Obesity: It’s Not Just the Sugar

Professor Roy Benaroch, M.D.

For a while, fat was the culprit – eating too much fat was making us fat.

We were swamped by low-fat products, like cheese and salad dressings and even low-fat potato chips. Briefly, Burger King even offered low-fat French fries (Those quickly disappeared from the menu. Don’t mess with the fries.) Yet, with or without the low-fat foods, obesity rates continued to climb.

More-recently, sugar has emerged as the “deadly villain” in the obesity epidemic. Forget the fat – it’s the sugar, or the refined high fructose corn syrup, that’s messing with our metabolism and expanding waistlines. Just cut back—or eliminate—added sugar, and our weight problems will be over.

This article originally appeared in Professor Roy Benaroch’s blog, The Pediatric Insider.

But a recent study from Australia shows that maybe it’s not so simple as blaming the sugar, either. Researchers there found that, on a population level, reduced sugar consumption was associated with an increasing rate of obesity. It’s funny how real-world data seems to clash with our little pet theories sometimes.

The authors used data about food consumption from several different academic and government sources, creating graphs of overall per capita sugar consumption among Australian adults and children from 1980 and 2011. Although the exact numbers vary by demographic groups, there was a clear overall trend towards less sugar intake over those years. They then looked at obesity rates, based on national surveys.

The combined data is in the graph below. Sugar consumption is in blue, and though it goes up and down some years, the overall trend is downwards. In red you can see the Australian obesity rates. There’s more data in the paper about specific groups (men versus women, children versus adults), but overall the trend is clear: less sugar consumption is associated with more obesity.

Graph demonstrating the relationship between sugar consumption and obseity rates in Australia

The authors conclude, “There may be unintended consequences of a singular focus on refined sugars…”

So if it’s not the sugars, and it’s not the fat, what is it? I think it’s unlikely that there is a single boogeyman, or a “one thing” we can point our fingers at as the culprit. Obesity has many contributors, including decreasing physical activity, eating bigger portions, and eating more frequently. Low-quality “fast food” is quick and convenient, but it’s certainly not cheap in the long run. A ton of extra sugar can’t be good for your teeth, and is one source of extra calories you don’t need. But it’s not just the sugar that we’re eating too much.

Professor Roy Benaroch, M.D. is Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine
His lecture series Medical School for Everyone: Pediatrics Grand Rounds is now available to stream on The Great Courses Plus.
This content is for informational purposes only. Communicating via this post does NOT create a doctor-patient relationship. If you have a medical concern specific to your child, contact your own pediatrician.


  1. We need to look at other things that have increased since the obesity epidemic, including things our pets are exposed to since it has also affected dogs and cats. Diabetes has become common,where it used to be rare in dogs and almost non-existent in cats. I wouldn’t blame it on feeding them scraps since I know of some cats who had diabetes who were never fed scraps. One item that has increased tremendously is the use of plastics, including for food packaging and storage and for water pipes. An experiment using laboratory animals fed food exposed to various plastics and not exposed would be in order if it were possible to find food and water that hasn’t been exposed.

  2. How about all the fake sugars that are poisonous and making people who drink diet sodas fatter… Or the genetically modified foods that our guts and bacteria don’t recognize entirely recognize as “food”. .. Or our guts are overwhelmed and losing good bacteria because of bad eating habits… then there is all the stress of technology occupying all our time, making some people anxious, or not getting exercise…. Or maybe sleep?

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