|Year : 2014 | Volume
| Issue : 4 | Page : 199-200
Obesity pandemic: An earnest appeal for the transdisciplinary persuasion in research and management
Ashok D. B. Vaidya
Chief Editor, JOMR
|Date of Web Publication||11-Dec-2014|
Ashok D. B. Vaidya
Chief Editor, JOMR
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vaidya AD. Obesity pandemic: An earnest appeal for the transdisciplinary persuasion in research and management
. J Obes Metab Res 2014;1:199-200
Majority of the original articles and reviews submitted to JOMR are from the medical faculty and also do have a preference for obesity/overweight surveys and prevalence in some defined groups. The faculty of humanities is generally conspicuous by their absence. The humongous challenge of the pandemic of obesity is not merely a problem for the world of medicine and nutrition. The multi-factorial basis for overweight/obesity impinges on the expertise and concerns of the domains of psychology, pedagogy, social sciences, economics, politics, agriculture and ecology. The consequences and risk factors associated with obesity are of such a nature that the government, the academia and the industry too must be proactive to stem the pandemic.
The editorial is meant to open up an informed debate on the adoption of a transdisciplinary strategy for research and management in Bariatrics. It is obvious that new knowledge from research in Life Sciences and Social Sciences can contribute significantly to the amelioration of the obesity pandemic. Linda Nebeling, from the National Cancer Institute of NIH, has stressed on such an approach on the "relationship between excess adiposity and cancer risk."  It is hoped that the rate of discoveries and translational speed would be the advantages that will accrue over those with the unidisciplinary approach.
The current emphasis and research have shown adequately that India is turning obese, diabetic and prone to cardiovascular diseases (CVD). , There is an urgent need to engage the Ministry of Human Resource Development (HRD), Government of India (GOI), to give a top priority to the prevention and management of obesity in the school-going children. Rather than focusing on irrelevant changes in curriculum, an effective nationwide campaign of "Stay Slim" by the HRD minister would benefit the nation immensely. The Department of Health Research (DHR), GOI. The resources provided to DHR for translational research in noncommunicable diseases, in the 12 th five-year plan, can be judiciously utilized for the development of a transdisciplinary approach to counter the menace of obesity.
The commissioning of a transdisciplinary team approach for obesity (TTAO) has to be preceded by an in-depth discussion amongst the top experts on the models, methods, management, manpower and money needed for a time-bound program, with defined targets of reduction in the prevalence and amelioration of overweight/obesity. The proposed TTAO should be empowered to suggest legislation, taxes, punishment clauses, advertisement norms vis-ΰ-vis the obesogenic beverages, foods and snacks. The emphasis on a healthy diet, games, exercise, sufficient sleep, and yoga and stress management should be flexibly incorporated at the school and college levels. The accreditation of schools and colleges must give weightage to implementation of such programs and their impact on the health indices of their faculty and students and not only on the academic performance. Lawrence Frank, University of British Columbia, had a program "to study how the built environment impacts physical activity, diet, obesity, incidence of stroke, and overall health status of the people who live there.  The book by Frank et al. on "Health and Community Design" is an eye-opener as to how the built environment influences physical activity.  The TTAO can evaluate how the environment in schools and community is related to diet, physical activity and stress. It is a sad commentary on our educational institutions that many of them do not have playgrounds and games and sports are given a low priority.
There are also commercial interests that are exploiting the situation by offering 'packages' and "concoctions," for reducing weight with tall claims, in garish advertisements in newspapers and magazines. The gullible obese are taken in by the conmen. Even quacks have jumped in for a part of the kill. TTAO needs to enforce ethical and scientific claims in advertisements and labeling. Heavy legal punishments are needed for quacks treating obesity and for companies profiteering from tall and unproven claims of efficacy and safety. JOMR invites the professional bariatric physicians and surgeons to bring such malpractices to the knowledge of authorities and pursue for actions. As the obesity and diabetes epidemics progress, such malpractices will tend to grow.
There are some initiatives for transdisciplinary programs in obesity. From the University of Nebraska and the South Dakota State University, Wanda Koszewsky and Teresa Kemmer have one such program - Transdisciplinary Childhood Obesity Prevention Program (T.O.P.)  The team includes experts in nutrition, exercise science, family/consumer education, biostatistics, adolescent/youth studies, health promotion, biochemistry, and sociological research. Their definition of transdisciplinary states, "Transdisciplinary research refers to scientific inquiry that cuts across disciplines, integrating and synthesizing content, theory and methodology from any discipline area which will shed light on the research questions." It has been a pithy and direct description, As the obesity is a very complex field, it is essential to create mechanisms and networks which are transdisciplinary and let us think and act out-of-the box. The T.O.P. model may be adequate for research and education. But for the prevention and management of obesity we need to innovate not only experts of the team but also the inter-institutional organization and the nature of community participation. As we have learnt from experience of the teamwork in diabetes care, the obesity management needs obesity educators (OE). The development of the training program for OEs is the first priority for the TTAO. The graduate students of T.O.P. have conceptualized obesity issues in the form of a very complex mind-map.  Any group contemplating interdisciplinary, multidisciplinary or transdisciplinary programs should see this mind-map for the choice of the discipline relevant to their objectives.
The current issue of JOMR carries several articles on how obesity predisposes to disorders and lesions in other systems of the body. ,, The increased risk of diabetes, hypertension, cancer, osteoarthritis, CVD etc., in obesity makes it worthwhile that a transdisciplinary team can identify their earliest features and prevent or delay or mitigate those conditions in time. Currently, there is no such organized transdisciplinary approach for many chronic diseases. The consequences are obvious. We do not detect the early deterioration. Acute emergencies in chronic diseases or uncontrolled chronic diseases strain our health care systems. No wonder even rich countries have poor health care.
A plea is made to challenge the obesity successfully by a transdisciplinary program in education, services and research. The GOI - HRD and DHR should take the initiative with the help of the professional societies concerned and working to combat obesity.
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