Guest Essay by Kip Hansen
Prologue: This is the fourth in a series of essays that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, The Salt Wars. This essay covers the Obesity Epidemic, aka The Obesity Wars. The purpose of the series is to illuminate the similarities and differences involved in each of these wars. Warning: This is not a short essay. Dig in when you have time to read a longer piece.
Trigger Warning: This essay is about obesity – the condition of being fat or overweight. It is about being overweight, body size, fatness; it is about all the problems that accompany that condition. If reading about these topics will cause you any emotional distress or make you feel unsafe or threatened in any way – stop reading here.
Stephen Hawking is a very smart guy, a very very smart guy. But like some smart guys in other fields, he can make very foolish statements based on ideas that are commonly believed but almost entirely inaccurate.
In a video produced by Gen-Pep, a Swedish non-profit organization “that works to spread knowledge and get people involved in promoting the health of children and young people”, Hawking made the following statements:
[Important Note: Stephen Hawking, as you probably know, is and has been severely physically handicapped, suffering from ALS, and has been wheelchair bound since the late 1960s. His experiences with diet and exercise are not, by necessity, the same as for you and me. Neither human physiology nor human medicine are his fields of study. I do not know why he was called upon to make this promotional video for Gen-Pep.]
Hawking starts off by saying: “At the moment, humanity faces a major challenge and millions of lives are in danger…”
“As a cosmologist I see the world as a whole and I’m here to address one of the most serious public health problems of the 21st century.”
“Today, too many people die from complications related to overweight and obesity.”
“We eat too much and move too little.”
“Fortunately, the solution is simple.”
“More physical activity and change in diet.”
When Hawking says these things he is simply repeating the official opinions of almost every major medical and health organization in the world:
The US Surgeon General:
“… the fundamental reason that our children are overweight is this: Too many children are eating too much and moving too little.
In some cases, solving the problem is as easy as turning off the television and keeping the lid on the cookie jar.”
The UK’s National Health Service:
“Obesity is generally caused by eating too much and moving too little.”
The UN’s World Health Organization:
“The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been:
an increased intake of energy-dense foods that are high in fat;
and
an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.”
The National Institutes of Health tell us:
“What Causes Overweight and Obesity?
Lack of Energy Balance
Overweight and obesity happen over time when you take in more calories than you use.
An Inactive Lifestyle
People who are inactive are more likely to gain weight because they don’t burn the calories that they take in from food and drinks.”
Of course, the NIH goes on to list the following as “other causes…”:
“Environment, Genes and Family History, Health Conditions, Medicines, Emotional Factors, Smoking, Age, Pregnancy and Lack of Sleep”
Everyone knows that the causes of obesity are eating too much and not exercising enough. All the major federal agencies, the United Nations, and the learned societies agree.
So how is this a Modern Scientific Controversy?
Simple: They are all wrong. Just how wrong are they on this issue? Just how wrong is Stephen Hawking on this issue?
Almost entirely wrong.
Bruce Y. Lee, associated with the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health, was so concerned by Hawking’s message that he was prompted to write an article for Forbes magazine titled “Stephen Hawking Is Right But Also Wrong About Obesity”.
Let me be perfectly clear: The obesity epidemic is a major challenge for medical science and public health because, quite simply, we have almost no idea whatever as to the true cause(s) of the phenomena, or, in another sense, we have too many ideas about the cause(s) of obesity.
In fact, Gina Kolata, in the Health section of the NY Times, says that Dr. Frank Sacks, a professor of nutrition at Harvard,
“…likes to challenge his audience when he gives lectures on obesity.
“If you want to make a great discovery,” he tells them, figure out this: Why do some people lose 50 pounds on a diet while others on the same diet gain a few pounds?
Then he shows them data from a study he did that found exactly that effect.
Dr. Sacks’s challenge is a question at the center of obesity research today. Two people can have the same amount of excess weight, they can be the same age, the same socioeconomic class, the same race, the same gender. And yet a treatment that works for one will do nothing for the other.”
Dr. Lee Kaplan, director of the obesity, metabolism and nutrition institute at Massachusetts General Hospital, is quoted by Kolata as saying:
“It makes as much sense to insist there is one way to prevent all types of obesity — get rid of sugary sodas, clear the stores of junk foods, shun carbohydrates, eat breakfast, get more sleep — as it does to say you can avoid lung cancer by staying out of the sun, a strategy specific to skin cancer.”
But wait, what about our beloved Stephen Hawking’s “Fortunately, the solution is simple. More physical activity and change in diet.”? Well, frankly, that is not just wrong, that’s utter nonsense.
Dr. Kaplan and his associates have identified, so far, fifty-nine (59) different types of obesity.
Dr. Stephen O’Rahilly, head of the department of clinical biochemistry and medicine at Cambridge University, and his group, have identified 25 genes “with such powerful effects that if one is mutated, a person is pretty much guaranteed to become obese.”
Many of these genetic disorders are on the rare side, but Ruth Loos and her team at the Icahn School of Medicine at Mount Sinai, have other evidence – that any one of 300 different genes may be involved in the tendency to overweight, and that each gene can add to the effect of the others—add to the genetic propensity for overweight and obesity. “It is more likely that people inherit a collection of genes, each of which predispose them to a small weight gain in the right environment….each may contribute just a few pounds but the effects add up in those who inherit a collection of them.”
There are more than three dozen available therapies (Dr. Kaplan claims to have 40 at his disposal) for overweight and obesity, and 15 different drugs. Using them is guided by experience and plain old-fashioned trial-and-error.
Bariatric surgery, in which the size of the stomach is physically altered by various means, is a drastic last resort for the profoundly obese.
Only the last mentioned treatment, bariatric surgery, is universally successful at bringing about a major and permanent reduction in the body weight of the obese.
In June of 2013, the American Medical Association announced that it had classified obesity as a disease. This event was covered by the NY Times – in the business–not science—section:
“The American Medical Association has officially recognized obesity as a disease, a move that could induce physicians to pay more attention to the condition and spur more insurers to pay for treatments.
In making the decision, delegates at the association’s annual meeting in Chicago overrode a recommendation against doing so by a committee that had studied the matter.
“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” Dr. Patrice Harris, a member of the association’s board, said in a statement. She suggested the new definition would help in the fight against Type 2 diabetes and heart disease, which are linked to obesity.”
“The vote of the A.M.A. House of Delegates went against the conclusions of the association’s Council on Science and Public Health, which had studied the issue over the last year. The council said that obesity should not be considered a disease mainly because the measure usually used to define obesity, the body mass index, is simplistic and flawed.”
The move by the AMA was hugely controversial within the medical community. In fact, it prompted an editorial from the editors of the journal of the Australian Medical Association, Lee Stoner and Jon Cornwall, titled “Did the American Medical Association make the correct decision classifying obesity as a disease?”
“The American Medical Association (AMA) recently classified obesity a disease, defining obesity as having a Body Mass Index (BMI) measure above 30. This decision went against the advice of its own Public Health and Science Committee, and has sparked widespread discontent and discussion amongst medical and healthcare communities. The fact that this classification has been made has potential ramifications for health care around the world, and many factors need to be considered in deciding whether the decision to make obesity a disease is in fact appropriate.”
“Are we classifying obesity correctly?
“Before considering whether obesity should be considered a disease, we must question the suitability of BMI as a rubric. The assumption is that the ratio between height and weight provides an index of body fatness. However, there is an imperfect association between BMI and body fatness, and BMI does not and cannot distinguish adipose type and distribution. While total body fat is important, studies have shown that central adiposity (e.g., visceral fat) poses a higher risk for developing disorders associated with obesity than overall body fatness. There are superior anthropometric indices of central adiposity, including waist-to-hip ratio, yet BMI continues to be the criterion owing to previous widespread and historical use despite its obvious shortcomings. Using the BMI tool, incorrect clinical categorisation of “overweight” or “obese” is common. Therefore, this editorial accepts that the AMA has selected an imperfect tool for classifying obesity, and will hereafter focus on the theoretical notion of obesity.”
“Undeniably, obesity is a risk factor associated with a clustering of complications, including hypertension, hypercholesterolemia, and type 2 diabetes, each of which independently and additively increase cardiovascular disease risk. However, obesity is exactly that—a risk factor. Being obese does not necessarily equate to poor health, despite the hormonal alterations that are associated with high body fat. Strong evidence has emerged suggesting that an adult may be “fat but fit”, and that being fat and fit is actually better than being lean and unfit.”
The Australian Medical Association’s editorial wraps up with this:
“Conclusion
Obesity has reached pandemic proportions, is strongly associated with myriad co-morbid complications, and is leading to a progressive economic and social burden. However, being obese does not necessarily equate to poor health, and evidence suggests individuals may be fat but fit. Perhaps most importantly, labelling obesity a disease may absolve personal responsibility and encourage a hands-off approach to health behaviour. This knowledge raises the question of morality, as individuals must now choose whether they will invest effort into maintaining a healthy lifestyle in order to free society of the healthcare burden associated with obesity. Given the myriad issues surrounding the decision to classify obesity in this way, perhaps a new question should be posed in order for society to continue this discussion: who benefits most from labelling obesity a disease?”
And what about a cure? Is it possible, short of radical invasive surgery, to help an obese person permanently lose enough weight to become a normal weighted person?
If the learned societies, and Stephen Hawking, are correct in stating that obesity is as simple as eating too much and exercising too little, then the obvious cure is to take obese people, feed them less and exercise them more.
Let’s go back and look at the results from Dr. Frank Sacks, professor of nutrition at Harvard, and his study “Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates”.
Results
At 6 months, participants assigned to each diet had lost an average of 6 kg [13 lbs], which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to …[the four diets, ranging from 6 to 9 lbs]…Among the 80% of participants who completed the trial, the average weight loss was 4 kg [ 9 lbs]; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels.
Digging in a little more, we find that:
“At 2 years, 31 to 37% of the participants had lost at least 5% of their initial body weight, 14 to 15% of the participants in each diet group had lost at least 10% of their initial weight, and 2 to 4% had lost 20 kg [45 lbs] or more (P>0.20 for the comparisons between diets).”
These are serious weight loss diets, closely supervised, with group and individual reinforcement sessions, for 2 years. Only 2 to 4% of the participants lost truly substantial amounts of weight that would reclassify them as normal weight persons. The rest of the participants lost those easy first 10-15 pounds in the first six months, but after a year, they began to regain their lost weight, despite staying on the diet and receiving group counseling, to end up with average loss, for 80% of the participants, of 9 pounds [4 kg], after two years of supervised dieting.
Let’s see what these results mean for those suffering from obesity:
I’ve added three colored dumbbells, showing just what a permanent 10% reduction in body weight means for three sample obese patients. Two have managed to move from Morbidly Obese to Obese, and one is still Obese. We have not considered the more extreme cases, which are not rare – persons weighing > 286 lbs. You can picture for yourself what the loss of 9 lbs would represent for you or someone you know who is far too heavy.
The real finding is that under a strict diet, most people can generally (but not always) lose 10-15 pounds if they are supported by counseling (professional or family). With care, these people can keep most of those extra pounds off. This benefits those whom who (h/t jsuther2013) are classified Overweight, but not generally those that are truly Obese, who remain obese after this weight loss. Nonetheless, medical bio-markers do improve even with these fairly small weight loses. Whether this improvement in bio-markers adds up to improved health and longevity is not known.
It is important to note that the above chart is based on the metric BMI which is under serious doubt within the obesity research community.
25 genes guaranteed to make you obese; 300 genes that add to each other to pack on pounds; 56 different types of obesity; 15 drugs; 40 therapies; three or four surgical approaches…definitely not simple, Mr. Hawking.
But that’s not all.
Erin Fothergill’s “Biggest Loser” study found:
“In conclusion, we found that “The Biggest Loser” participants regained a substantial amount of their lost weight in the 6 years since the competition but overall were quite successful at long-term weight loss compared with other lifestyle interventions. Despite substantial weight regain, a large persistent metabolic adaptation was detected. Contrary to expectations, the degree of metabolic adaptation at the end of the competition was not associated with weight regain, but those with greater long-term weight loss also had greater ongoing metabolic slowing. Therefore, long-term weight loss requires vigilant combat against persistent metabolic adaptation that acts to proportionally counter ongoing efforts to reduce body weight.”
What this means is that a person’s body fights back against weight loss and adapts its base metabolic rate to burn fewer calories while resting in an apparent attempt to regain weight lost by dieting and thus maintain a set weight point under conditions of lower caloric intake. This study was such big news that it is featured in the New York Times’ “Medical and Health News That Stuck With Us in 2016”.
Eleonora Ponterio and Lucio Gnessi, in their study “Adenovirus 36 and Obesity: An Overview” report that:
“…the data indicating a possible link between viral infection and obesity with a particular emphasis to the Adv36 will be reviewed.”
Thus, the Obesity Epidemic might be just that, an infectious epidemic.
In a study titled “Trim28 Haploinsufficiency Triggers Bi-stable Epigenetic Obesity”, Andrew Pospisilik and team found that there are titillating hints that epigentics may play a role in determining who is fat and who is lean, even when they generally share the same genes (closely related individuals) , or in the case of identical twins, exactly the same genes.
No, the obesity epidemic is far from Hawking’s, “Fortunately, the solution is simple.” And the solution to obesity is orders of magnitude more complicated than “More physical activity and change in diet.” In fact, universally reliable solutions to the problem of obesity do not yet exist.
There is nothing clearer from obesity research than that the simplistic policies of the federal health agencies and the learned societies – all of which were summarized by Stephen Hawking — “Eat Less & Exercise More” are totally inadequate to address the problem and are not based on scientific evidence. The “Eat Less & Exercise More” policies include the war on sugar and the war on soda – they cannot and will not make a clinically important difference in public health.
Summary:
- The kernel of truth in obesity studies is that consuming more calories (food energy) than one expends can lead to weight gain–energy stored as fat.
- Reversing this does not lead to a remedy for obesity – eating less and exercising more is not a cure for obesity.
- The reality of the problem of obesity is vastly more complex and only vaguely understood at this time.
- Current public policy on obesity is almost universally based on #1 above, ignoring #2 and #3. Thus, this public policy – no matter how strenuously enforced through education, indoctrination, regulation of the food industry, punitive taxation, etc will not resolve the Obesity Epidemic.
- On a positive note, the recommendation that people “eat less and exercise more” will not hurt anyone [with the rare exception of the profoundly underweight, the anorexic, etc] but, in general, will actually improve most people’s health even though it may have no effect whatever on their weight status.
- The Obesity Wars share the common feature seen in other modern scientific controversies — public government agencies and scientific [and medical] associations forming a consensus behind a single solution, one known to be ineffective, to a complex problem – uniting in a broad effort to enforce the ineffective solution on the general public through regulations, laws, and mis-education.
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Author’s Comment Policy:
I have utilized only a tiny fraction of the information I have collected on this topic in the writing of this essay. Readers familiar with the literature on the topic will notice this immediately. This is not due to ignorance or laziness on my part – I have been constrained by the necessity of keeping the essay to a readable length, without unduly stretching the patience of you, my readers.
I realize that many readers here will want to move on immediately to discuss the Climate Wars – one of the distinctive science wars of our day. I ask that you please try to restrain yourselves
The last essay in the series will be an attempt to lay out a coherent pattern of modern science wars and maybe suggest ways that the different science fields themselves can break these patterns and return their specific area of science back to the standards and practices that should exist in all scientific endeavors.
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The older I get the more difficulty i have in pinpointing events in my earlier life on a timeline. It seems to me that it was in the late 70’s or early 80’s that I went to bed an average man and woke up obese. That was the point in our historical timeline when the government officially adopted the BMI as the end all be all to classify and define it’s citizenry and i discovered over my morning coffee via the front page of my morning newspaper.
Now, it will not come as a surprise if someone corrects my time frame and I discover through this page that this took place in the 60’s or the 90’s nonetheless thanks to my Government I woke up one morning to discover that i was FAT and I dare not argue.
“we EAT like CRAP.”
No, we EAT CRAP.
Being obese in India is as rare as being rich in India. Despite that, being fat is seen as a sign of “beauty”, because being fat means you are NOT POOR.
We should point out that obesity is a modern problem. 50-100 years ago 1/3 of North Americans were not heavily overweight. That puts pressure on the gene-related theory which I think over-complicates a simple problem. We under-estimate how much we eat, we don’t realize how inactive we are and we EAT like CRAP.
Television, automobiles, take-out food, heavily-processed food, snacks and candy.
Eat less, more exercise. Simples!
Adam ==> If it were only true…..what a wonderful world it would be.
Kip…why so prickly?
I’m guessing you struggle with your weight?
Try laying off any food that uses synthetic fats.
Incoming==>the body recognises them as fats and stores them…but is unable to recover and metabolise them<==. If you get my drift.
charles nelson ==> Still wrong … making guesses about strangers, especially without any data whatever, is never a good idea.
If you read the essay, you’ll discover why “Eat Less – Exercise More” is not a solution to obesity — it just isn’t.
Kip Hansen Said:
“If it were only true…..what a wonderful world it would be.”
It IS true. That people underestimate the amount of calories they intake, and overestimate the amount of calories they burn doesn’t make it untrue. It means that people are the problem, not the concept of expending more calories than you ingest.
People who exercise enough to burn more energy than what they get from their food ALWAYS loose weight. Every time. Anything else would violate the laws of thermodynamics.
Calorie were deemed obsolete in science after the SI system was adopted in the 1950’s
A few points.
Any athlete knows the BMI is seriously flawed. Most ultra fit, lean, professional athletes, especially those in involved with strength such as contact sports and those who are taller, would classify as obese. These are people involved with what is considered to be doing what everyone needs to do-exercise more. Typical examples of rugby players for example around 6’2 and who are strong, fast runners can weigh around 100-110 kg, which is considered obese. They are not.
The body adapts to its environment-most non-contact tennis players and surfers for example need to be light and lithe, they can be tall, but they are light so they can move around easier; equivalent height footballers are nearly always heavier, even for the same body physique. The body distributes muscle mass where it knows it needs it, and lessens mass where it knows it doesn’t and can conserve- a tennis player doesn’t need strong thigh muscles, whereas a NFL player does.
Another point, you haven’t touched on one major factor, industry policies and regulation. It is plain obvious the reason there is so much sugar in virtually everything is because it sells-especially to children- because they are wired to both like it and seek it out. Accountants look at the numbers and realise that if they put extra sugar in breakfast cereal, it sells more, so that is why they do it, and in just about everything. Over the long term, this contributes to obesity.
Mcdonalds has the same issue with bread and meat ratios versus vegetables in its products; the more bread and meat and the less vegetable ratio in its products the more it sells those products, because vegetables are not the things the body craves, and Mcdonalds just looks at the numbers and adjusts its products accordingly. Over the long term this contributes to obesity, along with many other food market practices.
Coca cola and other soft drink companys have long known that people who are thirsty will tend to buy a drink regardless if there is no other drink option available, so they have made contracts with food outlets which are only allowed to sell their product. It is a form of monopoly; food outlets should be made to sell a range of products-especially drinks -which gives the buyer more choice.
You have touched on viruses and epigenetics, but there are many social factors that contribute-it is indeed a complicated issue, but one thing you havent mentioned is various examples of market failure, or market flaws such as monopolies on products etc: the market will supply the drug- such as sugar -and people will become addicted, if there are weak or ineffective regulations.
thingodonta ==> This is another case of what you say is true, but it does not work in any practical way.
Dr. Lee Kaplan, director of the obesity, metabolism and nutrition institute at Massachusetts General Hospital, says:
“It makes as much sense to insist there is one way to prevent all types of obesity — get rid of sugary sodas, clear the stores of junk foods, shun carbohydrates, eat breakfast, get more sleep — as it does to say you can avoid lung cancer by staying out of the sun, a strategy specific to skin cancer.”
BTW, soda companies ALL make non-sugared versions of their products and are perfectly happy to have you buy these cheaper-to-produce products — as long as you buy their brand. The big boys in the field are even more thrilled if you buy their brand of water — which contains no other ingredients and it far-and-away the most profitable for them to produce and sell. You are just repeating propaganda on this subject.
Kip===> Its a complicated issue that has multiple causes, as you and I have both said. But I do think that more efficient market regulation is a factor.
And I do wish the BMI was updated somehow, it’s ridiculous to say a professional athlete who also exercises regularly is ‘obese’.
What about us people who are prescribed drugs for certain problems that cause weight gain. I almost stopped eating and still gained weight. The weight gain stopped when we changed meds.
hey, if you don’t want holes in your teeth , don’t got to the dentists. If you don’t want pills don’t got to the quack.
I’m glad you are finding your way out of the maze.
stephana ==> Drugs/Medicines are one of the many factors in weight gain — a well known phenomena.
I agree that stephana’s experience with prescrption psychotropics is a much more important variable than most people have realized. Thank you so much for sharing your experience, stephana.
And could we please control for drinkers and non-drinkers?
“I almost stopped eating and still gained weight.”
I don’t think that is possible. The fat has to come from somewhere outside your body. You have to put the fat into your body in order to become fat. You can’t get fat just breathing.
stephana says, “I almost stopped eating and still gained weight.”
TA says: “I don’t think that is possible. The fat has to come from somewhere outside your body.”
I can offer a little bit of insight if personal anecdotes and a little neurology are permitted…
I was about to undergo proton beam therapy and the doctor told me a potential side effect was weight gain, no matter how little I ate. –Now this is the probable neurology behind his statement:
The thalamus and the hypothalamus are secretory parts of the limbic system of the brain and control weight gain and weight loss. He apparently was expecting some wear and tear and his experience was that damage in this inaccessible area would cause weight gain.
http://nawrot.psych.ndsu.nodak.edu/Courses/465Projects04/Aggression/structure_files/image002.jpg
This article by Kip Hanson is both a challenge and good fun. It got me thinking of the exceptions to the rule, “diet and exercise.” Also, goodness, hardly any one here has ever been pregnant and gained 30 extra pounds in 6 mos. (Kip Hansen mentioned this via the NIH.)
Interesting stuff Zeke,
However, “no matter how little I ate” clearly does not include not eating. The hypothalamus can only regulate how the body processes food , it can’t make fat come from nowhere.
It is counter intuitive. But here is one study you can look at. I posted it below but maybe stephena would like to see it so I will repost.
This is a very deep structure in the brain, well-protected and hard to reach with scientific instruments. It is described sometimes as the orchestra conductor because it seems to be relaying signals from/between other areas. Hope this study gives some hint in the right direction.
Stephana, medications often affect the gut microbiome. They can act as antibiotics, and change the diversity and ratios between different types. One area of research is about how the make-up of the gut microbiome affects obesity. They can take feces from fat mice, put them into thin mice and make them fat.
Here is something on antipsychotics, but it applies to other meds as well.
http://www.microbiomeinstitute.org/blog/2015/10/29/the-microbiome-plays-a-role-in-antipsychotic-mediated-weight-gain
I am interested in how certain environmental factors may influence weight gain/loss as well as diet and exercise. Someone has already mentioned that many older people grew up without central heating so (in the UK where I live) we were cold a lot of the time in winter. But while living in the USA for some time back in the 1980s we noticed there were very few fat people at 5000 feet in the Rockies, but a lot of obviously overweight people on the West coast, especially in Washington state. Does anyone know if altitude is a significant factor or how the obesity levels vary across the US and what factors might affect this?
It may. But Colorado generally has the fittest population of any state because of all the outdoor activity opportunities year round, and its demographics.
yeah with all that sea level rise coming out of Colorado , I guess everyone is having to do a lot of climbing. 😉
Nobody has mentioned Ancel Keys yet. He was the fat equivalent of James Hansen. He’s the one who cooked the science and told us not to eat butter and to drink only skim milk. link Some people think he’s the one who started the obesity epidemic.
Look, losing weight is easy. Stop eating and you will be a sack of bones, in 30 days… no matter how much exercise one performs. So the matter is really one of maintaining weight. What seems to work for me is to eat freely when very active and very small and selective whenever I am in couch potato couch mode. I am 6’2 – 180lb and an old man and my activity level varies wildly according to the season. Mid-winter I am a complete couch potato. Spring and fall I am a active demon. Summer more laid back but active. FWIW -GK
About four years ago, there was some “study” that was echoed in the press that claimed atmospheric CO2 was contributing to the obesity epidemic. I found the idea intriguing, but not credible. A great premise for a science fiction story, for sure.
Here, I find equally intriguing, and far more credible that “eat less, exercise more” is ineffective. Lots to ponder here.
I think obesity has a lot to do with one’s tolerance for being hungry. Some think they have to eat before they feel hungry so they don’t ever feel the discomfort of being hungry. Some eat immediately when they feel the initial hunger pangs. Some can put off eating for a short while, and some can function normally for hours while hungry and it doesn’t bother them.
Don’t treat being hungry like it’s a crime. Its normal, get used to it. Get away from the house, far far away from the house and do something where you will have no alternative than to be hungry because there will be no food to grab in ten seconds. I’m no nutrition expert but I think you even burn fat when you’re hungry.
All I know when I haven’t eaten, I am doing something interesting (logging, fishing, hunting trapping, etc) calorie consuming and far from the refrigerator, I rarely notice that I’m hungry. Even when I am cold (shivering really burns the calories by the way). Its when I’m sitting around the house doing nothing is when I notice that I’m hungry.
“I think obesity has a lot to do with one’s tolerance for being hungry. ”
Bingo. And the “tolerance’ is not even real, it is social . Naturally the human animal will go through extended periods with NOTHING to eat and nature has blessed us with a system to deal with that. It’s called FAT. Fat is both an insulator and a reserve. nearly all animals fatten up before the winter.
Every adult in the modern, western world should elect to go with nothing but water for at least 5 days at least once in their life to understand what hunger is, and what NOT being hungry is.
That does not mean to suffer hell and never moan again, it means to realise that going without food does not really hurt. It does not get worse and worse.
Most of the time we eat for the pleasure, for the fun, not because we NEED to eat.
Until you have gone without food for five days, by necessity or by your own choice, you will not understand that.
If your reaction to that is OMFG, he’s crazy, then you need to try it. You do not even know what hunger is or how it works.
I find myself having some kind of intolerance to being overfed. If I’ve eaten too much during the previous week, I skip meals, hardly even thinking about it. Apparently most people aren’t like that.
Compare the human body to a car. The car needs both fuel and replacement parts to keep running..
The calories in the food we eat provides the fuel, the vitamins and minerals provide the replacement parts.
When we eat food with plenty of fuel but few replacement parts, ,we’ve got to make up for the shortage of replacement parts by consuming more of that food.we’ve got problems.
Alan McIntire ==> Interesting analogy, but not quite right. The body demands more food when it does not get enough calories — it does not demand vitamins, minerals, etc. Salt is an exception — a body can demand salt. When a body runs short of other building blocks, it cannibalizes itself.
Technically Alan, the protein in the food we eat provides “replacement parts,” as they are the source of amino acids which are used to build new proteins.
I think the take away from this study is the impact our genes have on our weight gain.
Over the millenium the human body has adapted to the feast/famine cycle by storing calories when times are good. When we go on diets the human body responds by trying to store more calories. When we come off the diet, our bodies are still in the mode to store calories. In effect, the encoded feast/famine DNA responds by changing our metabolism in response to our diet.
So here’s a little math for you. Each time I go on a major diet I subsequently gain all the weight back plus an additional 10 pounds. I’m now 50 pounds overweight. How many diets have I gone on?
Too many.
SMS ==> Quite right — genes play an enormous role in overweight and obesity — and in the disorders that are “associated” with obesity — heart disease, high blood pressure, and diabetes.
I read some recents studies showed obesity was linked to a lack of microbial variety in the gut..about 40 specific absentees in the obese. They then found foods to increase the variety of mircobes and the weight came off. This was done wthout changing energy in and/or energy out. I will need to find the reference but I recall it was UK based research. Ie diet alters gut bacteria in those people that are susceptible to obesiy.
Thanks for mentioning this Macha. About 10% of our calories come from bacteria that produce small-chain-fatty acids in our guts. Obese people have different microbiome profiles. It seems that their gut bugs extract more energy from their food. They can gain weight on the same diet as a thinner person.
Macha ==> There is quite a bit if research being done on gut biomes — and some indication that this may have something to do with nutrition, health, and how the body absorbs what it needs from the food we eat.
I have seen nothing definitive about it in relation to obesity — though there may be a study or two out there.
Recently, the Food and Drug Administration has been asking drug research companies to demonstrate clinical efficacy; ie, does the drug or procedure improve people’s health and longevity? Drugs were required to being compared to placebo to show a difference in a particular drug or doing nothing. Now what the F&DA is asking, is this change relevant? Do the outcomes warrant the risk?
Early on, drugs or diet or exercise were shown to lower Cholesterol, decreasing a person’s cholesterol by 11%; ie, from say 200 to 187. Did this decrease mean more people are now living because they decreased their cholesterol 13 mg/dl? The answer of course was: NO.
Then the issue has become: “good Cholesterol” like HDL (High Density Lipoprotein). Raise your HDL, decrease your LDL (Low Density Lipoprotein) and good things are supposed to happen. Well, to say the jury is still out is an understatement. A drug Niacin, decreases one’s LDL and raises one’s HDL and….heart attacks, overall mortality showed no difference between Niacin and placebo. Stay tuned.
“Nonetheless, medical bio-markers do improve even with these fairly small weight loses. Whether this improvement in bio-markers adds up to improved health and longevity is not known.”
It is possible the wrong markers are being followed and reported upon.
Recently, looking at people who live to be 100 and longer: 1/2 smoke cigarettes most of their lives and continue to smoke at 100; 1/2 are obese; most drink alcohol; 25% don’t nor have they exercised at all in their lives. The most important factor, did they have a close relative who also lived to be 100. Relatives with longevity, obesity, exercise, smoking, alcohol use/abuse probably play some role in some people’s health and longevity at some time, its just that all the admonitions by “experts” are glib references to how much no one knows at this point.
Loose weight if you like the way you look a few pounds less.
There’s more than a little truth to the “energy balance” concept of weight loss. About 20 years ago, I was prompted to lose weight by my then doctor, due to a number of conditions I had associated with being overweight (I was 5′ 11″ tall, and weighed 257 pounds). So I did two things. I consumed nothing but ice water after 6:00 pm, and restricted my caloric intake to 1,000 calories a day. I lost 75 pounds in a little less than three months, and kept if off for a number of years. It was too much, though. My BMI was “right,” but I looked like a concentration camp survivor. Many of my colleagues across the country thought I had cancer.
I must admit, thought, that I felt amazingly good.
My experience was similar. My kids thought I looked terrible and assured me that I was in the grip of some kind of mad food cult. I got a lot of criticism for not looking fatter so societal pressure is an interesting aspect of how we deal with fat and all of the misguided press coverage.
*Even when they are aware of the problem*, people have a tendency to treat problems as if they have *one* solution, and to stop looking for it when they think they’ve found it.
In addition, a lot of people treat all their ideas as if they were religious tenets – people here are quite familiar with this concept, like the “97%” nonsense.
So, basically, people lock themselves into 60 different solutions and then dig in and fight over it.
And the people suffering from the problem also face the scorn of others for not having personally solved the problem that the great community of experts have *also* not solved.
Don’t anyone dare wonder why I spend so little time around other people. Y’all’re bonkers.
Obesity is a result of modified food. If you eat healthy food you don’t get fat no matter the quantity.
“Obesity is a result of modified food. If you eat healthy food you don’t get fat no matter the quantity.”
I’ve wondered about that. I’m not overweight so I have the luxury of eating most things, although I do have to watch and not go overboard, so I have never tested your claim, other than noting that when I was young, most meals were prepared and eaten at home, which was the norm for most people of the time, and there were very few fat people in those days.
I have suggested to people who are overweight and want to lose it, to start fixing home-cooked meals, instead of going out to eat in fast food/mass produced food places. It seemed to make sense to me that that would at least be healthier and might contribute to losing some weight.
That suggestion has not been very well received. It is easier and faster just to go to the fast food place. If they want to lose weight, they order the salad, although that may not help them much. In other words, they are not too serious about losing weight.
My decidedly fat ex thougy that, and was raised in the Seventh Day Adventists, and was mostly vegetarian. It did not work, as she was fat all the time I knew her.
Amazing how the Americans (and some other people) grew fat over a few dozen years. You must have a very strange genome, evolving so fast… Never thought about a potential problem with your two-pint “regular” soda glasses (the “small” glass exists, but it is not shown on the menu), your seven-tier burgers, loaded with salt, sugar and low-quality fat (then again, a normal sized portion does exist, but only on special request. The rest of the world is watching, with interest. Ask the Finns or the French : they are not really poor, they eat quite well, and most of them are not obese.
mountainape5 ==> That is an hypothesis not supported by evidence.
It has been evidenced and tested that eating too much of what’s available in the market makes one fat.
I come from a small remote village where the main food were dairy, meat, starch, vegetables etc. All local produce. Not one single person was obese. After the arrival of “outside” food people started getting fatter and fatter.
The only explanation for that is modified food.
I can highly recommend Dr Barry Sears “Zone Diet” (drsears.com) for those who want to drop a few pounds. I’ve been on it for around 14 years and never looked back. Feel great, not hungry and at 6’2″ & 185-190 lbs very stable.
Dr Sears recommends you try it for 2 weeks (I usually give things a month) and if you don’t notice about 1 lb a week drop in weight, not hungry for 5 hours after a meal, sleeping better and not drowsy after a meal then “try something else because the zone isn’t working for you”.
My blood tests have been excellent as well for the whole time I’ve been on the zone and I’m not on any meds.
Good luck and great health to all.
Question. When did high fructose corn syrup usage in food become common…..
And why does the baking industry love it so much ? (And others )
(Retired Ind. Eng. with close to 40 years in the food industry)
Because sales increased. People ate larger helpings….
We referred to it as “high fattening ” corn syrup…
Quite agree. Not all sugars are created equal. Ground zero for the obesity epidemic is North America where the staple is corn. Obesity levels are much lower in places where the staple is rice or wheat or potatoes. Corn converts to fructose not glucose as these other things do
The human body is, as far as evolution is concerned, in the Stone Age or earlier. It is designed to accumulate energy (fat) during the good times and to utilise that energy in lean times. The most successful humans (in Stone Age terms) are those who accumulate fat the most efficiently during the times of plenty.
A search for the San people and their women-folk of Namibia will prove my point.
Various populations in different parts of the globe adapted to solve the “feast-or-famine” problem in different ways and so the various populations survived in the face of often incredible adversity. The adaptations thus made have, in somewhat more modern times (a couple of thousand years, give or take a few) been widely scattered throughout the global population.
Is it any wonder that any 21st Century attempt at trying to impose a universal weight-reduction program is, by definition, totally doomed? It’s not just “Energy-in V Energy-out” it’s a matter of how your body is progammed to respond, and that is goverend by each and everyone of your ancestors, going back to the emergence of the first hominids.
Is it any wonder that different people respond to different diets differently?
I was a fitness instructor for about twenty years, and I have heard every excuse in the book, seen every perversion of discipline, heard every rationalization about following a plan to become more physically fit. I have witnessed both tragic physical demise as well as remarkable transformations in physiques.
I am suspicious of the latest trend in articles that promote the idea that obesity is a … “complex” … problem.
I suspect that the complexity involves such things as how truthful people are in reporting what they eat, … how truthful people are in reporting how active they are, how consistent they actually are in practicing physical activity with the necessary focus to garner any noticeable effects.
Also, the complexity involves social problems that limit access and opportunity, more than problems of willingness and dedication. Infrastructure of society, organizational structures that do not allow or encourage time for activity, lack of priority in our educational system to actually train children to be conscious of their health, and other things are the … complexities.
You don’t have to blow your heart out, burn your muscles, starve yourself, … lift monster-truck wheels, run marathons, go to a gym, have the latest workout attire, water bottles, digital heart monitors, etc. You just have to practice regular physical consciousness, and this can be quite non-exerting, but, if not consistent — religiously consistent — then no good.
What is complex is the vast differences in people’s perceptions of how they behave. For example, I have witnessed a person saying that she was fasting for health, but, in the next breath, she was eating potato chips (just a taste of them, she would say), somehow dismissing this as a contradiction, still embracing her perception that she was “fasting”. This is how a “taste” can turn into a binge, followed by starvation until the desire for just a “taste” returns.
On surveys, therefore, that rely on personal reports of behavior, I have serious doubts about the accuracy of many responses that guide researchers to gather data to make reports about the obesity epidemic.
Many people are not honest with themselves, so how can they be honest with their health-care providers or with researchers trying to determine what is going on.
Hence, I tend to agree with what another poster wrote:
Robert Kernodle ==> You may agree with the other commenter, but the evidence does not agree with your viewpoint.
Anyone can lose a few extra annoying pounds through a dedicated diet and exercise program, and it does not matter which one they chose,
But these diet and exercise programs do not reliably solve obesity for most people….that’s why I have included links to the studies in the essay, so that you can look at real evidence and not rely on opinions.
Reply to Kip Hansen comment on December 17, 2016 at 7:02 pm
YOU WROTE:
“these diet and exercise programs do not reliably solve obesity for most people”
MY REPLY:
Your comment shows a startling lack of knowledge about dieting — I hereby declare you are disqualified from writing about obesity in the future.
You are correct that people who change their eating and exercising habits can lose weight.
What you don’t understand, and I think this is shocking, is that AFTER people lose weight they often go back to the eating and exercising habits that caused them to gain weight in the first place.
In addition, people often gain weight slowly over decades but want to lose weight fast, which the human body resists.
A strict diet that causes fast weight loss is not one people enjoy being on, or could continue for a lifetime.
The real problem is what the eating and exercise habits will be AFTER the diet “ends”.
If you want to lose weight and become more physically fit, you have to change your eating and exercising habits PERMANENTLY from those habits that made you fat and out of shape to begin with!
For some reason the “establishment” doesn’t seem to mention that much.
Richard Greene ==> I see you have a very strong opinion, but the vast majority of obesity research does not support your view — they “don’t seem to mention that much.” because it does not agree with the findings of very good research on the matter.
It would not hurt if you [re-]read the essay — and if you took a very good look at the Biggest Loser study and the Sacks diet study, I provided links.
What you propose is what is known as “the lazy cheating fat people” hypothesis — “fat people won’t continue to exercise and cheat on their diets that’s why they don’t stay thin” — which has been proven false over and over in carefully conducted clinical research.
Reply to Robert Kernodle on December 17, 2016 at 4:29 pm
YOU WROTE:
“On surveys, therefore, that rely on personal reports of behavior, I have serious doubts about the accuracy of many responses that guide researchers to gather data to make reports about the obesity epidemic.
Many people are not honest with themselves, so how can they be honest with their health-care providers or with researchers trying to determine what is going on.’
MY REPLY:
Bingo – great wisdom from someone having experience with exercise and nutrition, rather than a writer spouting an anti-establishment opinion.
People often eat while doing other things and don’t realize how much they are eating.
If fat people HONESTLY wrote down the exact weight / size of EVERYTHING they ate during a week, at the end of the week they could read their list and have a good idea why they were fat!
Jasper Carrot: “It’s not a disease. It’s because this hole” [pointing to his mouth] “is bigger than this hole.” [pointing to his arse.]
The only way to lose weight is to exhale it as CO2. What comes out your arse is stuff that never got absorbed in the first place.
It is amazing how the Nazis managed to find a complete cure for obesity as far back as 1943. It apparently applied to all people, regardless of genetic makeup – it was universal and involved no surgery at all.
Here are some of the happy successful beneficiaries of this radical treatment.
http://www.bergenbelsen.co.uk/images/Content/Photos/Database/Survivors/ID0969_BU3765.jpg
Good point, Leo.
I remember talking to someone who found himself building a Burmese railroad for the Japanese during WW2. He said he couldn’t understand why the fat ones died first. He thought they would live on their reserves, but apparently this was not the case.
The fat ones probably had heart attacks.
I’m sure I’ll be corrected if I’m wrong on this, but I think I read that every pound of fat you have requires one mile of blood vessels to feed it. So your heart is pumping one extra mile of blood vessels for every extra pound of fat you have. If you have a lot of excess pounds of fat, your heart is pumping extra hard all the time.
Leo. I’m pretty sure patriotic socialists can figure out a solution without your help.
Leo that was a very disturbing Holocaust picture not necessary for comments on this obesity article.
According to internet Rule 5A, it is acceptable and expected that an internet argument will eventually end with both participants comparing each other to Hitler. So that’s okay.
But … we’ll never forget the Nazi Holocaust, so we don’t need graphic pictures to remind us.
Back in the day (60-70’s) we wound down car windows, had manual car steering, mostly used clutches and gears, used more public transport, more people walked greater distances, more people rode bikes, ate less high fat high sugar pre-packaged food – yada yada. Kids spent more time outside climbing trees, playing physical games outside, exploring their environment.
In my simnple mind all this extra excercise and less fat/sugar intake meant less obesity back then.
Maybe its my lyin’ eyes but I see mostly obese people loading their food trolleys with stuff like large bottles of coca cola, packets of white bread and pre-packaged high fat/sugar content food.
I’m in the same corner as Stephen Hawking and “almost every major medical and health organization in the world”.
My boy and I and the dog walk to the bus stop a quarter mile away every day, the kid next door gets a ride to and fro. Round trip that’s about 80 miles of walking per year, every year, usually carrying books and trumpets. Guess who’s the fit kid and who’s the chubster. Most places the bus stops right in front of the house. All we might have to do to stop obesity is require kids walk to school or a bus stop.
I used to believe the energy balance, laws of thermodynamics, or calories in Calories out model.
Then I read Good Calories, Bad Calories by Gary Taubes
Anyone interested in understanding the obesity epidemic I would suggest this is a good place to start. In this book he details a study around 1940 where the researchers tried to fatten prisoners. At 4000 Kcal per day sure enough some got fat others did not. Then 5000, 6000, 7000, 8000, 9000. That’s right 9000 Kcal per day for 2 remaining subjects that would not get fat. After 30 weeks of 9000 Kcal daily they each gained about 5 lbs. Contrast that with a women I know with a powerful self will determined to loss weight eating no more than 1000 Kcal daily and exercising like a fiend. She was always hungry, tired, and miserable but after 6 months plateaued at a weight loss of 15 lbs. After given up in frustration she gained all the weight back.
No explain to me energy balance and fat people just eat too much or move to little. .
Why We Get Fat (2011)
Why We Get Fat (paperback)
An eye-opening, paradigm-shattering examination of what makes us fat. In the New York Times best seller Good Calories, Bad Calories, acclaimed science writer Gary Taubes argues that certain kinds of carbohydrates—not fats and not simply excess calories—have led to our current obesity epidemic. Now he brings that message to a wider, nonscientific audience in this …
Good Calories, Bad Calories (2007)
[released as The Diet Delusion in the U.K.] In Good Calories, Bad Calories, Taubes tries to bury the idea that a low-fat diet promotes weight loss and better health. Obesity is caused, he argues, not by the quantity of calories you eat but by the quality. Carbohydrates, particularly refined ones like white bread and pasta, raise insulin
John H said:
“I used to believe the energy balance, laws of thermodynamics, or calories in Calories out model.”
“No explain to me energy balance and fat people just eat too much or move to little. .”
Any answer that contravenes the laws of thermodynamics, has an error in it somewhere. Simple as that… or bin your physics textbooks.
Sorry for not being clear. I did not in anyway want to suggest our bodies break the laws of thermodynamics but rather that the “eat less exercise more” crowd ignores our bodies ability to adjust for calorie intake depending on body type. Those who quote the laws of thermodynamics in weight control fail to consider this.
Consider: does a fat cell take up or give off fat for no reason as it scopes up what ever fat comes by or is there a signal that causes it to hoard fat or divest fat.
The major signalling hormone is insulin.
In my examples the 9000 Kcal per day man who does not gain weight is profoundly insulin sensitive and to my mind blows the calories in calories out model out of the water. The 1000 Kcal per day women who cannot loss weight is profoundly insulin resistant. She has high levels of circulating insulin and the fat cell door is slammed shut. Alternatively the 9000 Lcal per day man requires only a whiff of insulin to clear carbs from his system and thus his fat cell door remains open.
Can insulin levels be measured to confirm this? Yes and in fact it has been done in the 1970’s by Dr Joseph Kraft. His book Diabetes Epidemic is a tough read but for those who do they will find something quit profound.
Paraphrasing Dr Kraft” those with heart disease either have diabetes or have yet to be diagnosed” Then asked surely there must be those with heart disease not diabetic (remembering by diabetic he means insulin resistant) his response was again paraphrasing “yes I suppose you are right by I have not found them yet.” He was a pathologist who did 3000 autopsies and tested over 15,000 people for insulin resistance (measure insulin at intervals following a 100 gram load of oral glucose)
Gary Taubes book Good Calories Bad Calories is a seminal work on this subject and a must read for anyone who wants to understand this
Well yes. Fats is no problem r e. Wheat and cereals and any products thereof instant fat and pre-diabetic blood tests