Systems thinking and obesity: meet Bruce Y Lee

Professor Bruce Y Lee

EASO is pleased to share our interview with Professor Bruce Y Lee, Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University.

Professor Lee, you participated in a popular session at the 2017 European Congress on Obesity in Porto. Can you tell us about your session?

As I wrote previously for Forbes, I am frequently asked the following question, “What is the one thing that can be done to stop the global obesity epidemic?” My answer: “The one thing you can do is stop asking that question.” We’re never going to stop the global obesity epidemic until everyone stops looking for a single cause or a single solution…and stops saying that obesity is a simple problem…and stops blaming people for their weight issues. When is the last time a major worldwide problem had a single simple cause and simple solution?

If you just try to tell people to improve their diets, what if they are surrounded by unhealthy food and people who eat unhealthy food? If you just try to reduce fat in foods, what if they eat more sugar, salt, and artificial ingredients? If you tell people to exercise more, what if they don’t have access to parks or running trails or can’t afford to play sports? This is just a small sample of how complex a problem obesity is, since your genetics, biology, behaviors, family, friends, co-workers, environment, financial situation, and many other systems affect your weight.

My esteemed colleague during the session Dr. Harry Rutter summed it up nicely: thinking about complex things is not easy. The tendency can be to try to simplify complex problems. Instead, the key is to use new systems approaches and techniques to better understand the complexity involved and develop the right solutions. Systems approaches have transformed other fields and industries, such as manufacturing, meteorology and transportation, and has the potential of transforming obesity prevention and control. That essentially was the theme of our session at the European Congress on Obesity in Porto, Portugal.

What was the theme of your presentation?

After Dr. Stef Kremers led off with a good talk on the theory of Systems Approaches, Dr. Rutter then gave a lively presentation on why Systems Approaches are needed to address the obesity epidemic. Finally, I gave examples of how our computational simulation model of Baltimore, Maryland, in United States has helped decision makers design, test, and adjust different obesity policies and interventions in the “safety” of a computer before implementing them in the real world. We call this model VPOP (Virtual Populations for Obesity Prevention) Baltimore. The model represents each of the people, homes, schools, key food sources (e.g., corner stores, grocery stores, and restaurants), and key physical activity locations (e.g., parks and recreation centres) for Baltimore City. Think about it. NASA doesn’t send the Space Shuttle or a rocket into outer space without using simulation models to test different circumstances and possibilities, Why shouldn’t we do this when trying to address obesity and many more lives are at stake?

-In addition to being a professor at JHU you are director of The Global Obesity Prevention Center (GOPC) at Johns Hopkins http://www.globalobesity.org/about-the-gopc/ – the first center to bring a systems approach to the obesity epidemic. Can the you tell us a bit about the centre and a couple of your current projects?

Our Global Obesity Prevention Center (GOPC) at Johns Hopkins University is a University-wide Center, including faculty, staff, and students from a wide variety of disciplines, departments, and schools such as the Bloomberg School of Public Health, School of Medicine, Carey Business School, and Whiting School of Engineering. Our GOPC brings together a mind meld (for all you Star Trek fans) of experts from disciplines that have traditionally worked on obesity (e.g., nutrition, psychology, epidemiology and biology) with experts new to obesity (e.g., computer science, marketing and engineering) to bring innovative methods and tools and work with stakeholders around the world to tackle this major global epidemic.

Here are just a few examples of our GOPC’s work:

  • Our Systems Science Core, with the coordination of Marie Ferguson and Daniel Hertenstein, is developing computational simulation models of different cities and communities and tools to collect and analyze big data…and medium, small, and even itsy bitsy data.
  • Dr. Joel Gittelsohn has been designing and implementing multi-level community interventions to increase the affordability, availability and consumption of healthy foods within different communities.
  • Dr. Tim Moran has been conducting studies to better understand the complex biological pathways between our mouths, gastrointestinal tracts, and brains that govern hunger, satiety, metabolism, and weight.
  • Dr. Susan Carnell has been using brain imaging to determine how environmental cues affect our appetite and eating behaviors.
  • Dr. Brian Schwartz has assembled multi-level data on children from 37 counties in Pennsylvania and found relationships between different types of medication use in early childhood and subsequent risk of obesity.
  • Dr. Larry Cheskin has been evaluating the use of mobile devices and strategies such as text messaging to help with weight loss.

Our GOPC was started because the National Institutes of Health (NIH) recognized the need to apply a systems approach to obesity prevention and control. By applying a systems approach to obesity, we mean addressing all of the complex factors that affect our diet, physical activity, and health such as the environment, policy, biology, social networks, and economics to name a few.

I’m sure our New Investigators would be particularly interested in learning about your background and career trajectory:

You know those careers where you decide at an early age what you want to do, plan everything out, and then everything goes according to plan? That is the exact opposite of my career. Growing up I had a variety of interests including playing sports, math, science, playing with computers, drawing, photography, building things, writing, teaching, problem-solving, and helping others. After college and medical school, my path took a variety of twists and turns. I ventured into the business world, working in biotechnology equity research at Montgomery Securities, serving as Senior Manager at Quintiles Transnational, and co-founding a biotechnology company. Eventually I moved into academics because the prospect of having the freedom to teach, do research, and explore different things was attractive. After becoming an Associate Professor at the University of Pittsburgh, I was recruited to the Johns Hopkins Bloomberg School of Public Health, where I am now an Associate Professor of International Health, an Associate Professor at the Johns Hopkins Carey Business School, and Executive Director of the Global Obesity Prevention Center. Along the way, I wrote several books and began writing for various media outlets such as the HuffPost and Forbes. There were many times when my path didn’t seem to make sense to others who were more used to traditional paths. For example, it confused the heck out of one of my friends who had followed a textbook straight career trajectory to become a successful surgeon and had everything in his life seemingly go according to his original plan. But experiencing different professions and industries, working in numerous countries, and meeting many different people from many different backgrounds have given me experience, skills, and perspective that I use every day.

My advice to new investigators is the following:

  • There is no single right career trajectory. What works for one person or many people may not work for you. If someone tells you there is one way to do something, run the other direction.
  • Some people are happiest focusing on one thing and one area. Others are happiest doing many different things and trying to connect them. The world needs both types and those in between. Find out who you are and do that.
  • Don’t be too quick to judge an event in your life or career. You never know when it will turn out to help you. Unless you sat in an empty room, interacted with no one, and did nothing, there is no such thing as
  • completed wasted experience. They key is to find out what it can teach you.
    Try to find something that you enjoy doing day to day and solve problems (regardless of how big or small).
  • If you are in Benin in West Africa, do not have someone who doesn’t speak fluent French order food for you. You may not like what you get.

Professor Lee, your interesting, clear and sometimes laugh-out-loud writing has earned you a huge audience and following on Forbes, and social media and with it excellent opportunity to influence the general public and the business community. How do you balance this crossover role as journalist, research scientist and clinician?

You’ve heard of the saying, “If a tree falls in a forest and no one hears it, does it make a sound?” Well, similarly, a really cool scientific discovery or a key treatment can’t really help others, if they don’t understand it. There’s so much good scientific work being done around the world such as the projects seen at ECO2017, the 24th European Congress on Obesity. But not everyone knows about or really appreciates this work. While my foreign language skills aren’t the best (beyond being able to inadvertently offend people or ask “where’s the bathroom” in different languages), I really enjoy crossing over different disciplines, professions, and industries, experiencing their cultures, and trying to speak and translate their languages.

Biography

Professor Bruce Y Lee

Executive Director, Global Obesity Prevention Center (GOPC)
Associate Professor, Department of International Health
Director of Operations Research, International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health
Associate Professor, Johns Hopkins Carey Business School

Bruce Y. Lee, MD, MBA is an Associate Professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health, Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins (www.globalobesity.org) and Director of Operations Research at the International Vaccine Access Center (IVAC) as well as Associate Professor at the Johns Hopkins Carey Business School.  Dr. Lee has over 15 years of experience in industry and academia in systems science and developing and implementing mathematical and computational methods, models, and tools to assist decision making in public health and medicine.  He has been the Principal Investigator for projects supported by a variety of organizations and agencies including the Bill and Melinda Gates Foundation, the National Institutes of Health (NIH), the Agency for Healthcare Quality and Research (AHRQ), the Centers for Disease Control and Prevention (CDC), UNICEF, the Global Fund and USAID.

His previous positions include serving as Senior Manager at Quintiles Transnational where he led teams that developed economic and operational models for a variety of clients in the pharmaceutical, biotechnology, and medical device industries, working in biotechnology equity research at Montgomery Securities, and co-founding Integrigen, a biotechnology/bioinformatics company, and serving as an Associate Professor at the University of Pittsburgh, where he founded PIHCOR (Public Health Computational and Operations Research), which is now based at Johns Hopkins.

Dr. Lee has authored over 190 scientific publications (including over 90 first author and over 60 last author) as well as three books: “Principles and Practice of Clinical Trial Medicine”, “What If… ? : Survival Guide for Physician’s, and “Medical Notes : Clinical Medicine Pocket Guide”. He is an Associate Editor for the journal Vaccine and Deputy Editor for PLOS Neglected Tropical Diseases. .  He and his work have garnered attention in leading media outlets such as the New York Times, Los Angeles Times, Time, CBS News, Businessweek, U.S. News and World Report, Bloomberg News, Reuters, and National Public Radio (NPR). Dr. Lee received his B.A. from Harvard University, M.D. from Harvard Medical School, and M.B.A. from the Stanford Graduate School of Business. He completed his internal medicine residency training at the University of California, San Diego. His Twitter handle is @bruce_y_lee.

Dr. Lee is also a regular contributor to the Huffington Post and Forbes.

Find his publications here: https://www.ncbi.nlm.nih.gov/pubmed/?term=Lee+BY

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