Today–a stark glimpse of tomorrow.

Caloric intake that exceeds energy expended and its consequences, particularly development of type 2 diabetes mellitus, is emblematic of a climate change for modern medicine – a phenomenon so complex, embedded in culture and economics, and intertwined with conflicts between individual freedom and societal health that solutions are difficult to envision. Chronic caloric surplus (rather than obesity itself) is a central cause of epidemic type 2 diabetes,(1) but differences in response to energy excess,(2)-(4) disproportionately present among disadvantaged youth, increase susceptibility to type 2 diabetes in early life. Indeed, the percentage of type 2 diabetes in cases of new-onset…