Obesity is endemic. While treatment modalities flourish, they are unable to stem the tide of obesity, because prevention requires different approaches. The individual choices people make about food are informed by the broader environment, which, in recent decades, is described as obesogenic. Prevention strategies necessarily must precede treatment. Approaches that engage individuals include better prenatal care and education about maternal weight gain, prevention of gestational diabetes, prevention and intervention for adverse childhood events, and possibly the promotion of breastfeeding for infants. Individuals who undergo bariatric surgery tend to have families in which eating habits subsequently change, which may also help to prevent obesity.
Because the genetics of obesity cannot currently be manipulated, making changes to the environment holds more promise. The current recommendations are simple to state but difficult to implement. Eating more whole foods and fewer empty calories such as sugar-sweetened beverages, exercising more, and creating built environments that foster movement and better connection are current suggestions, with age-old roots.
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