There are moments in history when events unfold in ways that leave us both confused and bewildered. Such is the case with the current debate surrounding the concept of “obesity as a disease.” To understand how we arrived at this point, we must turn back the clock to the 1990s and early 2000s.

At that time, the number of obese adults was half of what it is today, and the obesity rate among children was only a quarter of current levels. This raises a critical question: What changed? How did these numbers rise so dramatically in such a short period? ¹

Were we truly facing a health crisis that required a pharmacological solution? Or were we witnessing sociocultural shifts that reshaped our behavior and daily lives? In hindsight, it’s clear that our lives were profoundly transformed during this period, and the focus should be on these structural changes.

During this decade, computers and cell phones began to dominate our routines in ways few had anticipated. Rather than “going out into the world,” the world came to us—literally at our fingertips. While this technological transformation brought undeniable convenience, it also had significant downsides. Suddenly, most tasks could be accomplished without leaving home, drastically reducing our levels of physical activity, altering sleep patterns, and impacting our overall health. To truly understand the rise in obesity, we must examine this cultural shift.

Central to this transformation was the way computers took over our lives and expanded our egos. Before the digital age, our sense of self was rooted in interactions with the outside world, grounded in face-to-face relationships. Being seen on screen was rare, typically reserved for television or film—a marker of celebrity.

However, with the advent of the digital age, the concept of being “on screen” shifted dramatically. Suddenly, anyone could be on screen, expanding their sense of self through the digital lens. This shift had a drug-like effect on consciousness.²

Psychologically, reinforcement plays a key role in shaping behavior—rewards influence our actions, and the more frequently they occur, the more likely we are to continue those behaviors. If you’ve ever played a slot machine, you understand this phenomenon. The same principle applies to the screens on our devices. Both environments tap into the same cycle of reward and reinforcement.

Now, let’s dig deeper into what is being reinforced. It’s one thing to use a computer for work or information; it’s another to engage in social media, where an online identity is crafted through photos, stories, and opinions. Gaining followers or validation online can become addictive. The more likes and clicks you receive, the stronger the attachment, and the more time you spend developing your online presence.

More importantly, the more sedentary your life becomes because of late-night screen time, the more likely you’ll suffer from sleep deprivation. This condition is notorious for increasing appetite and decreasing energy, creating a breeding ground for obesity: You eat more and move less, and your body suffers the consequences.

So, what do we do now? How can we begin a process that provides structure, information, and reinforcement, gradually reversing these cultural patterns over the next decade?

This is no easy task, especially with weight-loss drugs now dominating the scene. Still, it’s time to think programmatically, focusing on children and implementing lifestyle intelligence strategies within school curriculums.

Let’s imagine a world that has already addressed these issues. What would it look like? It would involve all aspects of a child’s life: family, school, and healthcare professionals. And most importantly, it would start in elementary school, giving it time to become embedded in consciousness.

Schools would serve as the hub for this interaction. Monthly meetings with parents would focus on core lifestyle intelligence elements: nutrition, sleep, and physical activity. Parents would listen to experts, discuss challenges, and develop strategies for implementing healthier habits. Changing a model of reality takes focus, discipline, and the ability to cope with inevitable frustrations. Schools would provide the necessary structure and support system.

Assuming this strategy gains traction, what else is needed to potentially embed this model into the culture? The answer lies in education. Elementary school textbooks could easily weave lifestyle themes into the fabric of their lessons. For example, literature could include stories that reference healthy behaviors, and math problems could involve exercise data. By subtly incorporating health-conscious themes into educational materials, we can help create a new lifestyle model of reality. This should be followed by a junior high school biology course that teaches teenagers the science of a healthy lifestyle.

In theory, this model for health-related behavioral change sounds good. But we all know how difficult it is to translate the abstract into the concrete. Now, let’s step back into our current reality. Obesity has been labeled a disease, and this label is unlikely to change any time soon. This begs the question: How did we get here, given the wealth of scientific information on the relationship between lifestyle and body size?