Tomorrow's Cure — "Obesity, Behavior, and the Heart: How We Fix It"

Podcast: Tomorrow’s Cure, Mayo Clinic
Date: February 4, 2026
Host: Kathy Werzer
Guests:

• Dr. Andres Acosta (Mayo Clinic, Gastroenterologist, Obesity Researcher)
• Nancy Brown (CEO, American Heart Association)
• Dr. Kevin Volpp (Scientific Lead, AHA Food is Medicine Initiative; Director, CHIBE, UPenn)

Episode Overview

This episode brings together leading voices in cardiovascular health and obesity to explore the US heart disease epidemic, focusing on the intertwined roles of behavior, biology, access, and innovation. The panel discusses new research, disparities, the promise of personalized prevention, and future visions—including “food as medicine”—to combat rising rates of obesity and heart disease.

Key Discussion Points & Insights

1. The Personal Nature of Heart Disease ([02:09]–[04:19])

• Host's Family Wake-Up Call: Kathy shares her family’s tragic prevalence of heart disease, setting a candid, personal tone.
• Panel's Connections: All guests share direct family or personal battles with heart disease or risk factors, including stroke, diabetes, and cardiac arrest.
  • Dr. Volpp on prevention and risk:

    “You realize that whatever your baseline risk level is based on genetics, you can lower it by ... changing people's behavior to embrace healthier lifestyles.” ([04:08], Dr. Kevin Volpp)

2. Why is Heart Disease Still the #1 Killer? Systemic & Behavioral Challenges ([05:32]–[08:19])

• Progress: Deaths have been halved since the 1920s, but risk factors like obesity and hypertension are rising.
• Social Determinants:
  • Access to care, food deserts, targeted marketing (e.g., for tobacco/sugary drinks), and economic inequality create barriers to healthy choices.
• Memorable Quote:

  “People don’t wake up every day saying, ‘I think I’ll live an unhealthy lifestyle so I can die early.’ ... Health buys them the ticket to everything else they want in life.” ([06:29], Nancy Brown)

3. The Expanding Epidemic: Childhood & Socioeconomic Disparities ([08:08]–[10:59])

• Alarming Trends: US obesity tripled since 1980; ~42% of Americans are now obese.
• Youth at Risk: Many teens exhibit heart disease risk markers by 18.
• Disproportionate Impact: African American, Latino, and low-income communities—and women—are especially vulnerable due to both genetic and societal factors.

4. What is Obesity? Disease Complexity & The Promise of Precision Medicine ([11:30]–[14:27])

• Obesity is Heterogeneous—not a one-size-fits-all condition. Genetics, environment, metabolism, and behavioral drivers differ.
• Acosta’s Phenotype Model: Four major biological/behavioral subtypes (“hungry brain,” “hungry gut,” “emotional eating,” and “low burn”).
• Tailored Interventions: Studies show that matching therapies (lifestyle, meds, devices) to phenotype can double weight loss outcomes.
• Quote:

  “The most important thing is understanding the biology ... what’s driving them to overeat or to not burn enough calories ... there’s an underlying treatment.” ([15:28], Dr. Andres Acosta)

5. Food As Medicine: Innovations in Nutrition, Equity, and Healthcare ([17:58]–[24:30])

• AHA’s Healthcare by Food Initiative: Researching prescriptions of specific food programs—tailored by clinical need, intensity, and patient readiness.
• Community Vision: Medically tailored meals or “produce prescriptions” could be reimbursed as part of therapy.
• Cost Effectiveness: Healthy food prescriptions may eventually prove more economical (and effective) than new anti-obesity medications alone.
• Employer & System Sustainability: Food interventions could help large employers and public insurers balance cost with health impact.
• Quote:

  “We can now say, give me a prescription for healthy food. Five years ago that would have been inconceivable.” ([21:34], Dr. Andres Acosta)

6. Real-World Impact: Heart Failure, Malnutrition, and the Power of Nutritional Interventions ([24:30]–[27:12])

• Heart Failure: Leading cause of hospital readmissions; intensive food interventions could cut this by 20–60%, improving outcomes and reducing costs.
• Speed of Improvement: Even 1–2 month nutrition interventions can restore health, particularly among the malnourished elderly.
• Muscle Mass in Older Adults: As important as weight loss—preservation is key for longevity and quality of life.
• Quote:

  “Gaining health can happen at any time. For all of us. It doesn’t matter the age.” ([27:17], Dr. Andres Acosta)

7. Moving from Reactive to Proactive Healthcare ([28:49]–[32:00])

• Current Healthcare Model: US excels at high-tech treatment after disease develops, but is poor at upstream, preventive care.
• Challenge: Helping people make healthy eating the easy, default choice amid an obesogenic environment and industry marketing.

8. Communication & Social Change ([32:00]–[33:32])

• AHA Advocacy: Combats the “noise” of unhealthy food marketing with targeted messaging (e.g., Go Red for Women, social media, community programs).
• Empowerment: Personal family health history is key—know your own risks and take control.

9. Future Visions & Hope ([33:32]–[38:52])

• Takeaways (Final Round, [33:32]):
  • Nancy Brown:
    • Cherish and focus on your own health, know your family history.
  • Dr. Acosta:
    • Precision diagnostics will soon guide personalized diets—ending trial and error by matching food and medicine to your unique biology.
    • Quote:

      “I would love in the future to have that diagnostic test ... [telling you] ‘you need to eat this diet, these things here’ ... personalized precision medicine.” ([34:54])

  • Dr. Volpp:
    • Research is accelerating: 35 ongoing studies.
    • Cutting sugary drinks is a simple but powerful individual intervention.
    • Behavioral “food as medicine” programs—and policy change—will transform cardiac risk on a population level.
    • Quote:

      “If there’s one thing you want to do for your health ... just drink less sugary beverages.” ([37:44])

  • Nancy Brown ([38:52]):
    • Heart.org for resources, registry for interested individuals.

Notable Quotes & Memorable Moments

• “Health buys them the ticket to everything else they want in life ... they may be a bit more dedicated to living more healthful lives.” ([06:29], Nancy Brown)
• “Obesity is a chronic, multifactorial, heterogeneous disease ... We don’t all walk through the same path.” ([11:55], Dr. Andres Acosta)
• “If you do a phenotype-tailored intervention ... the amount of patients who lose weight doubles.” ([14:42], Dr. Andres Acosta)
• “Give me a prescription for healthy food. Five years ago, that would have been inconceivable.” ([21:34], Dr. Andres Acosta)
• “Gaining health, it can happen at any time. ... Even folks who are older than 65 ... eating healthier should be a part of our lives.” ([27:15], Dr. Andres Acosta)
• “Our system is pretty good at reacting to disease ... We're not so good at getting further upstream and being proactive.” ([29:41], Dr. Kevin Volpp)
• “Go Red for Women is a campaign that urges women to understand that heart disease is their greatest health threat.” ([32:54], Nancy Brown)
• “If there’s one thing you want to do for your health ... just drink less sugary beverages.” ([37:44], Dr. Kevin Volpp)

Key Timestamps

• 02:09–04:19: Personal connections to heart disease (family history & firsthand experience)
• 05:32–08:19: Why heart disease persists; socioeconomic barriers, access, and cultural forces
• 10:03–11:30: Race, sex, and income disparities in obesity and heart disease
• 11:50–14:27: Obesity as a heterogeneous disease; phenotypes and tailored treatment
• 17:58–24:30: Food as Medicine programs—vision, equity, cost, and practical examples
• 25:36–27:12: Benefits of dietary change at any age; heart failure and malnutrition
• 32:00–33:32: Messaging challenges; AHA’s outreach and advocacy
• 33:32–38:52: Panelists’ hopes and predictions for the next decade
• 38:52: Heart.org as resource hub and registry invitation

Conclusions & Takeaways

• Heart disease remains the #1 killer, despite advances, due to persistent behavioral, social, and systemic challenges—including inequitable access, environmental factors, and rising obesity.
• Successful prevention means moving away from “one-size-fits-all” and toward personalized, biology-driven therapies—including tailoring diets, medications, and even social interventions.
• “Food as medicine” is no longer a radical idea—prescriptions for healthy food and individualized dietary plans are poised to reshape chronic disease care, with research already showing big potential.
• Even small changes (cutting sugary beverages) make a difference, and it’s never too late to improve health—with impacts seen quickly at almost any age.
• The future offers hope: diagnostic breakthroughs, targeted interventions, and system-wide policy shifts are on the horizon, set to advance both individual well-being and public health.

Resources

• Learn More/Join AHA Registry: heart.org
• Food as Medicine Research & Updates: AHA Food is Medicine
• Personalized Obesity Care: Mayo Clinic, Dr. Acosta’s research (Mayo Clinic - Weight Management)

A focused, informative, and hopeful look at how individualized care, smarter food policy, and scientific innovation could finally put a dent in America’s most stubborn public health crisis.