"learning to be lean"

I just read this article in The New York Times called "Learning to Be Lean." I recommend you read it; it's about emerging plans to decrease childhood obesity in the United States now that many insurance companies will have to pay for this kind of preventative care.

What strikes me in this article is how complicated the issue is. A person's weight is definitely influenced by diet and exercise, but those are not the only factors. Although these programs have been successful in some senses, they still fail in lots of others, and even with better diet and exercise, some of these patients gained the weight back.

Fighting chronic diseases like hypertension and diabetes - which are comorbidities of obesity - does require some kind of a lifestyle change. However, as this article points out, there is no magic bullet. There is never a magic bullet in public health, and education alone is not the answer to solving this complicated problem. And if there is this much of a challenge fighting obesity in the States, where many of the participants have the financial resources to choose healthier food options, then what are the implications for those in less developed countries? If there are limited resources for an intervention, should they be spent promoting these kinds of lifestyle change when there is evidence that the efficacy is limited?

P.S. Check out this awesome interactive chart from NYT. It shows who's in the top 1%, and it's not just bankers.