Obesity: Five Take-Home Messages That Might Challenge Your Assumptions

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.

  1. 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.
  1. 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.

  1. 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.

  1. 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:

  1. 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?

I created this word cloud through WordItOut.com.

Word cloud created by me at WordItOut.com.

*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.

*     *     *

standing color cropped tiny for blog postsCarrie 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.

245 Responses to “Obesity: Five Take-Home Messages That Might Challenge Your Assumptions”

  1. gdkonstantine

    Thank you for this informative article; a very good overview. A while back, we bought some new dishes and mostly for their design. What wasn’t originally noticed was that they were a little bigger. So, unwittingly, the portions became a little bigger. Then someone (I’m not an American, but I would like the plead the 5th Amendment here) got bigger. Switching to smaller place got things back to normal. 🙂

    Like

    • Carrie Rubin

      Very true. Studies show bigger plates cause us to consume more calories. The color of the plate matters too. When we eat food that matches our plate color we serve ourselves more of it!

      Like

  2. Britt Skrabanek

    Now I want Mediterranean food! Agree that the cuisine there strikes a nice balance of health and satisfaction, so that makes it effective for a lot of people.

    A sedentary society is something we have to battle, and technology is making that even harder. We have to step away, get outside and move our buns. Feel like TV was the culprit for so long and now it’s this damn internet stuff. Speaking of…bye! 😉

    Like

    • Carrie Rubin

      TV seems like the innocent child now, doesn’t it? It’s the internet that’s the troublemaker. We’re SO connected now. It’s difficult to shut down, for sure.

      You guys in Portland do it right, though. A very healthy city. 🙂

      Thank you for the Twitter share!

      Liked by 1 person

  3. Dawn Quyle Landau

    I’ve been giving all of this so much more thought lately…not because I’m obese, but because I want to be healthier. No doubt, I feel a lot better when i’m in Israel (and I lose weight!) eating an incredible Med. diet! This year I spent just over 1/4 of my year there… so that’s something. Now to get the rest of my year in order!

    Like

  4. MamaMickTerry

    Oh, Carrie! You are singing the song of my people. I would have loved to have attended this conference with you (and ugh, I need the CEUs!)
    I loved how you presented the information in a factual, yet attainable manner. Even if we only pick one dietary item to work on, it can make a huge difference in the long-term condition of our health.
    The Mediterranean diet, as well as the DASH are still two of my personal favorites.
    Thanks for posting this important piece — now I gotta figure out why I’m not getting notifications of your new posts….hmmm….

    Like

    • Carrie Rubin

      Thank you. It’s a great conference (but pricey so I don’t go every year).

      My posts are few and far between so it doesn’t take much to miss one. I’m not very prolific in the blogging department. 🙂

      Liked by 1 person

  5. pegoleg

    This is really interesting, Carrie. At a basic physical level, though, isn’t it truly as simple as less calories in than expended leads to weight loss and the opposite to gain? Whether or not that process is made more difficult by other factors?

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    • Carrie Rubin

      Yes, it’s definitely the root equation, but there are so many other forces that factor in, making it very difficult for some people to accomplish it. And since telling people to eat less and exercise more hasn’t gotten us anywhere, it’s time to approach it differently, and some of these forces are areas we can target. Getting people to change their behavior is difficult (as history has repeatedly shown us). If we can help them do that, maybe we can make some progress.

      Thanks, Peg! Hope you have a great weekend ahead.

      Like

  6. thefolia

    Oh yes the bread is a tough one indeed especially fresh out of the oven and the good old fashion recipe of water, salt & flour. I don’t go for anything packaged and processed, breads are the exception of what I buy that’s already made as long as the ingredients are no more than four and without sugar…it’s a challenge to find. Today I heard a grandfather telling his grandson to drink his store bought chocolate milk to make him strong! Did you see the ingredients in that bottle pops? Make your own cacao milk even if you don’t use plant based milk at least you can control the ingredients once again down to about three or four. We make ours with cacao powder, cinnamon, maple syrup and a touch of coconut oil. It’s complex with “health foods” being so convenient and not enough time in the day but if we took the time to learn what the food industry is doing then we may have a chance to save our health.

    Like

    • Carrie Rubin

      You’re so good about preparing your own fresh foods. I think many people don’t know where to begin with that, and many lack the time. It would be nice if there were more community programs that could help people learn to do it in a way that’s both affordable and convenient. It’s a shame what goes into some of the products we buy.

      Liked by 1 person

  7. Diane Henders

    Very interesting, Carrie! I fondly remember the days before I learned about good nutritional choices – life was much simpler then! But once I understood the mechanics of it, I slowly converted my diet by adding healthier foods and switching to healthier choices (more veggies, more whole grains, fewer processed foods). Now I’m at the point where I prefer that diet, but I still love my treats. I’m careful about portion sizes (they creep up so easily) and I eat one small dessert item every day because life’s not worth living otherwise! I can’t resist salty snacks so I’ve made a rule that I’m not allowed to buy them with the rest of the groceries. If I want chips, I have to walk to the store and get them. Mostly I’m too lazy to do that, but at least if I do end up snarfing down a bag of chips, I get a bit of exercise! 🙂

    Like

    • Carrie Rubin

      You sound very similar to me. I still enjoy a treat every day. I can moderate that pretty well. It’s the baked goods I can get too much of, so I don’t have them around much. And yes those portion sizes can creep up. The older I get, the more I notice their effects!

      Liked by 1 person

  8. Kourtney Heintz

    Great post, Carrie. Dealing with health and weight issues is a complicated equation. Sweets are my kryptonite. As long as I avoid/limit them, I’m in a better place health wise.

    Liked by 1 person

    • Carrie Rubin

      I enjoy my sweets for sure. But I can better moderate them than I can baked goods. So I have chocolate in the house but no baked goods except on special occasions, or an occasional baguette with dinner. Sigh.

      Liked by 1 person

      • Kourtney Heintz

        Smart move. I keep dark chocolate bars that are 72%-90%. Nothing too sweet. They are higher in fiber too so if I get the urge to eat to much, I know what will befall me. 😉

        Like

  9. Matt

    This was a great read, Carrie. I actally eat pretty terribly (my weaknesses are chips and Macdonald’s) and rarely gain weight. So there’s clearly, as you point out, more to the story than diet and willpower.

    Like

    • Carrie Rubin

      There is indeed. That doesn’t absolve us of responsibility, but it hopefully makes us less judgmental and more appreciative of others’ efforts. Thank you!

      Like

  10. Nurse Kelly

    Incredible post, Carrie. Clearly demonstrates your commitment as a physician and your passion for conveying helpful information through your writing. Hope all is well. 🙂

    Like

    • Carrie Rubin

      Thank you, Kelly. I hope readers don’t take away from my writing that I don’t think there’s individual responsibility, because of course there is. It falls on each of us to take care of ourselves the best way we can. But what I hope to show is the many forces that make it so difficult to do. Expecting people alone to change their behavior has not worked well for us. Clearly we need to approach it differently.

      Thank you. All is well. Hope with you too! (Go Cavs!)

      Liked by 1 person

      • Nurse Kelly

        It sure is difficult, and it’s wonderful to hear you acknowledge that so truthfully. I am always advocating for more one-on-one education and coaching in the workplace where people are, but cost is of course always a factor… we are gaining ground in seeing returns however, from work we’ve done over the past few years… it just takes a little time. The benefits of working with people on a personal level are immeasurable. It’s just what they need, in my opinion!
        And yes — GO CAVS! Been waiting for this, right?!!!

        Like

        • Carrie Rubin

          I have indeed. It’s nice to have something the hubs and I can do together, and since basketball is the only sport I enjoy watching, that seemed a good choice. Though I know he still wishes I liked football…

          Liked by 1 person

          • Nurse Kelly

            Did you by chance see the movie “Concussion?” It’s a real wake-up call to football! As a parent, it really makes you think about your child’s participation in the sport. Glad my son doesn’t play, to be honest!

            Like

            • Carrie Rubin

              I recently watched it. Great film, and another subject I feel passionate about. I was very against my oldest playing high school football, but my husband and him overruled me. Luckily, he didn’t get much play time, and it all went well, but I still wonder about caving to their pressure. My hubs says now he probably wouldn’t allow it. Gee, thanks. A little late for that. 😉

              Liked by 1 person

            • Nurse Kelly

              Happy your son is okay! I think football is just so ingrained in so many guys – they can’t help it! And then there’s the dream of having their son play that seems to be so strong! We are definitely a country who loves their football! I hope some positive changes are made in light of the concussion issues, though. It’s like Will Smith said in the movie – human beings weren’t intended to play that sport!

              Like

  11. Zen A.

    I had my fill of the Mediterranean diet when I was still living with my parents. The thing is though, many of our dishes are complex to make… or rather, they are the kind of dishes you make for a family. It’s not worth it to sit and prepare them for one person, because a lot of work goes into them.

    Since I’ve come to live alone I have been consuming waaaaay too much carbs and I think that’s my weak point (besides the obvious one – sugar!). I just cannot quit pasta and bread and rice. I tried for a few days and I was just so frustrated – and hungry, haha. I keep trying to reduce my intake, but it’s just so difficult! Why does it have to be so tasty? 😦

    Like

    • Carrie Rubin

      I wish I knew (about that tasty part), but I agree–so tasty! While I can moderate my sugar intake (which is probably why I haven’t given it up yet), I find it more difficult to limit the calories from yummy baked goods. And my body knows the difference too. Too much bread shows quickly on the scale.

      And you make a great point about the Mediterranean diet. Many of the dishes take some time to prepare, and many families don’t always have the time to put into it.

      Like

  12. Book Club Mom

    Obesity is definitely not an easy problem to solve. And, as you say here, it isn’t just a matter of eating less and exercising more. I hadn’t thought about some of the other factors that contribute to the problem, like hormonal and environmental. It’s much more complex than we think. And while a completely different problem, the number of peanut allergies, for example, has increased so much in the last 20 years and some people are saying its causes are partly environmental. Makes you think!

    Liked by 1 person

    • Carrie Rubin

      Yes, peanut allergies have taken off, and it’s frustrating because there’s still much we don’t know. It used to be recommended we delay exposure to peanut-containing products until a child was about three years old if they were at risk for peanut allergy (eg, family history). Now the thinking is that might actually promote allergy, and exposure should happen sooner. Difficult to know how to counsel people with such discrepancies.

      Liked by 1 person

      • Book Club Mom

        My son is allergic to peanuts and all tree nuts. I ate a lot of peanuts while I was pregnant because I don’t like meat very much and I was trying to get protein. Go figure! We hope someday there will be allergy shots for him, but for now he carries an Epi Pen.

        Like

  13. dgkaye

    Great article Carrie. Indeed hormonal changes in the body will shift the way our bodies metabolize sugars. Menopause is a testament to this. When estrogen wanes, cortisol hinders the way sugars are metabolized, hence ‘the middle aged spread’. I wrote about this not so happy side effect of mid life, lol. I found that my ongoing lifestyle of healthful eating and exercise, where the scales remained the same for decades, began to rise about 8 pounds that wouldn’t go away from all the traditional methods I tried.
    I finally fought back with lowering carbs which turn into sugar. I was never a big eater but it was the carbs that turned on me. 🙂

    Like

    • Carrie Rubin

      Yes, it definitely changes as we get older, doesn’t it? The things I ate when I was twenty would be impossible to do now without gaining weight. Like pizza at midnight. Yikes, did I really do that?

      I, too, find when I cut back on carbs, the scale is kinder.

      Thank you for the Twitter share!

      Liked by 1 person

  14. Curmudgeon-at-Large

    Since I get someone to exercise for me, I now have someone else eat all my healthy foods for me so I can concentrate on donuts and beer.

    While I agree that we “need to resist the simplistic assumption that the individual alone is responsible for overweight/obesity,” I do know of several cases where individuals could do more to take care of themselves. In one case, a long-time friend – a former physical education teacher no less – has poor knees that need surgical repair but the surgeon won’t perform the operation unless the person loses weight. My friend contends that her weight gain is hormonal and she can’t control it but loses her argument with me when she always asks for extra dietary creamers and pats of butter whenever she eats out.

    Like

    • Carrie Rubin

      Very true. The responsibility ultimately rests on us. But for those who do make the attempt, there are many things that make it more difficult. But you’re right, that can’t be used as an excuse.

      Like

  15. 2bcreativeblog

    We have cut down on portions and bread. We have been pretty good about sugar other than what is in a product. There is no cookies etc everyday type of sugar. I don’t keep pop in the house but I am terrible about going to get me one, but I have downsized. 🙂 We do eat out about once a week but most of the time it is good ole KFC so semi healthy. LOL I have cut back as much as possible on processed stuff but sometimes that is our quick meal for the week or snack. I guess we eat a variety mostly. I offer veggies and fruit every meal but they get that so much at school because the main meal sucks. LOL. So they don’t eat it much at home. I do cook meats with a side almost every evening. I vary it. Chicken, pork, beef. The only fish the boys like is tuna. We trying.

    Like

    • Carrie Rubin

      Sounds like you do a lot of what we do. We tend to do takeout on weekends, because I’m sick of cooking, so that’s not always so healthy.

      Funny that your kids get a lot of fruits and veggies at school because the main dish is gross. Guess they’re at least getting some benefits from it then!

      Liked by 1 person

  16. Pam Huggins

    Great blog Carrie (as always). I just wrote a few paragraphs then realized I had kind of overshared. LOL!
    In a nutshell….
    The more I focus on good health, the better I do.
    Thank you for your well thought out and well presented thoughts on the matter. It’s important.
    I’ll probably overshare later. 😉

    Like

  17. hilarycustancegreen

    I have been quietly altering our diet for the last fifteen to twenty years. I’m lucky as I had my children’s early years at home and never got out of the habit of home cooking. The fates also kindly gave me a husband who doesn’t like puddings. The Mediterranean diet is lovely but does include all those delicious processed meats (prosciutto, salami etc) which we are trying to leave behind. Salt is my sin.

    Like

    • Carrie Rubin

      No pudding? Really? Oh dear, I think I missed that gene.

      You’re right about those processed meats. Best to skip them. Luckily, they don’t tempt me.

      Like

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