Headlines in the supermarket checkout line about the “perfect diet” or “miracle weight loss” programs frustrate me, because so often these media teasers are deceiving and damaging to women’s self esteem. These headlines so often focus only on appearances, not on the amazing health benefits that come from losing a significant amount of weight.
Another problem with those headlines is that the material inside barely scratches the surface. For a weight loss program to be successful, it takes a lot of time, commitment and partnering with a health professional. A one-page article in a women’s magazine certainly won’t tell you all you need to know to lose weight in a healthy way – and keep it off.
But my biggest objection is the stigma these headlines perpetuate. They don’t address obesity as a disease, instead implying that if you just did this or that you would be able to get rid of the extra weight you’re carrying around easily. Anyone who has dealt with obesity can tell you it’s not that simple.
The Obesity Epidemic
Obesity has become a critical public health issue in the US. Statistics from the National Center for Health Statistics show that over 100 million people – nearly a third of all adults age 20 or older – in the US are obese. The statistics for children aren’t much better. Among those ages 6-11, 18% are obese; for teens aged 12-19, it’s 21 percent. These rates represent a significant increase over the past twenty years.
One of the national health objectives for 2020 is to decrease obesity in adults by 10% – but statistics don’t show much improvement yet. Why not? And what can we do about it?
This is not a simple problem to tackle, and it won’t be solved by any fad diet or specific program. But one of the messages I’m trying to instill into my clients is the more you know, the more you can do about it. If we talk about obesity and the factors that contribute to the issue, we are much closer to finding solutions.
In this article, I’ll talk about some of those factors, as well as what obesity does to your physical health, and how it impacts your whole body (including your mind). Then I’ll give you some suggestions for achieving and maintaining a healthy weight long term.
What is Obesity?
Obesity isn’t just having a few pounds to lose. It’s a medical condition that can impact health based on excess weight or body fat a person is carrying. Medical professionals typically use Body Mass Index (BMI) to assess whether someone has obesity. A BMI over 30 suggests that someone may have obesity.
Other factors also play a role in determining whether someone is at a healthy weight, such as waist to hip ratio, weight to height ratio, and how much fat a person has on their body, as well as where that fat is distributed.
Obesity has long been stigmatized as a willpower problem. A common belief is that if people would just eat less, they’d lose weight. But as we learn more about the physiological mechanisms behind obesity, and the myriad factors that can impact weight and BMI, a slow shift is occurring. Nearly 20 associations and organizations – including the National Institutes of Health, US Food and Drug Administration, World Health Organization, and the American Medical Association – now recognize obesity as a disease that needs treatment.
That’s good news, because it opens up more options for treatment, and more research to determine why some people develop obesity in the first place.
How Does the Disease of Obesity Impact Health?
Obesity has been linked to a wide range of comorbid disease states, often making these conditions worse or accelerating the progression of these diseases. With obesity comes impaired functioning of the body. Obesity is also associated with premature death.
Research has shown an association between obesity and increased risk for many medical conditions, including Type II diabetes, hypertension, cardiovascular disease, high cholesterol, stroke, polycystic ovarian syndrome, sleep apnea, arthritis, gallbladder disease and several different types of cancer. A study published earlier this month showed the strongest evidence yet of the link between obesity and significant health issues.
Emotional health is also signifincantly impacted by obesity, in part due to discrimination and the social stigma faced by individuals with obesity. Obesity is associated with higher rates of depression, and a poor quality of life.
With so many major health issues associated with obesity, it’s clear that something needs to be done. But there is no simple answer to the problem. Myriad factors impact whether an individual will develop obesity. Though we still have a lot to learn, we are beginning to understand more about the mechanisms that impact obesity.
Factors Behind Obesity
Research is broadening our understanding of obesity, but there’s still a lot that is unknown about the actual mechanisms at work. One thing we do know, however, is that lack of willpower isn’t the culprit. While eating behaviors can certainly play into gaining excess weight, those behaviors have complex origins that must be explored.
The development of obesity is a complex relationship between many factors ranging from environmental and behavioral to physiological differences in individuals. Let’s take a closer look at some of these factors.
These are the factors you probably hear about most – and the easiest factors for individuals to do something about. Some of the most common environmental factors noted are decreased physical activity and a more sedentary lifestyle; large portion sizes that lead to increased food consumption; highly processed, high calorie foods designed to make you want more; and higher use of medications that cause weight gain.
It’s important to understand that while these environmental factors can absolutely contribute to the obesity problem, on their own they are unlikely to explain the epidemic. Everyone in the US is exposed to these same factors, but not all people become obese. Some of that can be explained by lifestyle choices – choosing to be more active, or carefully selecting the foods you eat. But I’ve had too many clients who are doing all of that and still struggling to maintain a healthy weight to believe environment alone is the issue. And the obesity research agrees with me!
Do you have a co-worker who can seemingly eat whatever she wants whenever she wants and never gain a pound? Or a friend who shuns exercise of all kinds and still has a low BMI? We’ve all come across these people, haven’t we? On the flip side, I also know people who are extremely careful about what they eat, or who lead very active lives, who continue putting on weight. It seems clear that genetics can play a role in how your body holds on to weight.
Research has identified many genes that may contribute to the development of obesity either on their own, or in combination with other genetic factors. Some of these are well known and much studied; others are newer discoveries that need further research.
Hormones carry messages throughout your body that have a direct impact on how well your metabolism functions. When these hormones – especially insulin and leptin – are out of balance, your body doesn’t receive the correct messages, which can lead to weight gain. These metabolic factors have been well researched, and consistently linked to obesity. There is ample information on leptin resistance and insulin resistance in my health library.
Of course, eating too much of the wrong kinds of food will have an impact on weight gain and the development of obesity. But the root causes of these behaviors are complex, and without acknowledging them, the behaviors are difficult to change. It’s certainly not as simple as telling people to “just eat less.”
The central nervous system plays a big role in appetite and eating behaviors, and when this becomes dysregulated, changing those behaviors may be very difficult. Recent research points to the reward system, emotions, memory and cognitive control as playing a powerful role in human appetite.
A recent study showed that individuals with obesity derive more satisfaction from the food they eat, which may help explain why some people eat more than others. Impaired cognitive control may also lead to increased activation of the reward system. Stress and emotions, particularly depression and anxiety, also contribute to changes in appetite. All of these factors lead to changed behavior that can result in the development of obesity.
5 Tips to Combat the Disease of Obesity
Obesity is a complex issue, and there are no easy answers or quick-fix solutions. Effective treatment is possible, however, and the information we have about what might be at play is steadily increasing. Here are five tips that can help you lose weight in a safe, healthy, and sustainable way.
1. Have a Genetic Profile Done
Because genetics can make such a profound difference on eating behaviors and how your body responds to different types of food, the information your genetic profile can provide is invaluable.
There are many companies that can provide this genetic profile – These panels reveals the genetics that guide your eating habits, how your body reacts to common foods, what the best diet for your specific genetics is, what type of exercise may work best for you, metabolic factors and more.
That’s a lot of information that you can examine with your health care professional and use to determine which lifestyle choices might make the most difference to your weight loss goals and healthy weight maintenance. I always say knowledge is power — once you know what you’re working with, you can move forward with confidence!
2. Acknowledge and Deal with Emotional Issues
The emotional aspects of obesity may be the hardest to overcome, especially because of the stigma being obese still carries in our culture. It does you no good to pretend these issues aren’t there. Did you know that emotional trauma can actually change your body at the cellular level?
It’s never easy to acknowledge old trauma or abuse, but it’s essential if you want to take back your own power and change your habits forever. You may need the guidance of a professional therapist to help you sort out the internal messages you send yourself on a regular basis. I’ve found that my clients have found great emotional relief by using Emotional Freedom Techniques (tapping) or participating in programs like the Hoffman Quadrinity Process.
3. Use Food as Medicine
Food has become something much more than nourishment in our culture – but remember that it’s most important function is to provide your body with the essential nutrients it needs. When you shift your thinking about food and consider it the best medication you can find, you can make better choices.
Fresh, organic fruits, vegetables, and lean meats are your best choices, along with healthy fats. Avoid processed foods and refined sugar as much as you can. Learn to read labels and really know what’s in your food. If you can’t pronounce something on the label, leave it on the shelf!
There are so many great resources for healthy recipes in books and online. Try some new combinations of vegetables and spices, and discover just how delicious real food is!
4. Develop Lifestyle Priorities
While lifestyle changes alone aren’t enough to address the obesity problem, they do play a role. You have control over certain aspects of your health – including how much you move, how much you sleep, and how you respond to stress. All three of these are critical in maintaining a healthy weight.
Exercise need not (and sometimes should not) be high intensity to be effective. Particularly if your adrenal glands are dysfunctional, light exercise like walking, yoga, or gentle stretching might be what your body needs.
It can be so difficult to get enough sleep, but it’s so important to health – and weight maintenance! Set yourself up for success by creating a calm, relaxed sleep environment. Leave electronics out of the bedroom. Avoid caffeine late in the day, and try meditation or deep breathing to help yourself get to sleep at night.
Stress is perhaps the most critical lifestyle factor to address. High cortisol levels can make it nearly impossible to stay at a healthy weight. Remember to take time for yourself – sit and enjoy a few minutes of quiet in the morning, take a walk in the woods, or participate in any activity that brings you job. Connect with family and friends. Learn to say no when you need to.
5. Work with a Trusted Professional
Obesity is a disease. You wouldn’t try to treat diabetes or cancer without professional guidance, and you shouldn’t try to go it alone here either. A trusted medical professional can help you lose weight effectively and safely.
My new weight loss program is designed to help my clients drop up to a pound a day, without hunger, under close medical supervision. Most diet programs only have a 2-4% long term success rate. That’s because they aren’t addressing all the factors at play.
When you tackle eating behaviors only, not the reasons behind them, it’s very likely that once you stop the program you’ll gain the weight back. That’s why I address everything in my program – including hormonal health, emotional eating, environmental factors, genetics, and more!
Obesity is a Disease – and Treatment IS Possible!
It’s high time our society recognized that obesity is a disease, with a range of complex factors that contribute to its development. Stigmatization is making the problem worse, since it can exacerbate some of the emotional factors that contribute to obesity. When we acknowledge obesity as a health condition, not a character flaw, we can explore what’s really going on in the body. When you have all the information, you can do something about it! I urge anyone struggling with obesity to work with a trusted health professional who understands the myriad factors that are at play.
Reviewed by Dr. Mark Menolascino, MD