Many associate obesity with sloth and deficient self-control. They believe it can be cured simply by avoiding food that is high in carbohydrate and sugar content. Almost everyone knows this, but in the heat of the moment, it can be difficult to implement this discipline. Very often obesity has underlying causes that can’t be addressed only with diet and exercise. That is why it is best to treat obesity as a disease.
Today, there are far too many conflicting ‘tips’ on reducing weight and curing obesity, which makes it difficult to separate facts from myths. We want to debunk common myths about obesity and recommend a scientific approach to dealing with it.
What is obesity?
Traditionally, obesity is determined based on your body mass index (BMI). Here’s how to calculate BMI: Divide your weight in kilograms by the square of your height in meters. You can also get your BMI by dividing your weight in pounds by the square of your height in inches and multiplying the result by 703. The traditional BMI-based classification is as follows:
The fact is there are many “skinny but fat” as well as “chunky but healthy” people to whom this standard does not apply. What really matters is the ratio of fat mass to lean mass in the body. A metabolically healthy body has less fat mass than lean mass. So, even if your BMI is in the normal range, you are susceptible to the metabolic consequences of obesity like diabetes, metabolic syndrome, hypertension, high cholesterol, atherosclerosis, etc if your fat mass is more than your lean mass… Conversely, if your lean mass exceeds the mass of fat in your body, then metabolically your health is sound even though you may look chunky. That is why it is critical to discover the percent of fat mass in the body before embarking on a treatment program for obesity.
The distribution of fat is as important as the amount of fat
The adipose tissue beneath the skin is called subcutaneous adipose tissue (SAT), whereas the one lining internal organs is termed visceral adipose tissue (VAT). Adverse metabolic impact of obesity depends upon the location of fat deposits. Visceral adipose tissue (VAT) exerts a harmful effect on metabolic homeostasis, but of more importance is the ratio of VAT to subcutaneous adipose tissue (SAT). The ratio between abdominal VAT/SAT is an independent predictor of death and coronary events, irrespective of cardiovascular risk factors,
Why do we have fat, to begin with?
Adipose tissue is a loose connective tissue mostly composed of adipocytes. It plays a major role in storage of energy, but also serves as an important cushion and insulates the body from heat and cold.
Fat is more than a passive depot of extra energy
Besides its passive function, adipose tissue can become a major endocrine organ. Increased production of pro-inflammatory adipokines molecules by VAT causes insulin resistance, leptin resistance, hepatic steatosis (fatty liver), metabolic syndrome, hypertension, and an exaggerated inflammatory state. Adipose tissue is also a source of bad estrogen. The colon is surrounded by mesenteric visceral body fat. Based on intimate connection, it has been hypothesized that VAT-produced metabolites may have a direct influence on obesity-associated colon cancer aggressiveness and progression. It’s safe to conclude that VAT is a pathogenic fat deposit.
Determining the root cause of obesity is a must
It is important to understand the root cause of obesity. There are several risk factors that can lead to obesity, such as:
犀利士 ong>Genetics: Yes, it’s true that there are some congenital syndromes e.g. Prader Villi, where genetics play a role, but often the explanation of obesity running in families lies in family members sharing similar eating and activity habits.
- Lifestyle: Undoubtedly, indulgence in unhealthy, processed, and junk foods and a sedentary lifestyle tend to exacerbate obesity. Consuming empty calories in alcohol is another known cause of weight gain.
Causes of Resistant Fat: Why Can’t I lose weight?
Many of you may have failed to lose weight despite eating right and exercising. It can be very frustrating when you feel that your body is working against you. A few examples of these scenarios can be:
- Dysbiosis: Trillions of microorganisms inhabit the human body, some good and some bad. These microorganisms colonize the gastrointestinal tract and outnumber our own cells. Disruption of the ecological equilibrium in the gut (i.e., dysbiosis) has been associated with obesity and its related comorbidities. Prebiotics and Probiotics can reshape the gut microbiota and restore the balance between good and bad bacteria. Supermarket shelves are overflowing with products to help but a thorough evaluation is needed to determine what strains will help you the most.
- Fatty Liver or NAFLD: Obesity is associated with an increased risk of nonalcoholic fatty liver disease (NAFLD). An excessive amount of triglyceride represents a metabolic imbalance. This complex metabolic condition leads to a constellation of adverse alterations in glucose, fatty acid, and cholesterol resulting in systemic inflammation and insulin resistance making it difficult to lose weight. In simpler words, the liver has to repackage the nutrients it receives from the gut. Sometimes the metabolic pathways involved in doing so are preoccupied with metabolizing toxic substances like alcohol, pesticides/herbicides, industrial and household products, plastics, detergents, flame retardants or ingredients in personal care products. Other times the liver is receiving more than what it can repackage efficiently. Both these scenarios lead to fatty liver or NAFLD. The liver plays a crucial role in keeping blood glucose stable. When the liver is not functioning optimally blood sugar starts fluctuating leading to intense cravings for sugary foods.
- Hormonal Imbalance: There are multiple hormonal axes in the body. They work together for optimum physiology. Sex hormones are well recognized but they work together with hormones made in the adrenal, thyroid, and pancreas. For optimal health, they all need to work together like multiple musicians in an orchestra to play together to create a symphony. Hormone disruptors or mimickers like xenoestrogens such as BPA take the place of normal estrogen in the body. Artificial sweeteners contribute to metabolic syndrome and obesity by changing the host microbiome, decreased satiety, and alter glucose homeostasis, leading to increased caloric consumption and weight gain. Your body’s natural daily cycles are called circadian rhythms. They respond primarily to light and darkness. A “master clock” in the brain helps coordinate your body’s natural rhythms. Overexposure to blue light may affect melatonin, leading to changes in circadian rhythms and weight gain from altered eating patterns. Wheat gluten promotes weight gain in part by reducing the thermogenic capacity of adipose tissues. Lactose restriction leads to decreased levels of TSH. Gluten and dairy overload is a commonly believed trigger to the immune system which can lead to thyroiditis. Stress may play a major role in the development and maintenance of obesity in individuals who have an increased glucocorticoid exposure or sensitivity by affecting cortisol levels.
All these physiological changes together create a hostile milieu in the body where it becomes impossible to lose weight and you succumb to frequent sugar cravings, anger, irritability etc. This leads to a vicious cycle of overeating and guilt-tripping.
- Medication: Emotional disturbances resulting from hormonal imbalance are frequently treated with anti-depressants and anti-anxiety medicines. Many of these meds can cause weight gain and intensify food cravings.
Why Obesity is now labeled as a disease?
American Medical Association (AMA) in 2013 recognized obesity as a disease state. Obesity can lead to a plethora of diseases and ailments like metabolic syndrome, PCOS,
Type 2 diabetes, atherosclerosis, hypertension, high cholesterol, sleep apnea, heart disease, many kinds of cancer, and even infertility! Obesity is known to cause erectile dysfunction and irregular periods. Since all of these conditions are the result of high VAT ( visceral adipose tissue), it makes sense to resolve the root cause instead of putting a bandaid on each of these chronic conditions.
It’s always a good idea to begin with lifestyle changes, but if you are making an effort and not seeing results, then DO NOT blame or shame yourself. Instead take a scientific approach. Discover the root cause as to why your body is not working for you. As you address the root cause not only you will be able to lose weight, but also keep it off.
Your job is to maintain a proper diet, regular exercise, and keep a positive attitude!