Why are we so fat?
The diet industry tells us that 65 percent of the
public is fat or overweight. This is only according to heavily derived
mathematical figures which have little to do with reality. The reality is about
15 percent of us are genetically obese and able to get to the point of "severe
obesity" (BMI over 40) which then, is considered a medical condition worth
treating in the doctor's office. 25 percent of us are somewhat fat (BMI
30-35) which is also considered to be a medical condition. The rest of us only
FEEL we are fat - that's because we don't look super slim like the fashion
The fact is that most of the diseases "blamed on"
obesity are actually caused (in part) by lifestyle (which also can cause obesity
in susceptible individuals). (see McGinnis-Foege - 1993 "300,000 people die each
year from diseases in which sedentary lifestyle and poor food choices are a
NY Times science reporter, Gina Kolata, found that
some of the studies which found a strong link between obesity and illness or
pre-mature death, were severely flawed and good research does NOT show a
relationship between fatness and illness or pre-mature death. (4)
After her studies, Kolata concluded (as other
researchers seem to have) that fatness and height might be a factor in a society
where the population is better nourished. (ibid)
Some of the physical factors thought to CAUSE
Genetic structure - this is
probably the most prevalent cause of obesity - regulating from 40-80 percent of
the body-size (according to obesity scientist Dr. Rudy Liebel):
- The Thrifty gene - this genetic
makeup apparently fights like crazy against starvation - producing hormones to
cause the person to want to eat everything in sight if food is available and
also enabling the person to be very active but burn fuel highly efficiently
and finally the ability to raise the weight setpoint to the highest weight the
person has achieved. This genetic makeup is not only what makes some of
us fat, it also is what makes dieting make some of us even fatter. It
was what enabled people to survive in societies where food was scarce.
- The Diabetic gene - this appears
to be similar in action to the thrifty gene but specializing in being slow to
digest sugar (insulin resistance). This may have been what enabled people to
labor for hours with little or no food. Diabetics seem able to control
sugar levels if they exercise a lot (type II diabetes - that in which the
pancreas is not dead). Some societies which tend toward high levels of
obesity have BOTH the diabetic gene AND the thrifty gene - an example is some
native American tribes like the PIMA tribe, 60 percent of whom are considered
seriously obese. 33 percent of type II
diabetics have NEVER been fat at all.
Physical damage to the body
- Pituitary damage - sometimes the
mechanism regulating hunger is damaged causing the appetite to "never shut
off" - this damage could be caused by anesthesia or chemicals or other.
- After tonsillectomy - I have met
countless people who BEGAN to suffer severe obesity (coupled with ravenous
hunger) after they had their tonsils removed. Scientists now know that
the tonsils are the largest lymph node in the body and a key part of the
immune system. Fat cells which are very "intelligent" cells are also involved
in the immune system (see the "pig study") and thus the body begins to lay on
fat to compensate for the loss of the tonsils. Tonsils are seldom removed
currently but in the 1950's before their function was well understood, they
were routinely removed.
- Thyroid damage - the thyroid
gland regulates to an extent, metabolism and can be damaged or slow. It
is now thought that thyroid damage doesn't have that much effect on obesity -
years ago, a common treatment for obesity was to give the patient thyroid
medications which could cause a 10-20 lb weight loss. The thyroid gland
can be disarranged by chronic dieting, chemical (medication or food additives)
or even Weight Loss surgery.
Some of the lifestyle factors which
don't necessarily cause extreme obesity but can contribute
to it are thought to be:
- Eating as a recreation - when we
eat "for fun" which we do a lot of in our society, we typically eat foods
which are chemically made to taste very good and also provide a lot of
calories but very little bulk and surprisingly little nutrition including some
chemicals like transfat which are indigestible. When we eat
recreationally (i.e. party down or go to dinner) it is food often ADDED to our
usual daily intake. Unfortunately, most of our recreational
activities are centered around food. Even bicyclists who go for rides often
end up in restaurants eating unhealthy foods.
- Sedentary lifestyle - For decades
it was a mystery why the French could eat fatty foods and still be a much
slimmer society than Americans. Then some smart researcher discovered
that the average French person WALKS 10,000 steps a day (not many people own
cars and if they do, cars are not used to go three blocks to the market).
The average American walks less than 1000 (one thousand) steps a day.
- Food selection - we are one of
the most hard working societies in the world however, most of us do not burn
large amounts of calories at work (60 percent of jobs are desk jobs). When we
eat, we tend to select food which is easily available and does not require
much in the way of preparation i.e. fast food. But fast food, while providing
large amounts of calories, does not take up much area in the stomach, thus
doesn't make us fill "full" and does not nourish us much either. For
example, a "Big Mac" and "supersized" french fries can provide 1200 calories.
Most people do not need more than 2000 or 2100 calories a day so in one lunch
or snack, they have eaten most of the calories they need in a day.
Basically we are traveling through a "food jungle" and most foods which taste
good are either not healthy or fattening. :(
- Addictive eating - food is a
pleasure and all pleasures can become addictive (there is some evidence that
some foods actually have chemicals in them to cause them to be somewhat
addictive - this has never really been well proven but it hasn't been
disproven either). Bottom line - we are really GOOD COOKS today and food
tastes really good. People who tend toward
addiction, have are thought to produce less serotonin in the brain and are
trying to adjust this physical deficiency. Which is why the Serotonin reuptake
inhibitors (such as Prozac) sometimes help people to be less addictive with
food. It should be noted that food addiction is only discovered in the
25 percent or so of the population who becomes fat from it. It should also be
noted that if a person is very obese (BMI over 40) they, albeit may be doing
some addictive eating, more likely have the genetic predeposition toward
obesity as the major factor causing the obesity with the addictive eating
adding to the amount of obesity. And since obese individuals are often treated poorly,
addictive eating often FOLLOWS obesity in many cases (rather than CAUSING the
obesity in the first place). There are many individuals who have an eating
addiction who do NOT gain weight from it. One individual in his 70's bragged
to me that he eats 3000-3500 calories a day and still is at the same low
weight he was in High School. Six months after he bragged to me about
that, he had a massive heart attack and required coronary bypass surgery.
The moral of the story is overeating or eating addiction may not be healthy
even if it doesn't make you gain weight.
- Medications we take - some like
Birth Control medications can cause weight gain. Steroids can cause weight
gain. Anti depression medications can cause weight gain in some people.
and finally, last but certainly not least:
- Chronic dieting - 80 percent of
American women are on a diet at any given time. When we diet, our bodies
set our metabolisms down so we need less calories. It also increases our
appetite so we want to eat more and if we do not give in, it produces hormones
to make us feel fatigued. This (and not overeating as most think or
"lack of will power") is responsible for the poor long term success rates of
diets. (Statistics tell us that 95 percent of those who lose weight,
regain all or more within 4 years of the weight loss). Most women are setting their "ideal weights" way too low to be
healthy or to be what THEIR bodies want. Ideal Weights are often set
according to the mathematical formulas "du jour" (now we have the BMI which
takes neither gender, nor age nor body nor bone structure into consideration)
or worse yet, set to achieve a size similar to fashion models who are known to be
Most people do not know that being underweight is
a serious medical condition, far worse than obesity nor are they aware of the
fact that studies have linked cigarette smoking directly to lung and breathing
disorders i.e. 95 percent of those with COPD are or have been smokers and heart
disease (smoking hardens the arteries). This is because the medical profession,
is pushy about losing weight but seldom more than mentions smoking as a real
The risks of being clinically obese i.e. BMI over
40 and not
exercising are about the same as being a light smoker states Dr Paul Ernsberger,
an associate professor at Case Western Medical School. (Many people in our
society are light smokers but I don't see widespread worry about the light smoking epidemic).
From a 48 year history of dieting, I have found
there is only one way to force one's body to be at a weight lower than what the
body wants to be and that is by calorie restriction. Eating 1400 or less
calories a day CONSISTENTLY may force the weight lower than the body's setpoint
if you combine that with healthy food choices and daily cardio exercise. (Many
people of "model size" eat less than 600- 800 calories a day)
Unfortunately this type of calorie restriction can cause fatigue, ravenous
hunger, immune challenge and more if not done very carefully with healthy food
choices, which is why most people cannot do it.
It takes a daily war with the body to calorie restrict and for many people,
"life is too short". There is NO
EVIDENCE that maintaining a slim weight through calorie restriction is healthy
and some evidence that calorie restriction the way most folks do it, (not
avoiding 'fun' foods and not eating a lot of vegetables and not exercising) may
actually challenge the health and/or cause nutritional
deficiencies in many people. The Food Institute of the UK found that
chronic severe calorie restriction (less than 1000 calories a day) can cause PERMANENT brain damage.
All the so-called successful methods of "weight
control" such as surgery or diets, are designed to do ONE THING. To make
it uncomfortable physically or undesirable to eat much food in order to make
calorie restriction (to force the body to a lower weight) easier to do.
Unfortunately with today's calorie packed and very delicious foods, Weight Loss
surgery is only totally successful on the long run for 7 percent (see the Hebrew
University Study of gastric bypass patients - 1993) although some 75 percent
of weight loss surgery patients have been observed to keep off "some weight". (25
percent of gastric bypass patients re-gain back to original size) (2)
In one study, at the 13-15 year point it was found that most gastric bypass
patients still had weights in the "severe obesity" area of BMI (around BMI 35).
It also was found that many of these patients had plugging of the stomas, and
involuntary vomiting (3)
Eliminating whole food groups or restricting
oneself to low calorie bland tasting foods are other ways of helping some to
practice calorie restriction. Unfortunately these don't work for many
people. I've known fat vegetarians, fat vegans and even people who have
gained 50 lbs or more on the Atkins plan.
The Atkins diet is one of the most controversial
diets available (generally true of low carbing). Many medical providers
and nutritionists are against it and point out that not only does it NOT produce
good long term results but may endanger the kidneys and other organs. Yet, low
carbing (if you look on the web) has its share of ARDENT supporters.
Quick diets and liquid diets are highly
controversial as well. Again the medical profession generally is against these
diets (although some weight loss surgeons advise pre ops to go on a liquid diet
to reduce the amount of fatty liver often seen in people who eat a lot of fatty
foods regardless of weight) but people tend to like these diets because they
produce quick short term results and nice losses on the scale. Unfortunately, a
goodly amount of the weight lost on the quick diets (Medifast, Nutrasystems etc)
is NOT fat but valuable healthy muscle and bone mass. Things you do NOT
want to lose.
I'm beginning to feel that "weight control" (by
ordinary means) is something of a myth. We are told it's easy to maintain a
"healthy weight" (the number selected according to the latest mathematical
calculation having little to do with any kind of reality). Just "eat less
and move more". But if that is so, why is it that 95 percent of diets
fail? Never-the-less because we WANT to believe, the diet
and medical industries (sometimes indistinguishable in the field of "weight
control") can continue feeding us that myth. But for those of us like
myself who have been working out DAILY for 1-2 hours a day cardio and journaling
food, we know that this is not the way to force our bodies to what society feels
is a "healthy weight". It seems that the body is designed to automatically
maintain a weight IT thinks is healthy and it seems that most bodies DO maintain
that weight plus or minus 20-30 lbs unless we take extraordinary means. In
fact less than 5 percent of those who set out to lose a lot of weight, are able
to maintain it for any length of time. Weight Watchers, the only weight
loss organization to show a net loss, showed a loss of 11 lbs over two years in
the latest Heshka study.
Bottom line - understanding that fights against
nature can be unpleasant with the body still winning. Follow these rules
and don't worry about your weight or your cholesterol (heart attacks happen
EQUALLY in people with normal cholesterol levels) or other things and enjoy life
because stress is STILL the biggest cause of all illness. This is called "HAES"
(Health at Any Size) NOTE: doing the following below will render many
people on the slim side unless they have physical or genetic factors causing
obesity. It will likely keep your BMI below 40 or 45 regardless of your
- Avoid party foods, fast food, junk food
- Eat lots of veggies (5 portions or more)
either raw or cooked as in steamed without butter or oleo
- Eat 2 tablespoons of "healthy fat" (Omega
III-VI fatty acids) daily. Can be peanut butter, believe it or not!
- Avoid chemical food additives like nutrasweet
- Select low fat - portion controlled dinner
choices like Lean Cuisine and Weight Watchers "Smart Ones"
- When eating dinner, put yours on a "dessert
plate" because that's the size that dinner plates used to be, 100 years ago.
- Consume 3 cups or more of non fat milk daily
or the equivalent.
- Consider supplementing with a multivitamin,
B complex vitamins, Vitamin C, Vitamin E and co-enzyme Q10
- Avoid dieting (challenges the immune system,
is risky for the heart and often causes weight gain)
- Avoid alcoholic beverages
- Avoid anything with transfat in it including
- Watch portions - 1/2 cup is a reasonable
portion of pasta, veggies. Of high fat, fun foods, restrict to two
tablespoons. Fill up on good low fat foods like veggies.
- Try to do your serious eating at home -
focusing on good non recreational foods like veggies, proteins etc - when
you are out, eat your regular food first to fill up then just taste the
- If you think you are kidding yourself about
what you are consuming (most of us do kid ourselves), journaling food is not a bad idea. I journal
my points daily (a la Weight Watchers) and have done so for over 2 years.
Also measuring food is another good idea...
- NOTE: most folks "feel better" when dieting
at first because they are making better food choices, regardless of what
program they are on. You can make those better food choices without
worrying about losing weight and still feel better.
- Non Food
- Exercise daily - 60 minutes or more of
cardio. Cardio is exercise which doesn't hurt and doesn't make you
breathless. Examples of cardio are
- Replace food addiction with an exercise
addiction or something else other than food. Logic tells us that if we eat
whole boxes of doughnuts (or even more than 2) or large amounts of pizza that this will not have a
good effect on our bodies
- And most important - realize a person can be
beautiful AT ANY SIZE. Celebrate YOU. You are a lot more than the number
on the scale or your size. Women can look glamorous at ANY SIZE.
Often slimness as dictated by society or EVEN the
medical industry is bought at the price of health, well being and quality of
It's a choice which few Americans make in full
consent because the diet industry and the popular media withhold the facts.
1. JAMA 270 - Nov 10, 1993 pp 2207-2212
2. Dept. of Surgery C, Soroka Medical Center, Beer Sheba (Israel study)
Harefuah 1993 Feb 15;124(4):185-7, 248 (article is in Hebrew)
3. Obesity Surgery, Vol. 11 No. 4 August 2001, pp 464-468
4. Kolata, Gina: RE-THINKING THIN (NY,2009)
The following books have information on Obesity
research and some info on Weight Loss Surgery in them:
- Fraser, L., Losing It: America's Obsession with Weight
and the Industry that Feeds on it, 1997, Dutton (New
- Gaesser, Glenn, PhD:Big Fat Lies, Fawcett (NY,
1996) (updated edition - CA,2002)
- Colles, Lisa: Fat, Exploding the Myths, Carlton
- Ackerman, Norman, MD: Fat No More, Prometheus (NY, 1999)
- Simpson, Terry, MD -
WLS surgeon - Weight Loss Surgery - A light look at a Heavy Subject
- Pool, Robert: FAT - fighting the Obesity Epidemic (NY, 2001)
- Campos, Paul, PhD, THE DIET MYTH (NY, 2006)
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