmacy.  (She had a weight problem too.)

Weight is no different.  As a culture we need to step up and realize we have an obesity problem.  Part of that is putting the fork down, but the other part of that is putting the excuses down first.