We don't control everything. There are genetic influences. There are environmental exposures we don't control. I cannot guarantee anyone I counsel that by following what I hope is the good advice I offer them, they will live long and prosper. That's what I'm hoping for but I can't guarantee that. What I can tell them is this: "Look, I can help you firmly grip the wheel, and you can steer the ship. You're never going to control the winds and you're never going to control the seas. But if you sail well you can get through just about anything."

We don't control everything. There are genetic influences. There are environmental exposures we don't control. I cannot guarantee anyone I counsel that by following what I hope is the good advice I offer them, they will live long and prosper. That's what I'm hoping for but I can't guarantee that. What I can tell them is this: "Look, I can help you firmly grip the wheel, and you can steer the ship. You're never going to control the winds and you're never going to control the seas. But if you sail well you can get through just about anything."

The metaphor I routinely use is polar bears in the Sahara desert. You take creatures adapted to the cold and put them in the heat, the very traits that allow them to survive in one environment will conspire against them in the other. We are polar bears in the Sahara with one important distinction: we are smarter than the average bear. Once we identify the nature of the problem, we can think our way out of it. But it begins by acknowledging you didn't fail because you couldn't succeed. Because you didn't even know what the scope of the problem was. It's not your fault.

Color, rather than shape, is more closely related to emotion.

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.

We are creatures. We have a link with a native habitat just like every other species. Throughout most of human history, physical activity was unavoidable, calories were scarce and hard to get. In the modern era, calories are unavoidable, physical activity is scare and hard to get. The traits that allowed our ancestors to survive, and let's face it, the survival of our ancestors is the reason that we're here because the people who don't survive and make very crummy ancestors, are our traits. But they're very much at odds with the modern environment.

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.