The reasons for obesity are multiple and complex. Despite
conventional wisdom, it is not simply a result of overeating.
Research has shown that in many cases a significant, underlying
cause of morbid obesity is genetic. Studies have demonstrated
that once the problem is established, efforts such as dieting
and exercise programs have a limited ability to provide effective
long-term relief.
Science continues to search for answers. But until the
disease is better understood, the control of excess weight
is something patients must work at for their entire lives.
That is why it is very important to understand that all
current medical interventions, including weight loss surgery,
should not be considered medical cures. Rather they are
attempts to reduce the effects of excessive weight and alleviate
the serious physical, emotional and social consequences
of the disease.
Contributing Factors
Genetic Factors
The Pima Paradox
Environmental Factors
Metabolism
Eating Disorders &
Medical Conditions
The underlying causes of severe obesity are not known. There
are many factors that contribute to the development of obesity
including genetic, hereditary, environmental, metabolic
and eating disorders. There are also certain medical conditions
that may result in obesity like intake
of steroids and hypothyroidism.
Numerous scientific studies have established that your genes play an important role in your tendency to gain excess weight.
- The body weight of adopted children shows no correlation with the body weight of their adoptive parents, who feed them and teach them how to eat. Their weight does have an 80 percent correlation with their genetic parents, whom they have never met.
- Identical twins, with the same genes, show a much higher similarity of body weights than do fraternal twins, who have different genes.
- Certain groups of people, such as the Pima Indian tribe in Arizona, have a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.
We probably have a number of genes directly related to weight. Just as some genes determine eye color or height, others affect our appetite, our ability to feel full or satisfied, our metabolism, our fat-storing ability, and even our natural activity levels.
The Pima Indians are known in scientific circles as one
of the heaviest groups of people in the world. In fact,
National Institutes of Health researchers have been studying
them for more than 35 years. Some adults weigh more than
500 pounds, and many obese teenagers are suffering from
diabetes, the disease most frequently associated with obesity.
But here's a really interesting fact - a group of Pima
Indians living in Sierra Madre, Mexico, does not have a
problem with obesity and its related diseases. Why not?
The leading theory states that after many generations
of living in the desert, often confronting famine, the most
successful Pima were those with genes that helped them store
as much fat as possible during times when food was available.
Now those fat-storing genes work against them.
Though both populations consume a similar number of calories
each day, the Mexican Pima still live much like their ancestors
did. They put in 23 hours of physical labor each week and
eat a traditional diet that's very low in fat. The Arizona
Pima live like most other modern Americans, eating a diet
consisting of around 40 percent fat and engaging in physical
activity for only two hours a week.
The Pima apparently have a genetic predisposition to gain
weight. And the environment in which they live - the environment
in which most of us live - makes it nearly impossible for
the Arizona Pima to maintain a normal, healthy body weight.
Environmental and genetic factors are obviously closely
intertwined. If you have a genetic predisposition toward
obesity, then the modern American lifestyle and environment
may make controlling weight more difficult.
Fast food, long days sitting at a desk, and suburban neighborhoods
that require cars all magnify hereditary factors such as
metabolism and efficient fat storage.
For those suffering from morbid obesity, anything less
than a total change in environment usually results in failure
to reach and maintain a healthy body weight.
We used to think of weight gain or loss as only a function
of calories ingested and then burned. Take in more calories
than you burn, gain weight; burn more calories than you
ingest, lose weight. But now we know the equation isn't
that simple.
Obesity researchers now talk about a theory called the
"set point," a sort of thermostat in the brain that makes
people resistant to either weight gain or loss. If you try
to override the set point by drastically cutting your calorie
intake, your brain responds by lowering metabolism and slowing
activity. You then gain back any weight you lost.
Weight loss surgery is not a cure for eating disorders.
And there are medical conditions, such as hypothyroidism,
that can also cause weight gain. That's why it's important
that you work with your doctor to make sure you do not have
a condition that should be treated with medication and counseling.
