Wednesday, January 23, 2013

Isolationist Science and the Failure of Obesity Research

I'm an "obesity researcher". I have to admit that I'm not 100% sure what that means. I'm interested in the health issues that affect people who are overweight or obese, but I'm also interested in those health problems when they affect "healthy weight" people. I'm interested in how weight has changed across the population over time, and I'm interested in understanding the huge, complex system that led to those changes.

Even though I'm an "obesity researcher", I'm becoming more and more disillusioned with obesity research with each passing day. In some ways, I can see how "curing" the obesity epidemic seems to us now much like early efforts to "cure" infectious diseases. Except that with obesity, it's not that there aren't any easy answers--rather, there appear to be virtually no answers at all.

One of the reasons I think obesity research has struggled to find a "cure" is that most of the work aims to determine how much some variable affects obesity. Oh, everyone acknowledges that obesity is a complex problem, with many influential factors. But when it comes time to actually do research, we fall back on the traditional "randomized trial as gold standard" method of research (and I am most assuredly guilty of this myself). For a problem like obesity, it really doesn't matter how much any particular variable affects the outcome. It matters how all the variables work together. It matters how all the variables feed back on each other. It's "the system". (Click the picture for a blog post and link to an interactive version.)


There is certainly a (relatively) small group of people trying to think about obesity from this perspective. And almost any obesity researcher would agree that the above chart is "true". But doing this well requires funding, and funders make their decisions based on the wisdom of seasoned researchers, and most of these researchers find it particularly difficult to break out of the clinical paradigm of isolating a single variable.

At the moment, though, I'm struggling to decide if I should continue to fight the paradigm, or perhaps just go work at Waffle House. (See how complex obesity is? My decision on whether or not to study the complexities of obesity will affect my obesity!)

No comments:

Post a Comment