Why are we so fat? 

The diet industry tells us that 65 percent of the public is fat or overweight.  This is only according to heavily derived mathematical figures which have little to do with reality. The reality is about 15 percent of us are genetically obese and able to get to the point of "severe obesity" (BMI over 40) which then, is considered a medical condition worth treating in the doctor's office.  25 percent of us are somewhat fat (BMI 30-35) which is also considered to be a medical condition. The rest of us only FEEL we are fat - that's because we don't look super slim like the fashion models.

The fact is that most of the diseases "blamed on" obesity are actually caused (in part) by lifestyle (which also can cause obesity in susceptible individuals). (see McGinnis-Foege - 1993 "300,000 people die each year from diseases in which sedentary lifestyle and poor food choices are a factor") (1)

NY Times science reporter, Gina Kolata, found that some of the studies which found a strong link between obesity and illness or pre-mature death, were severely flawed and good research does NOT show a relationship between fatness and illness or pre-mature death.  (4)

After her studies, Kolata concluded (as other researchers seem to have) that fatness and height might be a factor in a society where the population is better nourished. (ibid)

Some of the physical factors thought to CAUSE obesity are:

Genetic structure - this is probably the most prevalent cause of obesity - regulating from 40-80 percent of the body-size (according to obesity scientist Dr. Rudy Liebel):

• The Thrifty gene - this genetic makeup apparently fights like crazy against starvation - producing hormones to cause the person to want to eat everything in sight if food is available and also enabling the person to be very active but burn fuel highly efficiently and finally the ability to raise the weight setpoint to the highest weight the person has achieved.  This genetic makeup is not only what makes some of us fat, it also is what makes dieting make some of us even fatter.  It was what enabled people to survive in societies where food was scarce.
• The Diabetic gene - this appears to be similar in action to the thrifty gene but specializing in being slow to digest sugar (insulin resistance). This may have been what enabled people to labor for hours with little or no food.  Diabetics seem able to control sugar levels if they exercise a lot (type II diabetes - that in which the pancreas is not dead).  Some societies which tend toward high levels of obesity have BOTH the diabetic gene AND the thrifty gene - an example is some native American tribes like the PIMA tribe, 60 percent of whom are considered seriously obese.  33 percent of type II diabetics have NEVER been fat at all.

Physical damage to the body

• Pituitary damage - sometimes the mechanism regulating hunger is damaged causing the appetite to "never shut off" - this damage could be caused by anesthesia or chemicals or other.
• After tonsillectomy - I have met countless people who BEGAN to suffer severe obesity (coupled with ravenous hunger) after they had their tonsils removed.  Scientists now know that the tonsils are the largest lymph node in the body and a key part of the immune system. Fat cells which are very "intelligent" cells are also involved in the immune system (see the "pig study") and thus the body begins to lay on fat to compensate for the loss of the tonsils. Tonsils are seldom removed currently but in the 1950's before their function was well understood, they were routinely removed.
• Thyroid damage - the thyroid gland regulates to an extent, metabolism and can be damaged or slow.  It is now thought that thyroid damage doesn't have that much effect on obesity - years ago, a common treatment for obesity was to give the patient thyroid medications which could cause a 10-20 lb weight loss.  The thyroid gland can be disarranged by chronic dieting, chemical (medication or food additives) or even Weight Loss surgery.

Some of the lifestyle factors which don't necessarily cause extreme obesity but can contribute to it are thought to be:

• Eating as a recreation - when we eat "for fun" which we do a lot of in our society, we typically eat foods which are chemically made to taste very good and also provide a lot of calories but very little bulk and surprisingly little nutrition including some chemicals like transfat which are indigestible.  When we eat recreationally (i.e. party down or go to dinner) it is food often ADDED to our usual daily intake.   Unfortunately, most of our recreational activities are centered around food. Even bicyclists who go for rides often end up in restaurants eating unhealthy foods.
• Sedentary lifestyle - For decades it was a mystery why the French could eat fatty foods and still be a much slimmer society than Americans.  Then some smart researcher discovered that the average French person WALKS 10,000 steps a day (not many people own cars and if they do, cars are not used to go three blocks to the market).  The average American walks less than 1000  (one thousand) steps a day.
• Food selection - we are one of the most hard working societies in the world however, most of us do not burn large amounts of calories at work (60 percent of jobs are desk jobs). When we eat, we tend to select food which is easily available and does not require much in the way of preparation i.e. fast food. But fast food, while providing large amounts of calories, does not take up much area in the stomach, thus doesn't make us fill "full" and does not nourish us much either.  For example, a "Big Mac" and "supersized" french fries can provide 1200 calories.  Most people do not need more than 2000 or 2100 calories a day so in one lunch or snack, they have eaten most of the calories they need in a day.  Basically we are traveling through a "food jungle" and most foods which taste good are either not healthy or fattening. :(
• Addictive eating - food is a pleasure and all pleasures can become addictive (there is some evidence that some foods actually have chemicals in them to cause them to be somewhat addictive - this has never really been well proven but it hasn't been disproven either).  Bottom line - we are really GOOD COOKS today and food tastes really good.  People who tend toward addiction, have are thought to produce less serotonin in the brain and are trying to adjust this physical deficiency. Which is why the Serotonin reuptake inhibitors (such as Prozac) sometimes help people to be less addictive with food.  It should be noted that food addiction is only discovered in the 25 percent or so of the population who becomes fat from it. It should also be noted that if a person is very obese (BMI over 40) they, albeit may be doing some addictive eating, more likely have the genetic predeposition toward obesity as the major factor causing the obesity with the addictive eating adding to the amount of obesity. And since obese individuals are often treated poorly, addictive eating often FOLLOWS obesity in many cases (rather than CAUSING the obesity in the first place). There are many individuals who have an eating addiction who do NOT gain weight from it. One individual in his 70's bragged to me that he eats 3000-3500 calories a day and still is at the same low weight he was in High School.  Six months after he bragged to me about that, he had a massive heart attack and required coronary bypass surgery.  The moral of the story is overeating or eating addiction may not be healthy even if it doesn't make you gain weight.
• Medications we take - some like Birth Control medications can cause weight gain. Steroids can cause weight gain. Anti depression medications can cause weight gain in some people.

and finally, last but certainly not least:

• Chronic dieting - 80 percent of American women are on a diet at any given time.  When we diet, our bodies set our metabolisms down so we need less calories. It also increases our appetite so we want to eat more and if we do not give in, it produces hormones to make us feel fatigued.  This (and not overeating as most think or "lack of will power") is responsible for the poor long term success rates of diets. (Statistics tell us that 95 percent of those who lose weight, regain all or more within 4 years of the weight loss).  Most women are setting their "ideal weights" way too low to be healthy or to be what THEIR bodies want.  Ideal Weights are often set according to the mathematical formulas "du jour" (now we have the BMI which takes neither gender, nor age nor body nor bone structure into consideration) or worse yet, set to achieve a size similar to fashion models who are known to be underweight.

Most people do not know that being underweight is a serious medical condition, far worse than obesity nor are they aware of the fact that studies have linked cigarette smoking directly to lung and breathing disorders i.e. 95 percent of those with COPD are or have been smokers and heart disease (smoking hardens the arteries). This is because the medical profession, is pushy about losing weight but seldom more than mentions smoking as a real danger.

The risks of being clinically obese i.e. BMI over 40 and not exercising are about the same as being a light smoker states Dr Paul Ernsberger, an associate professor at Case Western Medical School. (Many people in our society are light smokers but I don't see widespread worry about the light smoking epidemic).

From a 48 year history of dieting, I have found there is only one way to force one's body to be at a weight lower than what the body wants to be and that is by calorie restriction.  Eating 1400 or less calories a day CONSISTENTLY may force the weight lower than the body's setpoint if you combine that with healthy food choices and daily cardio exercise. (Many people of "model size" eat less than 600- 800 calories a day) Unfortunately this type of calorie restriction can cause fatigue, ravenous hunger, immune challenge and more if not done very carefully with healthy food choices, which is why most people cannot do it.  It takes a daily war with the body to calorie restrict and for many people, "life is too short".  There is NO EVIDENCE that maintaining a slim weight through calorie restriction is healthy and some evidence that calorie restriction the way most folks do it, (not avoiding 'fun' foods and not eating a lot of vegetables and not exercising) may actually challenge the health and/or cause nutritional deficiencies in many people.  The Food Institute of the UK found that chronic severe calorie restriction (less than 1000 calories a day) can cause PERMANENT brain damage.

All the so-called successful methods of "weight control" such as surgery or diets, are designed to do ONE THING.  To make it uncomfortable physically or undesirable to eat much food in order to make calorie restriction (to force the body to a lower weight) easier to do.  Unfortunately with today's calorie packed and very delicious foods, Weight Loss surgery is only totally successful on the long run for 7 percent (see the Hebrew University Study of gastric bypass patients - 1993) although some 75 percent of weight loss surgery patients have been observed to keep off "some weight". (25 percent of gastric bypass patients re-gain back to original size) (2) In one study, at the 13-15 year point it was found that most gastric bypass patients still had weights in the "severe obesity" area of BMI (around BMI 35).  It also was found that many of these patients had plugging of the stomas, and involuntary vomiting (3)

Eliminating whole food groups or restricting oneself to low calorie bland tasting foods are other ways of helping some to practice calorie restriction.  Unfortunately these don't work for many people.  I've known fat vegetarians, fat vegans and even people who have gained 50 lbs or more on the Atkins plan.

The Atkins diet is one of the most controversial diets available (generally true of low carbing).  Many medical providers and nutritionists are against it and point out that not only does it NOT produce good long term results but may endanger the kidneys and other organs. Yet, low carbing (if you look on the web) has its share of ARDENT supporters.

Quick diets and liquid diets are highly controversial as well. Again the medical profession generally is against these diets (although some weight loss surgeons advise pre ops to go on a liquid diet to reduce the amount of fatty liver often seen in people who eat a lot of fatty foods regardless of weight) but people tend to like these diets because they produce quick short term results and nice losses on the scale. Unfortunately, a goodly amount of the weight lost on the quick diets (Medifast, Nutrasystems etc) is NOT fat but valuable healthy muscle and bone mass.  Things you do NOT want to lose.

I'm beginning to feel that "weight control" (by ordinary means) is something of a myth. We are told it's easy to maintain a "healthy weight" (the number selected according to the latest mathematical calculation having little to do with any kind of reality).  Just "eat less and move more".  But if that is so, why is it that 95 percent of diets fail?  Never-the-less because we WANT to believe, the diet and medical industries (sometimes indistinguishable in the field of "weight control") can continue feeding us that myth.  But for those of us like myself who have been working out DAILY for 1-2 hours a day cardio and journaling food, we know that this is not the way to force our bodies to what society feels is a "healthy weight".  It seems that the body is designed to automatically maintain a weight IT thinks is healthy and it seems that most bodies DO maintain that weight plus or minus 20-30 lbs unless we take extraordinary means.  In fact less than 5 percent of those who set out to lose a lot of weight, are able to maintain it for any length of time.  Weight Watchers, the only weight loss organization to show a net loss, showed a loss of 11 lbs over two years in the latest Heshka study.

Bottom line - understanding that fights against nature can be unpleasant with the body still winning.  Follow these rules and don't worry about your weight or your cholesterol (heart attacks happen EQUALLY in people with normal cholesterol levels) or other things and enjoy life because stress is STILL the biggest cause of all illness.  This is called "HAES" (Health at Any Size)  NOTE: doing the following below will render many people on the slim side unless they have physical or genetic factors causing obesity.  It will likely keep your BMI below 40 or 45 regardless of your genetics.

• Food
  • Avoid party foods, fast food, junk food
  • Eat lots of veggies (5 portions or more) either raw or cooked as in steamed without butter or oleo
  • Eat 2 tablespoons of "healthy fat" (Omega III-VI fatty acids) daily. Can be peanut butter, believe it or not!
  • Avoid chemical food additives like nutrasweet and MSG
  • Select low fat - portion controlled dinner choices like Lean Cuisine and Weight Watchers "Smart Ones"
  • When eating dinner, put yours on a "dessert plate" because that's the size that dinner plates used to be, 100 years ago.
  • Consume 3 cups or more of non fat milk daily or the equivalent.
  • Consider supplementing with a multivitamin,  B complex vitamins, Vitamin C, Vitamin E and co-enzyme Q10
  • Avoid dieting (challenges the immune system, is risky for the heart and often causes weight gain)
  • Avoid alcoholic beverages
  • Avoid anything with transfat in it including margarine.
  • Watch portions - 1/2 cup is a reasonable portion of pasta, veggies.  Of high fat, fun foods, restrict to two tablespoons. Fill up on good low fat foods like veggies.
  • Try to do your serious eating at home - focusing on good non recreational foods like veggies, proteins etc - when you are out, eat your regular food first to fill up then just taste the party foods.
  • If you think you are kidding yourself about what you are consuming (most of us do kid ourselves), journaling food is not a bad idea.  I journal my points daily (a la Weight Watchers) and have done so for over 2 years.  Also measuring food is another good idea...
  • NOTE: most folks "feel better" when dieting at first because they are making better food choices, regardless of what program they are on.  You can make those better food choices without worrying about losing weight and still feel better.
• Non Food
  • Exercise daily - 60 minutes or more of cardio.  Cardio is exercise which doesn't hurt and doesn't make you breathless. Examples of cardio are walking, bicycling, trikke-ing, skating
    • Cardio videos for people of all sizes
    • Richard Simmons videos (excellent and fun and exercises all your muscles!)
  • Replace food addiction with an exercise addiction or something else other than food. Logic tells us that if we eat whole boxes of doughnuts (or even more than 2) or large amounts of pizza that this will not have a good effect on our bodies
• And most important - realize a person can be beautiful AT ANY SIZE. Celebrate YOU.  You are a lot more than the number on the scale or your size.  Women can look glamorous at ANY SIZE.

Often slimness as dictated by society or EVEN the medical industry is bought at the price of health, well being and quality of life.

It's a choice which few Americans make in full consent because the diet industry and the popular media withhold the facts.

by SueW
 

Sources:

1. JAMA 270 - Nov 10, 1993 pp 2207-2212

2. Dept. of Surgery C, Soroka Medical Center, Beer Sheba (Israel study)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8495893&dopt=Abstract
Harefuah 1993 Feb 15;124(4):185-7, 248 (article is in Hebrew)

3. Obesity Surgery, Vol. 11 No. 4 August 2001, pp 464-468
http://www.obesitysurgery.com/Abstracts%2011(4)/11(4)Abs2.html

4. Kolata, Gina: RE-THINKING THIN (NY,2009)

Bibliography:

The following books have information on Obesity research and some info on Weight Loss Surgery in them:

• Fraser, L., Losing It: America's Obsession with Weight and the Industry that Feeds on it, 1997, Dutton (New York)
• Gaesser, Glenn, PhD:Big Fat Lies, Fawcett (NY, 1996) (updated edition - CA,2002)
• Colles, Lisa: Fat, Exploding the Myths, Carlton (London, 1998)
• Ackerman, Norman, MD: Fat No More, Prometheus (NY, 1999)
• Simpson, Terry, MD - WLS surgeon - Weight Loss Surgery - A light look at a Heavy Subject (NY, 2004)
• Pool, Robert: FAT - fighting the Obesity Epidemic (NY, 2001)
• Campos, Paul, PhD, THE DIET MYTH (NY, 2006)

More information

• diet exercise books (other book resources I have studied)
• Less calories caused rats to DIE not live longer

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