nature publishing group COMMENTARIES CHILDHOOD OBESITY

Shifting the paradigm Our understanding of the causal factors that contribute to the obesity epidemic has evolved over time. Although some still describe the problem as “people eat too much and move too lit-tle, ” this articulation has not brought us closer to understanding what to do to reverse current trends. Various conceptual mod-els have framed the problem of obesity in di!erent ways. Bray suggested an epidemiological model which illustrates agents such as food, viruses, and toxins acting on a host to produce disease, and a homeostatic model where fat acts on the brain (controller) which in turn feeds back to act on the fat (con-trolled system) (1). He described the interpretation of these models as “genetic background loads the gun, but the environ-ment pulls the trigger ” and suggested they imply the need for a simple FLOURIDE (For Lowering Universal Obesity Rate