The obesity crisis was not caused by a single factor. Unfortunately, like the perfect storm, many events come together in sequence to result in this health emergency tidal wave; Such is the #ObesityCrisis.
To date, the obesity crisis and our lack of understanding has destroyed the quality of life of millions of Americans. The lack of:
- Nourishment education – What the body needs and gets from different foods – energy, macronutrients, and micronutrients
- Biological functions – How the body works to achieve homeostasis – energy balance.
This lack of knowledge makes it difficult to achieve a healthy weight for the long term. Don’t take my word for it, review the scientific evidence of @KevinHall, PhD. Kevin is a senior investigator at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK). What is significant about Kevin is he is the Section Chief of Integrative Physiology Section, Laboratory of Biological Modeling. @BonnieLiebman, MS is an author, and Director of Nutrition at the #CenterForScienceInThePublicInterest (CSPI). Bonnie interviewed Kevin and published in the #NutritionActionHealthLetter (a publication of CSPI) – How Did We Get Here? July/August 2018 Volume 45 No. 6; pg. 3 – 5 print.
Because obesity is a multifactorial event, understanding the causes and effect is extremely challenging. So, let’s take a basic look into a few hormones that work with us and against our health benefit.
The Basic Science of Human Weight Management
Normally, 2 key hormones work against each other to control our weight:
- Leptin (the energy management hormone) – Released from the fat cells located in fat (adipose) tissue. One of its main functions is long-term regulation of the body’s energy supply. Leptin signals the brain (hypothalamus) to stimulate or suppress appetite and alter the burn rate of stored energy. When we lose body, fat leptin stimulates appetite and reduces stored energy burn rate. Weight gain triggers the opposite series of events (eat less burn more).
- Ghrelin (the hunger hormone) – According to National Institute of Health (NIH), ghrelin does much more than signal the brain when to start and when to stop eating. It is released by the stomach, and other glands. in context of weight management, Ghrelin among other functions helps regulate taste sensation, energy and glucose balance #LeptinVsGhrelin
The Calm Before the Storm (Before 1970):
- Leptin and ghrelin went about their business of cooperating to control our body weight (homeostasis)
- Families ate more often at home than at restaurants and at other eateries; additionally high food prices and family size prevented excessive eating
- Families were more physically active (work & play – virtually no access to computers to promote sedentary behavior)
The Storm is Energized by Key Players (1970):
- President Nixon became aware of complaints about the rising cost of food. Consequently, he directed the USDA to fix the problem.
- The USDA initiated policy to subsidize farming to stimulate yield of basic foods like corn and soybeans.
- The farmers subsequently increased the production of corn, soybean, and other crops. This massive supply caused a drop in the price of basic foods that became major ingredients in the processed food supply.
- The manufacturers of processed foods employed food scientists, and engineers to develop ingredients like high-fructose corn syrup to enhance “Ultra-Processed” food products that were:
- Great tasting – Food scientists are better (appetite stimulators) cooks than mom and granny; they mastered the ideal combination of salt, sugar, fat, and flavor additives to increase flavor, (and unfortunately calories). This development triggered a super-normal appetite. #BlissPoint
- More Stable – The addition of extra salt, high-fructose corn syrup and other technologies helped foods last longer in unrefrigerated settings like store shelves and homes.
- Cheaper – Consumers enjoyed more food at lower prices, and consequently began to eat more meals away from home.
- Seventy percent of salt we eat comes from processed foods, and restaurant foods
- Seventy-nine percent of total sugar we consume comes from processed foods, restaurants, and dining halls.
- More Convenient – Less cooking required. Heat and serve made busy lives more manageable.
- Powerful Food Advertising That Target Children – Drove overeatingof unhealthy foods high in carbs/sugar, salt, and saturated fats resulting in consumers:
- Eating the foods that are most profitable”. #WeightOfTheNation
- Eating more at restaurants, and dining halls
- Buying more convenient heat & serve food products.
- Snacking more frequently on tasty high calorie food products
- Physical activity continues to be inadequate in burn off the significant increase of calories consumed – causing an energy imbalance, obesity.
The Abyss of Overweight and Obesity
- Nationwide, 223 million people (71%) are overweight or obese (2015 – 2016). https://www.cdc.gov/nchs/fastats/obesity-overweight.htm; the obesity rates range from 22% in Colorado to 38.6 percent in West Virginia.
Overweight, and obesity significantly increase the risk for preventable chronic diseases, disability, premature death, and massive healthcare costs:
- 34 million people of all ages (9.4%) had diabetes in 2015
- 88million people (33.9%) were estimated to have prediabetes
- 2 million suffered from cardiovascular disease –
- Heart disease kills 655,000 people
- Coronary artery disease (365,914 deaths in 2017)
- Stroke (795,000 per year)
- Heart attack (805,000 per year),
- Kidney related deaths (51,000 per year)(CDC)
- 40% of all cancers diagnosed are associated with overweight and obesity. (CDC)
What About Dieting, Exercising, and Wishing?
The casual observer may interpret Kevin Hall’s weight loss research as if leptin and ghrelin have gone rogue. But, in actuality, these two hormones have not deviated from their mission: To prevent our bodies from quickly losing fat weight (stored energy), best known as starvation. Unfortunately, the super tasty and fragrant food products have given rise to our super-appetites – And energy imbalance. To counter the fat weight gain, we test a variety of weight loss programs. Unfortunately, as we work to lose extra fat pounds, leptin and ghrelin carry out their mission (that work against our goals). So, as our fat level drops in our bloodstream, leptin level drops and our stomach secretes ghrelin level to new heights. Leptin also helps to decrease the rate at which we lose weight (burn body fat, pausing at the dreaded ‘plateau’.
Spoiler alert: Hunger is a tough sensation to ignore. Sometimes hunger sneaks in stealthily like a thought, or a whim.
Kevin Hall’s experimentation and modeling revealed that, “when people were losing body fat weight, their appetites increased by about 45 calories per day (above baseline) for every pound of body fat weight that they lost”. To make fat weight loss more difficult, leptin reduces the body’s fat burn rate.
Again, Kevin cites that, “the number of calories that they were burning went down by between 10 and 15 calories per day for every pound of fat weight lost”. This means if you lost 10 pounds, the average person would burn 100 to 150 less calories per day. Keep in mind that burning 3500 calories equals 1 pound of fat lost. Yep, it is going to take a little longer to lose that fat weight than many individuals expect. So, prepare your mind for this reality. You will need an effective plan that you believe in to continue your effective fat weight loss journey.
Climbing Out From the Abyss
Currently, there are no miracles for achieving persistent weight loss. Losing weight and keeping it off is difficult for most mortals. There are many suggestions, products, and practices on the internet that promise to help us easily lose weight. Sadly, many of these plans are not based on scientific evidence. Consequently, most are doomed to failure, and may harm the health or attitude of the individual. Search the WEB for the ‘fen-Phen’ heart valve crisis.
Some uncontrollable factors that drive fat weight gain and obesity.
- Socioeconomic status (easy access to affordable healthy foods)
- Prescribed medications (known as obesogenic) like some antidepressants, blood pressure meds
But, for those of us who are lucky enough to not have these barriers, must work at it (plan-do-measure-repeat). We all must learn to eat differently for a lifetime. We must sacrifice a little or a lot due to our eating traditions, habits, and the uncontrollable factors. Some of us must suffer to some degree, depending on our level of obesity. We will lose the weight is we are persistent.
However, self-managed sustained weight loss requires persistent commitment that ranges from eating differently to the extremes of gastric by-pass surgery and its potential complications. And, even then pre-surgery patients must learn to eat differently before and after the surgery or suffer consequences. If bariatric sergury is the solution, then find an organization that stresses the critical importance of detailed preparation that you clearly understand. You have one body, it is critical to understand that healthy eating means providing our bodies all the macro and micronutrients it needs to function properly. #PortionControl #PrecisePortions.com
Failure to lose excess weight [based on body mass index (BMI)] and keeping it off increases the risk of developing metabolic syndrome – “A cluster of diseases that increase the risk of heart disease, stroke, and diabetes. This includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.”
debilitating diseases like:
- Type 2 diabetes
- High blood pressure (leading to kidney failure and stroke)
- Types of cancers (NIH)
- Colon cancer
- Rectal cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin’s lymphoma
To fight obesity, all of us who are committed to community health have a crucial role to play in empowering consumers to follow effective and sustainable weight loss strategies. At the same time, consumers need to hold themselves responsible to attempt only evidence-based strategies to achieve self-managed body fat weight control.
Let us all continue the conversation to help:
- Alert public awareness to the forces driving #overeating and #obesity
- Reduce the increasing rate of obesity in the USA, and the world
Keywords: obesity crisis, fat weight loss, calories, hormones, leptin, ghrelin, Ultra-Processed foods, metabolic syndrome