The Many Causes of Obesity

If the solution to obesity were as simple as saying “eat less, move more”, I wouldn’t be writing this.

Unfortunately, many practitioners give exactly that advice to those looking to lose weight. Just as a broken clock tells you the correct time twice a day, that advice is helpful for some people, but for the majority it is not sufficient.

Everyone knows someone who has lost weight with seemingly very little changes in their lifestyle or with minimal effort – the friend who quits drinking soda and loses 20 pounds in 4 months, or the coworker who makes it her mission to use the elliptical for 45 minutes every day before work and loses 15 pounds just like that.

For a small subset of people, solely eating less and moving more works. Although these people are not one in a million – they’re common enough that we all know one of them – simple fixes like that don’t work frequently enough and it is crucial that we broaden our understanding of what causes and contributes to obesity.

The following is a generalized list of some causes of obesity. There are almost certainly more to add, but in my experience, this encompasses a large portion of the reasons why patients become obese. Keep in mind that almost none of these occur in isolation. Most people have multiple reasons listed below that need to be addressed, and some are more important than others depending on age, lifestyle, etc. This is why a personalized approach to weight loss is essential.

Each factor below could have an entire article devoted to it – we’ll continue to expand on these individually in future posts:

1.     Increased intake of the wrong calories

· Calories from certain food sources raise insulin  significantly which promotes fat storage (1)

2.      Increased caloric intake

· Some patients don’t realize they are taking in 1000 or more calories than they should; extra calories add up to extra fat storage over time

3.     Hormonal influence

· Changes in estrogen and testosterone levels affect fat metabolism and muscle growth. Other hormones also regulate appetite

4.     Intestinal microbiome changes

· Changes in your bacteria influence your ability to metabolize food effectively

5.     Decreased movement

· Movement burns calories, influences hormones positively, and reduces stress

6.     Increased stress

· Chronically elevated cortisol levels promotes muscle breakdown and insulin resistance (2)

7.     Decreased Sleep

· Raises cortisol, alters appetite towards carbohydrate cravings, and decreases motivation to exercise (3)

8.     Carbohydrates without fiber

· If soluble and insoluble fiber are absent in carbohydrate rich foods, an increased percentage of calories are absorbed

9.     Too much fructose intake

· Fructose is more lipogenic (“fat creating”) than glucose and leads to insulin resistance in the liver

10.   No periods without food

·  Snacking all day keeps insulin levels elevated, making it less likely for your body to turn to stored fat to burn

11.   Obesogens

·  Unfortunately, environmental toxins are widespread and negatively impact our health on many levels, including contributing to obesity. See below reference from National Institute of Environmental Health Sciences (4)

Losing weight can be a complex and often frustrating path filled with both successes and temporary setbacks. Having an understanding that there are at least 11 potential factors that may be contributing to your inability to lose weight and start feeling better helps provide a framework to reference and avenues to investigate when weight loss stalls. This also goes to show why you can’t just prescribe a shake or  a generic one size fits all fitness program and expect it to work for everyone. Getting to the root of the problem requires a personalized approach that takes into account all of the above and provides a support structure to help you work on all these variables.

While it’s true that many people need to eat less and move more as part of their approach to weight loss, using that approach in isolation falls short of a comprehensive approach to a complex problem. Many patients will be left frustrated and without answers when weight loss stalls. At Weightloss207 we strive to be better than that because patients seeking help deserve more than the standard approach.

Sam Madore DO

References:

1- Ludwig, D. “ The carbohydrate-insulin model of obesity “ JAMA July 2018

2- Patel, S. “ Association between reduced sleep and weight gain in women”  Am J Epi. November 2006

3- Christiansen, JJ. “Effects of Cortisol on Carbohydrate, Lipid, and Protein Metabolism: Studies of Acute Cortisol Withdrawal in Adrenocortical Failure”. JCEM. 2007

4-https://www.niehs.nih.gov/health/topics/conditions/obesity/obesogens/index.cfm


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