Adipose in Candyland: Diet and exercise in a pill

Daniel Lambert, born in Leicester in 1770, was one of Georgian England’s biggest celebrities. Literally. Lambert weighed 52 stone 11 pounds (335 kg) when he died aged just 39 years¹ – a body mass index of 104 kg/m². His waist circumference was 9 foot 4 inches (284 cm). His calf circumference, 3 foot 1 inch (94 cm),¹ was about the same as today’s maximum recommended waistline for men from most ethnicities.²

More than 250 years later, the struggles of morbidly obese people are reality TV mainstays. But most adults battle their bulge. In 2019, the most recent estimates, 28.0% of adults in England were obese. Another 36.2% were overweight. So, two-thirds (64.2%) were either overweight or obese. About one adult in every 30 was morbidly obese (3.3% of all adults).³ Obesity became so common because of a fundamental ‘mismatch’ between the biological factors that endeavour to keep us alive and our changing environment.¹ As Power and Schulkin comment ‘We evolved on the savannahs of Africa; we now live in Candyland’.¹