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The Art and Science of Obesity Management

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Most of us can remember a time when the Marlboro Man was an admirable image of the romantic, rugged individualist. Despite the fact that cigarette smoking was known to increase health risks as early as the 1940s, smoking was widely advertised to adults and children alike, beginning in the 1950s. Amid growing evidence of tobacco's link to morbidity and mortality, this practice continued into the 1990s before any marketing limits were enforced. In fact, in 1992, the most recognizable Marlboro Man, Wayne McLaren, appeared at the annual shareholders meeting of the Phillip Morris Corporation and requested that the company voluntarily limit its advertising, especially to children. McLaren, like thousands of smokers before him, was dying of lung cancer.

For decades, the tobacco industry spent billions of dollars to glamorize smoking, a behavior that is now almost universally accepted as a dangerous and in some cases deadly habit. In recent years, public and political support has increasingly favored limitations on the marketing and consumption of tobacco products. These limits have been hard won against the argument that smoking should be a personal choice, and smokers should accept the consequences of their own actions. However, as evidence mounted that tobacco was detrimental not only to smokers, but also to society at large, public opinion was swayed, and policy reform occurred. Limitations on tobacco marketing and smoking were initiated only after decades of commitment on the part of scientists, politicians, and public policy advocates working together.

Today, we face an alarming epidemic of obesity. The etiology of this epidemic is complex and is affected by economic, psychosocial, and physiological factors, all of which are addressed in this Diabetes Spectrum From Research to Practice section and elsewhere within this issue of the journal.

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