If obesity was an infectious disease, we would marshal all of our resources in fighting it. Clearly, we’re not there yet. The dichotomy is that as obesity increases, the societal emphasis on thinness and weight management also increases. Each year, the diet industry makes between 40 and 50 billion dollars from weight-loss products. In the year 2000, 38% of adults were trying to lose weight.
Does dieting work? Clearly it does. A recent study published in the New England Journal of Medicine suggests that any dietary strategy is going to work, but here is the caveat: YOU HAVE TO STICK WITH IT. The average dieter lasts 2 weeks. You’re not going to get where you want to be in two weeks.
There is more fraud and misinformation in this industry than in any other. We’re spending more money, but we’re not getting the results. We know that children and adolescents are concerned with weight. In a study involving high-school girls, 28% to 40% reported being on a diet or concerned with being fat. Teens believe the best strategy to lose weight is to exercise and skip meals. That is wrong. Calorie management and exercise is what really works, but surveys suggest that teens don’t believe that.
How do we get obese?
As with every other chronic illness, genetics can rule the day. When both parents are morbidly obese, there is an 80% chance that their children would be also. The good news is that when neither parent is obese, there is less than a 10% chance that children would be obese. However, about 25% to 30% of obese people have normal weight parents. Some studies with twins suggest that there is a genetic component. It is estimated that your genetic makeup can account for about 50% up to 90% of the variations you might have in terms of your ability to store body fat.
You can look at it this way: genetics can load the gun, but the environment pulls the trigger. You might have the genetic predisposition, but environmental factors activate those genes.
Fat-Cells
We have three different types of obesity. We have hyper-cellular, hypertrophic, hyperplastic. Hyper-cellular obesity is an above average number of fat cells. You can be born with them, or you can develop them through over-eating. Hypertrophic obesity happens when fat cells are larger than normal. These cells continue to expand as they fill with fat. When they are full, the body has the ability to make new fat cells. Here’s the scary part: when body fat is 3 to 5 times the normal amount, you have the ability to make more fat cells.
Weight loss doesn’t decline the number of fat cells, making it difficult to lose weight once the body has created them. Why is that the case? When the fat cell becomes empty, it sends triggers asking for more food.
Sex and Age
Sex and age also play a role in the development of obesity. This is because men and women set different standards for themselves. Growth and development occurs at different rates and has a different outcome for boys and girls. If I could rule the world, I would teach puberty a little bit different to adolescents: Boys grow up and out under the influence of testosterone, and add significant amounts of lean mass. Girls grow up and fill out. They add some body fat under the influence of estrogen. That is a normal phenomenon that should occur, but girls look at this as undesirable. They see their older brother getting bigger and more muscular, and then see how they get fat inside of their thighs and think it is wrong. That is absolutely normal and good.
Males, in general, are more accepting of personal weight gain. That makes sense. When I gain weight, I generally add a significant amount of lean mass, so I’m fine. Adult males tend to see themselves as overweight at higher weights, while women think they are overweight even when they are close to a healthy bodyweight. Some women only feel thin when they are about 10% below their ideal bodyweight.
Both men and women gain most of their weight between the ages of 25 and 34. For women, that weight gain can go on until menopause.
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