Last fall I attended the Cleveland Clinic’s 10th Annual Obesity Summit, a conference I like to go to whenever I can. During the event, I live tweeted snippets from various expert speakers. Given the complex nature of overweight/obesity,* I thought it might be interesting to expound on some of them.
Preventable Chronic Disease
Notice the above tweet does not say “50% of obese U.S. adults.” Regardless of our number on the scale, half of us could better our health by improving our diet and physical activity, no medication required. For example:
- We could lower our risk of type 2 diabetes by eating less sugar and more whole grains and vegetables.
- We could increase our bone density by doing weight-bearing exercise and eating foods rich in calcium and vitamin D.
- We could lessen cell damage that leads to cancer, heart disease, and Alzheimer’s by eating foods rich in antioxidants like berries, beans, and apples.
Best Diet Out There?
The speaker’s point was not to say the Mediterranean Diet is the best diet for weight loss and weight maintenance. Rather his point was that no matter how effective a diet is, if we can’t adhere to it—for example, a diet that’s too restrictive—we won’t maintain weight loss. But since the Mediterranean Diet is tasty and easy to stick with, it’s a good “best diet” candidate. Plus, studies support its heart-healthy benefits.
Hormonal-Induced Resistance to Weight Loss
That complicates the equation of calories in minus calories out, doesn’t it? Our bodies do not like change. They want to maintain homeostasis. So when we lose weight, our bodies go into preservation mode and try to gain it back, making continued progress that much more difficult.
Furthermore, when we reach a certain BMI through dieting, we may not be able to eat as many calories as someone who’s always been at that BMI.
Obesity and Infection
Research animals infected with adenovirus-36 (Ad36) had a 60-100% increase in body fat, even though they ate the same amount as animals not given the virus. In another study, 30% of obese people had antibodies to Ad36 virus compared to 11% of normal-weight people.
This shows just how complex the issue can be, which leads nicely to the final tweet:
Obesity Is a Multifactorial Disorder
We need to resist the simplistic assumption that the individual alone is responsible for overweight/obesity or that weight loss is as simple as eating less and exercising more. In the past 30 years, the obesity rate has more than doubled in adults and children. It has quadrupled in adolescents.
People didn’t suddenly lose their willpower since the 1980s. Certainly we’re more sedentary than we used to be, a product of both our built environment and our increased reliance on technology. We’re also bombarded with addictive food high in fat, sugar and salt, and we cook less of our meals at home. Plus, our portion sizes have ballooned, along with the number of advertisements that entice us.
But research suggests there is even more at play, including genetic, hormonal, infectious, social, and even chemical factors (e.g., BPA).
One thing is clear, however: a multifactorial problem requires multilevel interventions. Only when we target all the forces behind obesity will we see any lasting change. Yes, the responsibility ultimately falls on the individual, but to ignore these other forces is to invite failure.
After all, how has it been working for us so far?
*Note: I use the term “obesity” in my writings because it is the medical word for the condition and its meaning tends to be universally understood. It is not, however, my favorite word—I find it clinical and rather cold. My apologies to those who feel the same.
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Carrie Rubin is a medical thriller author with a background in medicine and public health. For full bio and a list of her books, click here.