An article in your regular health feature ‘Health on Monday’ (TMID, 5 December) claims that the science of overeating can be unlocked with neuroscience. It quotes a book, The Amen Solution: The Brain Healthy Way to Lose Weight and Keep It Off, by Richard Geres. This book does not quite provide the answer to today’s obesity because it omits the real core issue of the recent increase in obesity – suffice it to say that the problem is less a question of overeating and more a question of unhealthy lifestyle. 

While it is plausible to say that our brain “makes our eating decisions” (we anyway use our brain to make all our decisions!), this still does not provide an explanation why obesity has reached “epidemic levels” only recently, during the past two or three decades, while our brain still works very much in the same way as it did long before Julius Caesar. 

Unless we assume that our brain has undergone a sudden mutation, the timing of this recent increase in overweight, both in adults and children, suggests that the cause lies  elsewhere and beyond any proposed biological or psychological mechanisms. Rather than in ourselves, the cause is more likely to be our changing circumstances. This points to modifiable changes in our behaviour which have arisen in an environment which has subjected us to new, unhealthy influences.

While an abundance of food (which is often energy-dense) does play a part, the more likely suspect is the combination of universally available labour-saving devices and the ongoing process of urbanisation and degradation of the environment leading to reduced levels of physical activity. In fact, the unprecedented increase in obesity (along with diabetes and heart disease) coincides very neatly with the advent of convenient personal transport and technology, both of which tend to keep us glued to a seat or armchair.

Adults have become increasingly dependent on the motor car, children get transported to school in buses (or by their parents) whereas previously they walked, cycled or used public transport, and so on. At the same time, unhealthy passive behaviour such as watching television for hours on end (even without the need to drag ourselves up from the sofa to change television programmes) has become universal, particularly among children.

A clear correlation between hours spent daily by children watching television and obesity has been clearly demonstrated whereas a relation to the amount of energy-dense calories eaten by children is less significant. This casts doubt on the usefulness of recommending “matching strategies for overeating to the type of brain pattern or patterns that are affecting us” as suggested by Geres because it simply does not address the fundamental issue which is, in reality,  a lack of physical activity and its unwelcome attendants – unfitness and overweight. Another important factor is that obese children grow into obese adults – so children have to be particularly targeted.    

The word ‘obesogenic’ is a useful descriptive word coined in the 1990s. It neatly sums up the threat facing Western society. Put simply, an ‘obesogenic environment’ is an environment which  “discourages exercise while making it easy to eat more”. The emerging obesogenic environment is now perceived to be a driving force behind the escalating obesity epidemic. Thus the obese subject – or any physically unfit individual – is a victim of his unhealthy surroundings. It is therefore reasonable to say that, unless steps are taken to improve our unhealthy surroundings and its consequent encouragement of bad habits, no amount of well intentioned efforts of health professionals or psychologists is likely to make an impact.

Therefore it would be wrong to regard obesity merely as a question of dieting or psycho-counselling while ignoring the other, more important side of the energy equation, namely, that of trying to change our environment to one which promotes a healthy, physically active  lifestyle. This is fast becoming an overriding factor needing attention in Malta.

■ G G Debono

Sliema