James H. Rimmer, Ph.D., Director

Thirty years ago, I was sitting in a small apartment in Queens, New York, writing a term paper for my exercise science class entitled, "The Obesity Epidemic." I can’t recall much about the paper, except for the first sentence that began with: "We eat too much, don’t exercise, grow fat and wonder why." The paper was a stark forecast of where we are at today.

During the 1990s, the prevalence of obesity nearly doubled in the United States and is now recognized as one of the primary health crises of this century. One of the most distressing signs is the dramatic rise in obesity among children and adolescents. Obesity prevalence has more than doubled in children and tripled in adolescents since 1980, and diabetes has increased more than ten-fold at major children’s hospitals throughout the United States. We’re now beyond an ‘epidemic’ and into a full-blown ‘mega-epidemic.’ What went wrong?

For the past 30 years, the National Institutes of Health spent a large part of their financial resources searching for cures for cancer, diabetes and obesity. Unfortunately, these diseases are still with us today and in substantially greater numbers than they were three decades ago. The race for the cure has, for the most part, curtailed resources for health promotion prevention research. Today, much of the federal funding at NIH appears to be spent on basic and clinical research with scientists searching for the ‘magic pill’ that will eliminate a disease, disability, or disorder. The powerful pharmaceutical industry also keeps bench scientists busy by supporting their efforts to find a mixture of chemicals that can turn into their next million dollar baby. They also have a substantial influence on Congress and continue to lobby for more federal dollars for basic research. Why should they lobby for health promotion research when there is no money to be made in encouraging people to become more physically active or eat more nutritious foods?

Instead of diversifying our precious federal dollars over the last 30 years between ‘cure’ and ‘prevention,’ we placed the bet entire bet on ‘cure’ and lost. People are heavier today than they were 30 years ago; we exercise less; and we eat substantially more. We’re now in the midst of a mega-epidemic with no end in sight -- rising health care costs associated with obesity; bariatric surgery units filled to capacity; the fast food industry enjoying record profits; and children and adolescents no longer engaged in a physically active lifestyle in their backyards or on playgrounds but instead planted in front of their computer screens for much of the day. Most basic scientists are convinced (although you won’t find one who will admit it in public) that we can’t change human behavior and that it’s an enormous waste resources to even try. Yet after 30 years of basic science research in cancer, diabetes, and obesity, what do we have to show for the billions and billions of dollars spent on finding a ‘cure?’ We have record numbers of people with type 2 diabetes; cancer rates have remained about the same or have risen in some cases; and obesity has taken a dramatic turn for the worse since the early 1990s. And people with physical and intellectual disabilities are being affected by this obesity mega-epidemic to a much greater extent that the general population. Obesity is a major cause of disability, and people with disabilities have much higher rates of obesity and extreme obesity.

At the end of my term paper, I included a photo from a New York Times Sunday magazine article that I will never forget. The photo showed a research scientist holding two Zucker rats (a type of rat bred to become obese) by the back of their necks (one rat in each hand). The rat in his left hand was on a fixed number of calories and had a running wheel in his cage to exercise. This little fellow was extremely lean. The rat in his right hand was on an unlimited diet and was allowed to eat as much as it wanted any time of the day and had no running wheel in his cage. It had the resemblance of a small balloon filled with water and its body was so large that you could barely see its eyes, head and feet. It was a striking image of what can go wrong when there is an imbalance of calorie intake and energy expenditure.

Today, millions of people are living in a similar environment as that obese rat – too much food and not enough physical activity. I hope that the funding pendulum begins to swing back to the center with more behavioral and intervention research complementing the important work of basic scientists. Together, interventionists and bench scientists will have a substantially greater impact on finding ways to stop or even slow down this mega-epidemic of obesity.