**5. Path dependencies and future "life chances"**

Childhood obesity typically determines important biological pathways early in life, such that adults who experienced obesity as children commonly show early onset of the comorbidities of obesity, such as diabetes and cardiovascular disease. Our problem of interest becomes relevant here, because while "willpower" has some impact on the margin for adults seeking to control obesity onset later in life, obese children find themselves coping with deeply set biological patterns that will make future control of their obesity difficult. Individualistic prescriptions for diet and exercise will be of limited value; even more extreme surgical remedies, such as bariatric surgery, show mixed evidence of long‐term success [45]. There is mounting evidence that extended exposure to chronic obesity may promote irreversible, "epigenetic reprogramming" events that permanently alter molecular pathways in humans, including nutrient‐sensing pathways in the brain, for which there is currently no practical hope to correct [46]. Sociologists have long examined early path dependencies shaped by children's race and class [43], demonstrating how early determinants of life chances have significant impacts over a long duration. In juxtaposing these cross‐disciplinary literatures, we see that recent medical research is finding remarkable, specific molecular evidence to support this well‐ established sociological literature on paths set in childhood. With this broad picture of pediatric obesity, it is easier to see the importance of engaging less individualistic analyses and more structural solutions.
