{"id":6858,"date":"2023-08-11T16:00:00","date_gmt":"2023-08-11T16:00:00","guid":{"rendered":"https:\/\/modernsciences.org\/staging\/4414\/?p=6858"},"modified":"2023-07-28T03:36:23","modified_gmt":"2023-07-28T03:36:23","slug":"the-obesity-epidemic-is-fuelled-by-biology-not-lack-of-willpower","status":"publish","type":"post","link":"https:\/\/modernsciences.org\/staging\/4414\/the-obesity-epidemic-is-fuelled-by-biology-not-lack-of-willpower\/","title":{"rendered":"The obesity epidemic is fuelled by biology, not lack of willpower"},"content":{"rendered":"\n  <figure>\n    <img  decoding=\"async\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/538592\/original\/file-20230720-27-qvsftl.jpg?ixlib=rb-1.1.0&#038;rect=222%2C138%2C4711%2C3107&#038;q=45&#038;auto=format&#038;w=754&#038;fit=clip\" >\n      <figcaption>\n        For many people, trying to lose excess fat is very difficult without help. Effective treatment is available when obesity affects health.\n        <span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span>\n      <\/figcaption>\n  <\/figure>\n\n<span><a href=\"https:\/\/theconversation.com\/profiles\/megha-poddar-1448966\" target=\"_blank\" rel=\"noopener\">Megha Poddar<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/mcmaster-university-930\" target=\"_blank\" rel=\"noopener\">McMaster University<\/a><\/em> and <a href=\"https:\/\/theconversation.com\/profiles\/sean-wharton-1452971\" target=\"_blank\" rel=\"noopener\">Sean Wharton<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/mcmaster-university-930\" target=\"_blank\" rel=\"noopener\">McMaster University<\/a><\/em><\/span>\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 100px; border: none; position: relative; z-index: 1;\" allowtransparency=\"\" allow=\"clipboard-read; clipboard-write\" src=\"https:\/\/narrations.ad-auris.com\/widget\/the-conversation-canada\/the-obesity-epidemic-is-fuelled-by-biology-not-lack-of-willpower\" width=\"100%\" height=\"400\"><\/iframe>\n\n<p>Since the time a human first used a tool to make life easier, increased weight has been inevitable.<\/p>\n\n<p>From that day the amazing and rapid progress of human achievement has been on a parallel trajectory with the growing availability of calories and the health and social consequences \u2014 initially positive \u2014 that have come with it.<\/p>\n\n<p>Through most of human history, <a href=\"https:\/\/doi.org\/10.1146%2Fannurev-nutr-080508-141048\" target=\"_blank\" rel=\"noopener\">our species has had to cope with food scarcity<\/a>. Scrounging enough calories to stay alive was a struggle, and our ability to compete and survive sometimes meant enduring long breaks between scarce meals.<\/p>\n\n<p>When food was abundant, our bodies stored excess energy in the form of fat to draw upon when food was not available.<\/p>\n\n<h2 id=\"ancient-metabolism-in-a-modern-world\">Ancient metabolism in a modern world<\/h2>\n\n<p>Human ingenuity allowed our predecessors to harness fire, create weapons for hunting and invent farming. Our brains enabled our species to develop an easier, more comfortable life and a steady supply of food to support population growth.<\/p>\n\n<p>As human progress continued, our ancestors learned to domesticate and use animals. Later, they invented machines to move ourselves and our belongings from place to place, and life became even easier.<\/p>\n\n<figure class=\"align-center \">\n            <img  decoding=\"async\"  alt=\"evolution silhouettes beginning with an ape, morphing into humans carrying fire or spears, and eventually to person pushing a grocery cart\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-ls-sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\"  data-pk-srcset=\"https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=282&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=282&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=282&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=355&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=355&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/538774\/original\/file-20230721-23892-afrwop.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=355&amp;fit=crop&amp;dpr=3 2262w\" >\n            <figcaption>\n              <span class=\"caption\">Our metabolism remains calibrated for a hard, uncomfortable life where every bite had to be earned through strenuous physical effort, and our brains are still telling us to eat more than we need.<\/span>\n              <span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span>\n            <\/figcaption>\n          <\/figure>\n\n<p>Today, mountains of calorie-rich (and often nutritionally poor) food and lakes of sugary beverages are readily available in much of the world. It\u2019s no longer necessary to leave home \u2014 or even stand up \u2014 to access this cornucopia.<\/p>\n\n<p><a href=\"https:\/\/obesitycanada.ca\/guidelines\/science\/\" target=\"_blank\" rel=\"noopener\">Our biology has not yet caught up to our progress<\/a>, though. Our metabolism remains calibrated for a hard, uncomfortable life where every bite had to be earned through strenuous physical effort, and our brains are still telling us to eat more than we need.<\/p>\n\n<p><a href=\"https:\/\/doi.org\/10.2174%2F138920211795677895\" target=\"_blank\" rel=\"noopener\">Polygenic obesity \u2014 the inherited predisposition to consume and store calories<\/a> \u2014 is the inevitable outcome of our primal instincts colliding with amazing, man-made abundance. It\u2019s also what makes it so hard to lose excess fat and keep it off.<\/p>\n\n<h2 id=\"the-brains-role-in-obesity\">The brain\u2019s role in obesity<\/h2>\n\n<p>From our clinical work and our research in obesity we know that while some people can carry extra weight and be truly healthy, others suffer serious health consequences, <a href=\"https:\/\/doi.org\/10.3390\/ijms20092358\" target=\"_blank\" rel=\"noopener\">including diabetes, high blood pressure, cancer and arthritis.<\/a>\nFor far too long society has treated obesity as a personal failing while in reality it\u2019s a <a href=\"https:\/\/obesitycanada.ca\/guidelines\/science\/\" target=\"_blank\" rel=\"noopener\">biological, physiological, environmental, chronic disease<\/a>.<\/p>\n\n<p>The fact is that for many, trying to lose excess fat is very difficult without help. The brain wants us to eat as much as we can because it thinks it\u2019s helping us survive, and it has the power to overwhelm our best intentions. <\/p>\n\n<p>Despite the prevalent view that people with large bodies should <a href=\"https:\/\/theconversation.com\/its-time-to-bust-the-calories-in-calories-out-weight-loss-myth-199092\" target=\"_blank\" rel=\"noopener\">simply eat less and move more<\/a>, it\u2019s nearly impossible to fight our genetic heritage or other factors that are not within our control. <\/p>\n\n<figure class=\"align-center \">\n            <img  decoding=\"async\"  alt=\"A chalk drawing of a brain, half of which is filled in with different types of food\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-ls-sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\"  data-pk-srcset=\"https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=278&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=278&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=278&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=349&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=349&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/538591\/original\/file-20230720-25-6r6648.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=349&amp;fit=crop&amp;dpr=3 2262w\" >\n            <figcaption>\n              <span class=\"caption\">The brain wants us to eat as much as we can because it thinks it\u2019s helping us survive, and it has the power to overwhelm our best intentions.<\/span>\n              <span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span>\n            <\/figcaption>\n          <\/figure>\n\n<p>Our body defends its weight vigorously. It changes levels of leptin and insulin, which regulate appetite. <a href=\"https:\/\/obesitycanada.ca\/guidelines\/science\/\" target=\"_blank\" rel=\"noopener\">Whenever we lose weight by restricting calories, hormones compel our brains to signal increased hunger and decreased fullness and they slow our metabolism in an effort to retain body fat<\/a>.<\/p>\n\n<p>This makes it difficult to reduce weight and keep it off through diet and exercise alone. <\/p>\n\n<p>In the meantime, another part of our brain, which regulates reward and pleasure, is also working to make us eat more. <\/p>\n\n<p>The pleasure of eating food is <a href=\"https:\/\/doi.org\/10.1016%2Fj.neuron.2011.02.016\" target=\"_blank\" rel=\"noopener\">driven by naturally occurring neurochemicals like dopamine, opioids and cannabinoids<\/a>, to help with survival and energy storage. People living with obesity may have a genetic predisposition toward a heightened reward system associated with food. Glossy packaging, aggressive marketing (<a href=\"https:\/\/www.apa.org\/topics\/obesity\/food-advertising-children\" target=\"_blank\" rel=\"noopener\">often targeting children<\/a>), delicious but nutrient-poor foods, drive-through windows and online delivery services all enable this. <\/p>\n\n<h2 id=\"effective-treatment\">Effective treatment<\/h2>\n\n<p>Just as human progress brought us problematic obesity, it may also help resolve it. <\/p>\n\n<p>That begins with accepting that <a href=\"https:\/\/obesitycanada.ca\/guidelines\/weightbias\/\" target=\"_blank\" rel=\"noopener\">polygenic obesity is a disease and not a matter of willpower<\/a>. Rather than blaming and shaming one another for our size, we should be more understanding and educate ourselves about obesity, to help take stigma and judgment out of the equation.\n<a href=\"https:\/\/doi.org\/10.2105%2FAJPH.2009.159491\" target=\"_blank\" rel=\"noopener\">Society sends damaging messages about weight, especially through popular culture<\/a>, so we want to make this very clear: our weight doesn\u2019t define who we are, and it does not define how healthy we are.<\/p>\n\n<p>It\u2019s important to recognize that when obesity does impair one\u2019s health, it needs treatment, and effective treatment is available. <a href=\"https:\/\/doi.org\/10.1503\/cmaj.191707\" target=\"_blank\" rel=\"noopener\">Canada\u2019s 2020 clinical practice guidelines<\/a> are based on three pillars: bariatric surgery, medication and cognitive psychotherapy.    <\/p>\n\n<p>Psychotherapy is critical to the effectiveness of surgery or medication, or both. Behavioural therapy can resolve questions such as: Why am I eating the way I do? What is my relationship with food? Where did that come from?<\/p>\n\n<p>These pillars are the primary interventions that have been shown repeatedly to be able to help people with obesity improve their health while reducing their weight and keeping it off in the long run.<\/p>\n\n<p>We need less judgment and more science. Progress is possible if we work for it.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img  loading=\"lazy\"  decoding=\"async\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  alt=\"The Conversation\"  width=\"1\"  height=\"1\"  style=\"border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important\"  referrerpolicy=\"no-referrer-when-downgrade\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-pk-src=\"https:\/\/counter.theconversation.com\/content\/209121\/count.gif?distributor=republish-lightbox-basic\" ><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https:\/\/theconversation.com\/republishing-guidelines --><\/p>\n\n<p><span><a href=\"https:\/\/theconversation.com\/profiles\/megha-poddar-1448966\" target=\"_blank\" rel=\"noopener\">Megha Poddar<\/a>, Assistant (Adjunct) professor, Deptartment of Internal Medicine, <em><a href=\"https:\/\/theconversation.com\/institutions\/mcmaster-university-930\" target=\"_blank\" rel=\"noopener\">McMaster University<\/a><\/em> and <a href=\"https:\/\/theconversation.com\/profiles\/sean-wharton-1452971\" target=\"_blank\" rel=\"noopener\">Sean Wharton<\/a>, Adjunct professor, Department of Medicine, <em><a href=\"https:\/\/theconversation.com\/institutions\/mcmaster-university-930\" target=\"_blank\" rel=\"noopener\">McMaster University<\/a><\/em><\/span><\/p>\n\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\" target=\"_blank\" rel=\"noopener\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/the-obesity-epidemic-is-fuelled-by-biology-not-lack-of-willpower-209121\" target=\"_blank\" rel=\"noopener\">original article<\/a>.<\/p>\n\n","protected":false},"excerpt":{"rendered":"For many people, trying to lose excess fat is very difficult without help. Effective treatment is available when&hellip;\n","protected":false},"author":558,"featured_media":6811,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","fifu_image_url":"","fifu_image_alt":"","footnotes":""},"categories":[12],"tags":[466,474],"class_list":{"0":"post-6858","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-and-body","8":"tag-obesity","9":"tag-the-conversation","10":"cs-entry","11":"cs-video-wrap"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/6858","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/users\/558"}],"replies":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/comments?post=6858"}],"version-history":[{"count":1,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/6858\/revisions"}],"predecessor-version":[{"id":6859,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/6858\/revisions\/6859"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/media\/6811"}],"wp:attachment":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/media?parent=6858"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/categories?post=6858"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/tags?post=6858"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}