January 28, 2013

Renowned researcher has high hopes for obesity research at ASU

Posted: January 28, 2013
James Levine on the challenge of obesity: "Finding the right solutions for individuals in their situation at that time that will work for them is what we’re trying to build here. Why, with something as complex as obesity, would we think that one size fits all?"

James Levine, a world-renowned obesity researcher at the Mayo Clinic who recently joined ASU as co-director of the Obesity Solutions Initiative, has worked for 25 years with patients who are struggling to lose weight, and has published his research widely.

He also has participated in the development of devices such as the desk treadmill, the Gruve and other activity monitors. 

Out of all the health problems in the United States, why is ASU tackling obesity?

I would challenge you to find anyone who disagrees that obesity is – if not the primary health challenge to ill health in America – at least one of the top challenges. It’s estimated it accounts for more than half of U.S. dollars spent on health care, for lost work days, diabetes, high cholesterol, hypertension, malaise or depression, early cancer, cardiovascular disease, arthritic pain, obstructive sleep apnea, and the list goes on. What is endured by people with obesity is extraordinary, and many of us health workers blessed with good health don’t realize what our patients are up against.

Do you see people in your practice who have tried many times to lose weight?

Patients in my clinic have made on average 17 attempts to lose weight. To me, that’s heroic. I can’t think of anything in my life I’ve tried 17 times and yet come back for more. My patients are up against such enormous challenges that even trying 17 times doesn’t solve it. That tells you a lot, about the battles people really endure and also the magnitude of the challenges. That’s why we‘ve formed the initiative.

Why is obesity such a complex problem?

It’s not as simple as advising people to diet and exercise more, because we’ve been doing that for decades, and that’s obviously not the answer. There are multiple factors involved. Poverty is a major driver of obesity in America. People living in poor zip codes have low access to healthy food. Also, we’re all under tremendous stress, and many of us respond to stress by eating. Many people are lonely, and they often eat more than they need to for sense of comfort. For cultural reasons, some people like to have a bit of extra weight. Lack of sleep is a major driver in obesity, as is prior abuse history. There are a whole catalog of factors that are maybe even more important than diet and exercise.

Finding the right solutions for individuals in their situation at that time that will work for them is what we’re trying to build here. Why, with something as complex as obesity, would we think that one size fits all?

How does poverty play into obesity, other than lack of access to healthy food?

I was just in Cleveland, where I’ve done a lot of inner city projects, and the challenges bring tears to your eyes. There are people who have diabetes but can’t get to a health care center. People who want to be active but are afraid to go out at night and exercise. Kids can’t go to the playground because that’s where the drugs are dealt, and kids can get shot. People want to be healthy, but it’s so difficult to achieve that.

Why is losing weight so difficult for people who have the means to exercise and eat healthy foods?

We’ve lost a sense of balance. Many people are so busy and caught up in the morass that we don’t put health at the top of the priority list. I talk to my patients about having breakfast, sitting down with a significant other, reading the paper, starting the day right. And healthy people do that. It’s an art as much as science. Part of what we’re trying to do is create the sense in individuals that health is available for all of us, but we need to grasp it. It needs to be prioritized. There are tools and techniques to do it.

If obesity is now so widespread globally, is it a problem that can be solved?

I’ve met people who don’t think obesity is solvable. They say it’s too late. They argue that the solution is to give all children a tablet to prevent diabetes and high blood pressure. But obesity has evolved over only one generation, so it’s a relatively new problem. It’s not going to be solved in one year. Who’s going to fight for our children and grandchildren if we don’t? Obesity is solvable, but we’re going to need to do it collectively, and to be sensitive to the fact that different people are going to need different approaches.

Why has Mayo Clinic partnered with ASU in this endeavor?

What we’re trying to do is build this amazing academic enterprise. The world’s finest medical center is the other half of this alliance. By combining Mayo and ASU in this endeavor, it’s like a dream team of how to impact obesity in America. We have a group of physicians and scientists who are expert, skilled in the art of understanding health. Here at ASU, having access to the scientists and mathematicians who work in complex adaptive systems, is obviously a perfect fit. We have a group of dynamic, innovative scientists and shared intellectualism to bring this to fruition. Could you think of a better combination than Mayo and ASU? If we ever had a chance to impact obesity in America, this has to be one of those opportunities.

You have helped develop technology that promotes activity. Will that be part of this initiative?

We have a large interest in using technology to help people be active and eat well. With 100 million Americans who are obese and overweight, we don’t have enough counselors. We have to use technology. We’re building certain technologies here. We’ve already funded an ASU company and multiple other companies are coming to us with their ideas.

Will developing new businesses be part of the initiative?

Overweight patients spend 65 billion dollars on creams, diet drinks and other products, many of them unproven. People with obesity are willing to give of their own personal resources to find a solution. So why hasn’t someone built a series of businesses that actually help people? We want to encourage young entrepreneurs to bring their business acumen to obesity. We want a multitude of businesses to come out of this initiative that bring clever, scalable business solutions that help people effectively and ethically lose weight.

Not only are there great scientific opportunities to do things we’ve never done before, but this is an area that is opportune to help so many people. New businesses will come out of this enterprise, and companies may come to us to test new products. I want lots of corporations to come to us, so we will know how to test and deploy these things as no one has done before. Ethics and business have to go hand in hand.

Why did you decide to affiliate with ASU, in addition to your work at Mayo?

The real answer is that I was entranced by the leadership, which is so dynamic and so committed to building enterprises that address societal issues, in a profound way. For the first time in my professional career, I was at an academic institution that literally wanted to take a societal issue and solve it. That literally blew me away.

It doesn’t take five minutes to look at the breadth of talent here, not just the faculty but the students, and you get a sense of the capacity of ASU. It’s extraordinary. This is a world-changing group of people. The faculty are amazing, but the people who will effect change are the students. Here I’ve met students who want to change the world they live in. What a privilege! What choice did I have?

What has been the response so far?

The response has been overwhelming, from faculty who want to work in obesity, and from students emailing me out of the blue, wanting to get involved. There has been a flood of interest in work we’re doing. Large corporations are coming to us. It’s humbling. Every day is like a magical roller coaster ride.

Sarah Auffret, sauffret@asu.edu
Media Relations