In an interview with Matt Lauer the First Lady says that the obesity crisis is “imminently solvable” and “doesn’t require any new technology.”  So, it looks as if we can shelve Qnexa and Vagus Stimulation Research, Michelle has got this one covered.

I’m giving the First Lady a hard time of course, but its important that the contours of the obesity problem be public knowledge. I used to think that experts were wholly incapable of seeing how the future would evolve. We would get these dazzling predictions of flying cars, cures for cancers and the end of poverty. Yet, they never panned out.

Deeper investigation into these issues often shows, however, that many experts were skeptical about achieving these goals in anything like a short time frame. Yet, the imagination of the intelligentsia was entranced and it became popular to speculate about great achievements that were just around the corner.

Obesity is the same way. There is no indication whatsoever that obesity is “imminently solvable” and I would bet that the solution, when it comes, will involve radical new technologies. I am sure that the First Lady has in mind Behavior and Lifestyle Modification (BLM), the idea that we can teach people to live and eat differently.

However, BLM has been an overwhelming failure in long term weight management and there is no reason I know of to think that will change. We can haggle over why BLM is failed. Maybe the interventions weren’t big enough. Maybe the people weren’t dedicated enough. Maybe big agribusiness has hooked everyone on salt and fat.  Maybe . . .

Still, if we can’t get it to work in a clinical setting, with brilliant doctors, fancy equipment and patients who have volunteered, then we should be extremely skeptical that this can be successfully rolled out to the general public.