How RFK Jr. could reverse our country’s foolish approach to obesity

The river was swift and brutal and the current carried victim after victim downstream. Local villagers responded by stretching nets over the water to prevent further drownings. But despite their efforts, the death toll continued to rise.

Finally, a newcomer to the village asked a simple but critical question: “Why do people fall into the river in the first place?” As they followed the water upstream, the villagers discovered the source of the problem: a crumbling bridge that sent person after person into the rapids.

This “upstream parable” illustrates the folly of America’s response to obesity.

Like the villagers, Americans have relied on reactive, downstream solutions to combat the problem. Bariatric surgery and, more recently, weight loss medications like Ozempic and Wegovy have helped people lose significant weight, but they don’t address the reason why people become obese in the first place. Likewise, decades of well-intentioned government efforts – food labeling, public health campaigns and exercise programs – have failed to stem the tide.

Addressing the root causes of obesity requires a shift from current reactive measures. Then along comes Robert F. Kennedy Jr. featured, the controversial candidate for Secretary of Health and Human Services. While his appointment raises important questions, it also provides a rare opportunity to confront the drivers of the obesity epidemic. If confirmed, Kennedy could change the trajectory of this growing crisis.

Obesity: Why the Cause of the Problem Matters

Obesity rates in the United States have skyrocketed over the past thirty years. According to The LancetThe percentage of American adults classified as overweight or obese has more than doubled, rising among women from 22.5% to 45.6% and among men from 18.6% to 41.5%.

For adolescents, the situation is even more alarming. During the same period, obesity rates tripled, with the CDC reporting a fivefold increase in the number of children ages 6 to 11 since the 1960s.

The health consequences extend far beyond just weight gain. Obesity is a major cause of diabetes and cardiovascular disease. The American Cancer Society identifies it as a factor in 40% of all cancer cases and 50% of cancer deaths, with clear links to malignancies of the uterus, esophagus, kidney, liver and gallbladder.

But despite the meteoric rise of the obesity epidemic in just a few decades, public health leaders are increasingly describing it as a genetic and biological condition. The Obesity Medicine Association calls it a “chronic, relapsing, multifactorial, neurobehavioral disease,” and the American Academy of Pediatrics considers childhood obesity “a chronic and complex disease with lifelong health consequences.”

While most organizations recognize that there are multiple contributing factors, their focus on biological explanations and medical treatments – such as drugs and surgery – has overshadowed the true driver of the epidemic. A doubling of obesity in just thirty years cannot be explained by genetics or biology; human DNA evolves over millennia, not decades.

The main culprit is the food industry and its deliberate production and marketing of ultra-processed, high-calorie products packed with refined sugars and unhealthy fats.

Genetics plays a role in obesity. The FTO gene, which increases susceptibility to overeating, helped early humans survive periods of scarcity by encouraging the storage of calories during times of abundance. Over the past thirty years, however, the food industry has exploited this evolutionary relic for profit. By developing products that trigger the release of dopamine in the brain, manufacturers have created food addiction behaviors that lead to overconsumption.

The result is a population that is increasingly dependent on nutrient-poor, high-calorie foods. Today, 42% of American adults are obese, costing the healthcare system $173 billion annually.

Although GLP-1 weight loss medications provide an effective treatment for people already struggling with obesity, they must be used lifelong to maintain results. Nearly half of all patients stop taking these drugs within two years, and the annual cost of the drug – more than $10,000 per person – puts enormous strain on patients and payers, including soon Medicare.

Without changes in food production and marketing, the chronic disease crisis – which is responsible for 30 to 50% of preventable heart attacks, strokes, kidney failure and cancer – will only worsen.

To improve our nation’s health and make medical care more affordable, the next HHS Secretary will have to force this change.

Robert F. Kennedy Jr.: A Controversial Hope

RFK Jr., who is awaiting Senate confirmation as President Trump’s nominee for HHS secretary, is a polarizing figure. Kennedy has a history of promoting scientifically debunked theories, such as the claim that vaccines cause autism or that COVID-19 was “targeted to attack white and black people” while sparing Jewish and Chinese people.

While these troubling views should not be overlooked, we should also not dismiss his advocacy for chronic disease prevention, nutritional reform, and the value of primary care. If confirmed as HHS Secretary, Kennedy has the potential to drive transformative change in the food industry, tackling the root cause of obesity more aggressively than any of his predecessors.

Kennedy has been outspoken in his criticism of the Food and Drug Administration, accusing the organization of suppressing access to products that “promote human health but cannot be patented by” pharmaceutical companies. He has also opposed the widespread use of GLP-1 drugs for weight loss, describing them as a short-sighted approach to combating obesity. Kennedy has even gone so far as to say that Novo Nordisk, the maker of Ozempic, is marketing the drug to Americans “because we are so stupid and so addicted to drugs.”

Looking to the past for healing

After promising to confront the food industry and revive American health, the question now is, “How could Kennedy achieve these ambitious goals?”

History provides a blueprint that has two parts: prohibition and taxation.

In the 1970s, research linked lead in gasoline to serious neurological damage in children. In response, the Environmental Protection Agency phased out leaded gasoline in 1986, a policy that has reduced lead levels in children by more than 90%. Likewise, eliminating lead in paint and pipes demonstrated the power of legal bans to bring about public health improvements.

More recently, local governments in Berkeley, California and Philadelphia implemented soda taxes to curb consumption of sugary drinks, causing sales to drop by as much as 38%. Despite resistance and heavy lobbying from the beverage industry, these measures show how negative financial incentives can effectively promote healthier choices.

The path forward

As long as high-calorie, processed foods dominate grocery stores, school cafeterias and restaurant menus, the nation’s health will remain in crisis.

A realistic solution lies in taxation. If sugar- and fat-laden products contribute hundreds of billions in health care costs, those expenses should be reflected in their prices. The revenue from these taxes, coupled with future savings from reduced healthcare expenditures related to obesity, could subsidize healthier food options for low-income families.

This dual approach – discouraging harmful choices and promoting affordable, nutritious alternatives – has the potential to reshape America’s food environment and improve public health for generations to come.

I have Robert F. Kennedy Jr. never met, so I can’t explain his most controversial and unscientific health views. But if his appointment is confirmed and his tenure transforms the food industry into a force for health, I will applaud his efforts to combat the root causes of obesity.

Within the halls of Congress, Kennedy has an opportunity to gain bipartisan support. Democrats have long supported nutritional improvements for disadvantaged families, while Republicans could support reforms that reduce health care spending and improve public health.

The time has come to move upstream – to rebuild the crumbling bridge of America’s health care system instead of relying on the safety nets of downstream solutions. The next HHS Secretary will face significant resistance from the food industry in pursuing this course, but bold and decisive action is essential. Strong leadership can turn the tide of the obesity epidemic and deliver a stronger, healthier future for our nation.