The global rise in obesity is a crisis decades in the making, driven by systemic failures in public health policy, the food industry, and medical education. It should come as no shock that it will get worse. According to a recent analysis in the Lancet, more than half of adults and a third of children worldwide will be overweight or obese by 2050, leading to unprecedented strains on healthcare systems and a surge in preventable diseases. This shouldn’t shock anyone.

While much of the discourse surrounding obesity reduction focuses on personal responsibility, I believe that the crisis is more deeply rooted in flawed assumptions about health, misguided dietary education, and the entanglement of food and pharmaceutical industries. Clearly, the current approach to health and wellness isn’t working. Without a fundamental shift in how we approach nutrition, behavior, and disease prevention, the solutions proposed will remain ineffective, perpetuating a cycle of dependency and poor health outcomes.

The Intersection of Big Food and Big Pharma

At the core of the obesity epidemic lies an uncomfortable reality: the food industry, which profits from mass-producing highly processed, hyper-palatable, and nutritionally deficient products, is deeply interconnected with the pharmaceutical industry, which benefits from the chronic diseases these products exacerbate. For example, just look at the fact that the Academy of Nutrition and Dietetics (AND) has invested funds in companies like Nestle and PepsiCo, as well as pharmaceutical companies. Or consider how supposed health organizations form partnerships with both food and pharmaceutical companies, which is a serious conflict of interest that likely compromises the integrity of health messaging. Sadly, these are just two of seemingly endless examples.

I believe this entanglement is not coincidental but structural. After all, as obesity rates climb, so does the demand for pharmaceutical interventions—ranging from weight-loss medications to treatments for diabetes, hypertension, and cardiovascular disease. In essence, the same economic forces that drive unhealthy food production also reinforce a medical system that prioritizes pharmaceutical management over genuine preventive care. As I have said many times, when medicine becomes profitable, you will always have disease. We are living this reality.

Don’t expect the government to help. Governments and regulatory bodies, rather than acting as neutral arbiters of public health, have historically been complicit in reinforcing this cycle. Subsidies favor cash crops like corn and soy, which are heavily used in processed foods, while fresh produce and whole foods remain comparatively expensive and less accessible to lower-income and less-educated populations. This typically results in a generational issue. Moreover, nutritional guidelines, often influenced by industry interests, have long promoted questionable dietary recommendations that fail to align with emerging research on metabolic health. This systemic misalignment ensures that the cycle of disease continues, generating profit for both Big Food and Big Pharma while leaving public health in a state of perpetual crisis.

Of course, this isn’t new information. The warnings have been there for decades. For example, Dr. Mark Hyman, MD, wrote about something similar all the way back in 2010. Yet, the problem persists, and some might argue that it has worsened significantly since then. The worst part is that those who are impacted by obesity are often blamed for their conditioned behaviors. Unfortunately, that’s a fallacy.

The Fallacy of “Healthy” Food and the Corruption of Nutritional Science

One of the most insidious barriers to effective obesity prevention is the widespread misunderstanding of what constitutes healthy eating. For decades, the public has been subjected to shifting and often contradictory dietary advice, much of which is influenced by poorly designed studies and industry-funded research, and most of which has ignored the fundamental premise of health. The demonization of dietary fat, for instance, led to an explosion of low-fat products that compensated for taste with added sugars—ironically worsening metabolic health and accelerating obesity rates. Similarly, the oversimplified focus on calorie counting, which often spurs weight gain, ignores the complexities of hormonal regulation, nutrient density, and the effects of ultra-processed foods on satiety and metabolic function.

Of course, scientific inquiry into nutrition is seemingly flawed from the outset, producing research that merely confirms pre-existing biases rather than challenging them. For example, many studies rely on self-reported food intake, which is notoriously unreliable, or they isolate single variables in complex dietary patterns, failing to account for how various food combinations interact within the body. Compounding this issue is the fact that many people now form deeply personal identities around their dietary choices—whether veganism, carnivory, keto, or plant-based—making them resistant to new or conflicting information. As a result, nutritional discourse often devolves into ideological battles rather than a rigorous examination of evidence or accuracy.

If the obesity epidemic is to be meaningfully addressed, it is imperative that we challenge and refine our understanding of what constitutes a truly health-promoting diet. Of course, this requires a willingness to discard outdated and industry-driven narratives, instead embracing an approach grounded in metabolic science, evolutionary biology, and real-world health outcomes. Unfortunately, doing so might result in a massive hit to the bottom line of those providing you the recommendations.

The Behavioral Underpinnings of Obesity and the Medical System’s Shortcomings

Obesity, like most chronic diseases, is largely behavior-driven. However, the modern medical system is usually ill-equipped to address behavior-related conditions because its educational foundations prioritize pharmaceutical solutions over lifestyle interventions. Moreover, most physicians receive little formal training in nutrition and exercise science, leaving them unequipped to effectually guide patients toward sustainable lifestyle changes – while simultaneously leading them to believe that nutrition and activity are not that important. After all, wouldn’t they be forced to learn about it if it were so important? Instead, they often default to prescribing medications, either as a primary intervention or as a means of mitigating the consequences of poor dietary and physical activity habits.

This disconnect is particularly troubling given that public health messaging frequently directs individuals to “ask their doctor” about nutrition – which is ironic considering that they have neither truly studied it nor find much value in it. Yet, if physicians lack both the training and the incentive to prioritize non-pharmaceutical interventions, we must understand that their recommendations will often only reinforce a cycle of dependency rather than empowerment. Frankly, that’s a problem because weight-loss drugs, bariatric surgery, and other medicalized solutions may provide short-term results, but they do not address the root causes of obesity—namely, systemic overconsumption of nutrient-poor and physiologically unsound foods and insufficient physical activity.

To reform this broken paradigm, medical education must integrate a deeper understanding of behavioral science, equipping healthcare providers with the tools to address the psychological, environmental, and social determinants of obesity. Either that, or they will need to allow those trained explicitly in behavior-related disease and mitigation techniques to play a larger role in chronic disease care. Effective obesity prevention requires more than just knowledge of nutrition; it demands an understanding of how habits form, how biases shape decision-making, and how lasting behavior change is best achieved. Of course, the medical community often ignores experts in these fields, largely due to disciplinary bias.

The Need for a Paradigm Shift: Asking the Right Questions

The global failure to curb obesity is not merely a consequence of inadequate policy responses but a reflection of flawed foundational assumptions. The prevailing approach—centered on calorie restriction, pharmaceutical intervention, and individual willpower—has simply failed to produce sustainable results. More of the same will get us more of the same. In other words, if we continue asking the same questions, we will continue receiving the same ineffective answers.

A true paradigm shift requires a radical reconsideration of the questions we pose about health, nutrition, and behavior. Rather than asking, “How can we get people to eat less?” (which is a bad idea, by the way), we should ask, “How can we change the food environment to make healthy choices the default?” Instead of fixating on weight loss as a singular goal, we should be asking, “What dietary patterns and lifestyle behaviors optimize metabolic health over a lifetime?” Or, better yet, we could ask about other behavior-related issues, such as digital overload and screen addiction, and then ponder its various impacts on activity, hormones, sleep, weight management, depression, and so on. Similarly, rather than assuming pharmaceutical interventions are the default solution, we should ask, “How can we make prevention more effective than treatment?” Education is a big part of this, and that’s precisely why health science professionals need to play a bigger role.

Ironically, the answers are clear and present, and the ideal outcomes are both achievable and within reach. However, our biases keep us from one simple truth – nature wouldn’t set us up to fail; it is we who have failed ourselves. Regardless, if these fundamental questions are not restructured, understand that obesity rates will continue to rise, chronic diseases will proliferate, and healthcare systems will buckle under the weight of preventable conditions. At the end of the day, I want you to know that the solutions lie not in the next weight-loss drug or the latest dietary trend but in a systemic transformation of how we think about, define, study, teach, and promote true health. I’ll close with this: If you insist on asking the wrong questions, you doom yourself only to get the wrong answers.

Speaking of things that shouldn’t surprise us! Sharyl Attkisson, a 5-time Emmy Award winner and recipient of the Edward R. Murrow award for investigative reporting, recently published an article about Vaccine Risk vs. Disease Risk that you might find interesting.