Tag: obesity

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Fountain of youth

The fountain of youth is such an old dream of humans that we are no longer surprised to witness perpetual reincarnations of the same theme again and again. The painting by Cranach the elder (1646) “Fountain of youth” (image below, Gemäldegalerie Berlin) sets the scene for what has become a billion dollar business nowadays. Whereas the old dream was about rejuvenation and cure from disabling diseases, we have become a bit more moderate in ambition to be happy about a halt to aging. Promises are reiterated and made in building on an army of influencers who push many remedies that lack rigorous scientific tests. Two studies published open access in “The Lancet Healthy Longevity” (Witham, McDonald 2026 and Duremdes Nava et al. 2026) provide evidence that in case of obesity and diabetes there are no easy or quick fixes available yet. Healthy longevity still relies mainly on lifestyle (changes), more exercise and careful nutrition rather than additional medication. Medium and long-term consequences of inactivity and unhealthy diets are to easily disregarded or their value discounted. How much are you willing to pay for an additional year of healthy living at age 30 or 70? Simple economics, but quite a successful business model as well.

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Medication adherence

In the broad range of medico-pharmaceutical science the topic of medication adherence is an uncomfortable issue. In the ideal scenario people would adhere 100% to the prescription. In the real world of not-optimal behavior and circumstances, people deviate substantially from what is best for or even good for them. Even in the tax-based health system of Denmark with relatively easy access to medication, a long-term study revealed the difficulties encountered to adhere to essential medications for persons with Type 2 diabetes. Nielsen et al. (2026) analyzed a cohort of 80.000 persons who newly acquired Type 2 diabetes of which about 25% showed a low adherence to medication plans with hazard rate of 1,27 to suffer a cardiovascular event. High adherence persons did not suffer such an event in the following 220 days over the 10 years of observation. A sedentary lifestyle or obesity increase the risk of type 2 diabetes and beyond medical treatments additional behavioral challenges like medication adherence make it clear, we do not live in the best scenario to fight type 2 diabetes.

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Brussels relaxes

Especially during the weekends and the summer activities some roads can be blocked for other uses. The obese societies of the 21 century need to make room for more exercise wherever possible. Brussels has done so for more than 5 years already. The “Bois de la Cambre” offers an amazing space to all those seeking respite from the busy and warm urban surroundings (Image below). Children and families exercise all sorts of activities and sports. The closed roads are perfect for cycling and jogging as well as the learning of both. Levels of air pollution drop and the running sport is no health hazard as in inner cities. Each and everybody advances at her/his own rhythm (Video Weekend jogging in Bois de la Cambre on Road 2026) or just watches others passing by. Ways to relax in cities are manifold, in a matter of choice and commitment. Commit to relax and detox, at least on weekends. This can be quite a behavioral change with serious health benefits.

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Time to prevent

If we take a medical life course perspective, we shall become aware that for each event there shall be a time to prevent it. From a scientific and socio-economic point of view, this is the crucial time to prevent failure of an organ, duration of an illness, death or an otherwise disruptive event. Taking our lung or liver as examples we intuitively know that there is a long time spell during which we have a chance to work on prevention. The monitoring of the early onset of disease is (Ge et al. 2026), potentially, a very cost-saving way as well in addition to avoid humans suffering later on in multiple ways. From a theoretical point of view it will be interesting to “think intervention as prevention” already, rather than the predominant way of intervention “post-hoc”, which means after the onset of disease. This implies a rather complete overhaul of medical research just as much as social research to guide policy makers interested in the “survival” of our social security systems as we know them currently in Europe. (Image is illustration in book on fairy tales: Beckmann in exhibition at Kunstbibliothek Berlin, 2026)

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Tether thy liver

There are few of us who take our liver seriously. Yet, this big organ plays a central role in our body to regulate metabolism. The obesity pandemic in western countries increases health risks, just as excessive alcohol consumption increases risks of liver dysfunction. Additionally, viruses increase the risk of failure of this organ.
Each of these risks as well as any combination of one of the risks with another one have led to rising public health risks. Several studies since 2020 have highlighted these increased risks for populations in general. The risks, however, have an unequal spread across subgroups of society. A recent comment based on the research of the INSERM U955 team in “The Lancet Regional Health” by Brustia et al. “Liver-related mortality strikes hardest where deprivation is greatest.” Health inequities consist in the lack of income available to buy healthy food or in untreated alcohol addiction, both more common in poor people.
In order to tackle the inequity, the team of medical doctors call for a shift in awareness. Structural reasons like diagnostic delay, remoteness or health literacy are just as important as individual predilections like nutrition or lifestyles. Inequality in access to health and ability to afford a healthy lifestyle have become serious drivers of social inequality in the 21st century.

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Less but better

There are many examples where a new mantra for the 21st century emerges from recent scientific evidence: “Less, but better” (Lbb). In studies of nutrition and human dietary requirements, the importance to eat less has been demonstrated on a regular basis. And this is even more important than to do more exercise if weight loss is the target or the attempt to explain obesity across the globe (McGrosky et al. 2025). The case for eating less is strong. Eating better refers to the need to avoid unhealthy, toxic or cancerous food or the way to prepare food. “Less but better” could become the new mantra or “categorical imperative” if you like it more philosophical in tone. We, the people gain, and the planet will gain as well. It is an easy win-win case, albeit with some behavioral implications.

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Obesity Revised

The scientific paper on a revised definition of obesity was produced by the special Commission on Obesity. It appeared in The Lancet Diabetes & Endocrinology in 2025-1. The previously common practice by medical doctors was to classify person in the obesity category based mainly on the simple calculation of the body mass index (BMI = weight/height²). A BMI  > 30 put persons into the obese category and stigma.
Since the Covid-19 society-wide testing experience, we are all familiar what it means if you get misclassified and have to live with the consequences (exclusion from work or events etc.). The simplifying and summarizing BMI calculation and classification has also produced many wrong classifications. For example, persons with a lot of muscles (just watch this at any fitness studio) will have a high weight relative to their body height², but they are likely to be more healthy than many other light weight, but seriously stressed persons.
In empirical test theory such cases are the so-called false positive cases, i.e. classified as obese, but not a medical problem at all. Medical doctors and health insurances should not finance special treatments for these persons, which foregoes treatment of other more needy persons.
With new expensive drugs on the market to treat obesity it is even more important to test with more precision the normal, pre-clinical and clinical status of obesity. Fatty tissue or muscles, that is the relevant question. Fatty tissue in muscles is the next level testing issue.