My view is, in between environmental determinism and personal responsibility, we say, "where there's a will there's a way." It's not true. You really need both and they're somewhat independent. We must both cultivate will and pave the way. If you inspire an impassioned people so that they have the will but there's no way, all around them are walls with no doors or windows. It's terribly frustrating. On the other hand, if you put a very nice way at their feet and they have no will to follow it, that doesn't produce anything very good either. Will is not way. You need both.

Epidemic obesity is an enormous problem. It's a pendulum that's swung too far. We have to swing it back. So it should come as no surprise that solution must be built from the ground up on the banks of this flooding river and it must be raised to a height higher than flood waters. Now what does that look like? It looks like policies and programs that cultivate healthy levels of physical activity, healthy dietary patterns in homes, in schools, in supermarkets, in neighborhoods, in clinics, in churches, in workplaces, throughout our society, every place we can reach people.

When I went to medical school, I was taught about two basic kinds of diabetes: juvenile onset and adult onset. From the time I did my training in medical school to the end of my residency we were already seeing the transformation of adult onset diabetes into Type II, which is what we call it now, which from my perspective is a euphemism we have draped over this condition to conceal the fact that what was a chronic disease in midlife is now epidemic in children. Frankly, Type II diabetes in a seven year old is adult onset diabetes. We just don't want to confront that unpleasant fact.

What we need to do now is recognize that it is the sum total of human ingenuity that is responsible for the epidemics of chronic disease. Throughout most of human history, calories were scarce and hard to get, and physical activity unavoidable. Calories are now abundant, and physical activity is hard to get. We took an unstable, uncertain food supply and fixed it. What now passes as exercise and requires specialized footwear used to be called "survival." You had to do it. Now you never have to do it. We solved it too well. Now we don't need our muscles for anything.

We have literature indicating that overwhelmingly, health is influenced by a very short list of modifiable behaviors topped by three: tobacco use, physical activity and dietary pattern. You could modify those three things; you can change people's fate. I wanted to change those. Smoking cessation, important but relatively simple - a lot of people are working on that. Physical activity: important to me, important to health but also relatively simple. I like nutrition. It's complicated; you really need to learn a lot of stuff to be an expert there.

There is one thing that very reliably try to trumps the food supply and that is food demand. At the end of the day, the business of business is business and they are just trying to keep the customers satisfied, it depends what we want. The problem in our current mess is we want all the wrong stuff. Why do we want the wrong stuff? Because taste buds are very malleable little fellows. They learn to like what they know. We're bathing our taste buds in too much sugar, too much salt, too much processed food all day long. That's what they know and crave.

My view of chronic disease prevention of fighting epidemic obesity and diabetes, of turning the tide, is that it is the job of professionals to pave the way and to cultivate the will; to stir people up so that they understand the stakes, so that they recognize that adult onset diabetes stalking children is a clear and omnipresent danger. The wolves are at the door. You must defend hearth and home. And here are the means to do it: we must provide programs, policies, tools and resources so that everybody can do the job.