I want to write a bit about obesity in this post, and about weight loss. As you are probably aware, this is an ongoing issue with me over the past ten years, and it seems that it isn’t going away any time soon, so instead of talking about it on the podcast, I am going to start writing about it again. I think it helps me to get my thoughts on “paper” (such as it is) and my hope is that it speaks to someone else out there having the same issues.
In the United States, it is estimated that 93 million Americans are affected by obesity. Individuals affected by obesity are at a higher risk for impaired mobility and experience a negative social stigma commonly associated with obesity. Socioeconomic status plays a significant role in obesity. Low-income minority populations tend to experience obesity at a higher rate and are more likely to be overweight. In 2001, the states with the top five percentages for obesity were Mississippi, West Virginia, Michigan, Kentucky, and Indiana. Almost 112,000 annual deaths are attributable to obesity. In the United States, 40 percent of adults do not participate in any leisure-time physical activity.
Those are the facts, and we can quibble about facts all we want, but the truth is the truth, and I don’t think most of us can argue against any of these things. It is important to note that there seems to be a correlation between high obesity rates and lower income. The reasons for this are pretty clear; bad food is cheaper, and lower-income people tend to be less active (my thought on that is it’s usually because they are the ones doing the more back-breaking labor during the day and have less time for “leisure” once that day is done, but I have no data to support that).
Being affected by excess weight, obesity or severe obesity significantly increases the risk of developing many other diseases, such as type 2 diabetes, hypertension, heart disease, stroke, osteoarthritis and much more. Severe obesity is characterized by an individual weighing more than 100 pounds over their ideal body weight or having a body mass index (BMI) of 40 or higher. To be clear on that BMI number, my current BMI (I am 5’10 and 271 as of this writing) is 38.9, meaning I am 1.1 points away from being considered SEVERELY obese.
I am heavy I know, but I am not severely obese, and hence the problem with BMI. Behavior, genetics, and environment are all contributing factors of severe obesity. In 2002, 25 percent of individuals affected by severe obesity were being treated for six or more obesity-related conditions (see above for some of those). The issue is really what is the ROOT cause of obesity. Are the co-morbidity issues causing the obesity, or is the obesity causing the co-morbidity?
Much like the “5 Why’s” method of root cause discovery, if you don’t weed out the underlying issue, or the ultimate cause, then the issue will never change. Excessive caloric intake is a proximate cause of weight gain, not the ultimate cause. It is dangerous to assume that because two factors are associated that one is the cause of the other. This much of the problem with the Calorie In Calorie Out theoretical framework. It is ridiculously simplistic in design and theory.
Take, for example, a 300-calorie bunch of spinach. It enters the digestive system and is processed as everything else is but because of the fiber etc only a minuscule amount is converted to carbs for energy. Now, eat a 300-calorie packet of energy gel. There is NO fiber so it bypasses a few steps, immediately enters the bloodstream, and is converted to energy or to fat.
See the difference?
Caloric intake and Expenditure are DEPENDENT variables. decreasing calories in will trigger a decrease in calories out. In other words, a 30% decrease in caloric intake equals a 30% decrease in a caloric burn, producing minimal weight loss. So in a perfect world, the caloric amount should remain the same, but what should change is the TYPE of calories consumed. A calorie is not a calorie, no matter what some nutritionists try to tell you. Food cannot be reduced to its caloric energy, because the metabolic response between food types are not the same.
A “normal” person has a base metabolic rate of 2,500 calories a day should lose weight if they consume less than that over time (yes, it takes more than a day), but if they eat 2,500 calories of carbohydrate-laden fast food, that weight isn’t going anywhere because most of that will be shunted to fat stores instead of burned. BUT, if you eat the same amount of calories but mostly vegetables, meat, and complex carbs (i.e. naturally occurring which is NOT added sugar) the weight should come off.
It is important to learn and understand that obesity is NOT a caloric disorder. Hormones control both calorie in and calorie out, as well as fat growth, which means that obesity is a hormonal disorder.