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The writer served as the US Food and Drug Administration commissioner under Presidents George HW Bush and Bill Clinton, and served as co-led Operation Warp Speed. His recent book is Diet, Drugs, and Dopamine: The New Science of Achieving Healthy Weight.
Americans are sick. The majority are on the path to developing cardiac metabolism and kidney disease, diabetes, certain cancers and neurodegenerative diseases, which are neurodegenerative diseases that occur when the disabled are old, if not death. Otherwise it should have been. The successful campaign for smoking in 1973, the development of lipid-lowering drugs, and the targeting of the molecular mechanisms of cancer came to life in 2019. A dramatic rise in metabolic diseases undermines all of its progress.
President Donald Trump’s management took the populists’ pulse by committing to bring America healthy again. The resonance of the Maha campaign is so deep that some believe they will waive enough votes to pass the Trumps to pass the election. US Health Secretary Robert F. Kennedy Jr. brought those voters to Trump, but the message with widespread support is rhetorically pivoted from anti-vaccine messages to tackling chronic illnesses.
The problem is that Kennedy and Trump don’t know how to really make America healthy. The focus so far has been on the removal of artificial food dyes and seed oils. But working on admirable food dyes is uncertain how many lives will be saved. Even less data suggests that removing seed oil can affect American health in any way.
Kennedy says the problem begins with the food we are eating. Medicine is beginning to recognize that excessive toxic fat is the central perpetrator of exacerbating America. Toxic fats are fats that enter the liver, pancreas, heart and muscles, and release excess of proinflammatory molecules.
However, public health efforts to tackle obesity over the past few decades have failed. Life expectancy in the United States is a critical part of obesity and therefore lags behind fellow countries. In the 1980s, approximately 47% of the US population were overweight or obese. Today, that’s 74%.
Telling people to eat less and exercise doesn’t work. Add fat, sugar and salt to every corner and it’s available 24/7 and can be eaten anytime. This has resulted in a carnival of energy-packed, extremely tasty, hyperglycemia-blooded (super-advanced) foods.
These foods are intentionally designed to include a powerful triple of fat, sugar and salt that causes the brain’s reward circuit in a nicotine-like way. Both trigger triggers that recur in cue-induced desires, cravings, and bad habits.
But the addiction of these foods is only part of their harm. Most often, they contain carbohydrates that can be absorbed quickly. Excess calories and carbohydrates lead to increased levels of circulating insulin in the body that causes an increase in liver fat, abnormal blood lipid patterns, type 2 diabetes, and many other chronic diseases.
We had previously taken this path with cigarettes. It took me over 70 years to reduce smoking in the US. It happened because of a fundamental change in how we viewed cigarettes. Once thought to be glamorous, sexy and associated with adventure, cigarettes have now come to be seen about what they are: deadly, addictive, disgusting products. Demonstrating to the general public how they are manipulated by the tobacco industry has resulted in significant perceptual changes.
Similarly, we need to clarify today that the problem is not food, but foods that do not exist naturally.
The good news is that there are tools to treat this metabolic chaos. Although they are not miraculous drugs, new anti-obesity drugs are extremely effective in reducing toxic fats, particularly those causing heart disease and kidney disease and chronic diseases that cause diabetes. However, they are often not covered by insurance, are very expensive, and those who need them are buying imitation versions that are not guaranteed by the Food and Drug Administration. The effectiveness of new anti-obesity drugs clearly shows that obesity is a result of biology and not a will. We discriminate against obese people and deny access to the medications we need.
To treat the causes of chronic illness, you need access to both excellent information, reliable treatments and proper care. We say we want America to be healthy and we actually want to do that.
