Obesity is not a disease but a silent killer.
I know what’s the agony of carrying of 50 pounds of excess body fat.
Most people believe that obesity affects people who eat a lot and don’t move.
Nothing could be further from the truth.
“It’s not about how much you eat, but what you eat”.
That’s right! We have always been lied to.
I am sure by the end of this reading you will be convinced too. I will lay down the scientific facts one by one and uncover the truth for you.
But let’s start with the basics and understand how did the word “Obesity” originate in the first place.
What is Obesity?
Obesity is a term used to define individuals who are extremely overweight.
If you have a BMI (Body Mass Index) of more than 30, you are most likely obese.
When you are obese, you carry an excessive body fat. This fat has negative effects on health.
Obesity increases the risk of various diseases and metabolic conditions like:
- Cardiovascular diseases
- Type 2 diabetes
- Depression, and
Obesity affects all age, rich and poor. It threatens to overwhelm both developed and developing countries.
World Health Organization (WHO) Statistics
- Worldwide obesity has almost tripled since 1975.
- In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.
- 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.
- Obesity kills more people than underweight.
- 41 million children under the age of 5 were overweight or obese in 2016.
- Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016.
The above graph is one of the best available data on obesity for the 21st century. It shows the obesity rates among English speaking countries. The United States has the highest number of overweight adults.
Today, 2 out of every 3 American men are overweight or obese. Furthermore, the rates are even higher for women. In a developing nation like India, 3 out of 4 adults living in an urban area are obese.
Besides the looming health risk, obesity has a bearing on the quality of life as well.
I am sure you will be able to relate to some of these if not all.
Psychological aspect of obesity
- Low self-esteem.
- Chronic depression.
- High anxiety levels.
- Poor concentration.
Social aspect of obesity
- Fewer friends.
- Lower education.
- Low Employment
- Improper health care treatment.
- Judged at social gatherings.
Being overweight or obese is not just about looking fat on the outside. It destroys both personal and social life.
This is where it all started..
In 1956, Dr. Ancel Keys launched the famous Seven Countries study.
Dr. Keys is an American physiologist and researcher. He rose to fame by working out the nutrition need for American soldiers in World War II.
Dr. Keys thought that there is a direct link between saturated fats and heart disease.
He proved that countries with high-fat consumption had the most heart disease.
But, his findings were incomplete. Countries for this study were cherry-picked by him to prove his hypothesis.
When this study became public, people started despising fat.
Recommendations were :
- Reduce fat consumption
- Lower Saturated fat consumption to 10% of total energy intake
- Do not consume more than 300mg of cholesterol a day.
- Increase carbohydrate consumption to 60% of total energy intake
What do you think happened next?
The food manufacturers started supersizing everything with some form of sugar. High fructose corn syrup found it’s way into almost every packaged food.
The result was an immediate increase in sugar intake. People were consuming 2-3 times of RDA.
Recommended Daily Allowance (RDA) for added sugar is 25 grams.
This initiated a series of physiological and psychological changes. As a result, people started putting on weight like never before.
The above graph is the data of overweight and obese people in the United States.
Do you see what I am seeing here?
Obesity skyrocketed from 1976-80 post introduction of new dietary recommendations.
back to school…
To understand obesity, we first need to understand metabolism. In particular, metabolism of carbohydrate in the body.
Metabolism is a set of life-sustaining transformations within the cells of living organisms. It’s a complex process.
let’s uncomplicate it…
Carbohydrate Metabolism & Insulin
When we eat food (rich in carbohydrates), sugar gets released into our body. Following this, Insulin gets secreted by the pancreas to move the sugar into cells.
Insulin is a hormone that helps to regulate blood sugar levels. It provides the cells in the body with the energy needed to perform various functions.
When the cells don’t need the energy, insulin directs the sugar to fat cells. Over a period of time, this leads to accumulation of fat in various parts of the body.
A gland is an organ in our body that secretes fluids. The Pancreas is one such gland. Its primary function is to secrete the hormone called insulin. Hormones are the communication messages that are sent from one part of the body to the rest. Every hormone has a special kind of message. Insulin carries the message of moving sugar into muscle, organs and fat cells.
Role of Insulin
Let break it up…
The amount of insulin needed to lower the blood sugar varies from person to person. The smaller the unit of insulin required to lower the blood sugar level, the more insulin sensitive you are.
Our body can only process a small amount (less than 1 teaspoon) of sugar at any time. Today, the foods that we eat are very rich in sugar and starch. As a result, the pancreas needs to constantly secrete insulin into our blood. This prevents the blood sugar level from staying heightened for long.
The constant spike in insulin levels forces cells in our body to become less receptive to insulin.
When insulin resistance sets in, the cells no longer acknowledge insulin’s message. Sugar levels go up in the blood. As a result, even more, insulin is released from the pancreas. Over a period of time, this leads to insulin hypersecretion (Hyperinsulinemia).
Let’s understand this with an analogy.
Imagine your 10-year-old kid needs to complete his homework. At first, he will try to focus and complete his work without much fuss (insulin sensitive). Now, what happens if his homework is too long and requires him to study continuously for hours? After a while, he might no longer be interested to study (Insulin resistant). It will take a lot of convincing from you (insulin hypersecretion) to ensure that he gets his work done.
Insulin resistance when left untreated can lead to over secretion of insulin. Constant high levels of insulin blocks/aids the release of other hormones. This leads to various other metabolic problems.
It doesn’t end there…
Insulin also has a role to play in the amount of food that you consume. There is a reason insulin is called a master hormone. It can influence/overrule the secretion of other metabolic hormones in the body. Two such hormones which are always at the mercy of Insulin are “leptin” and “ghrelin”.
- Leptin is a hormone made by fat cells that tell the brain that you are full and there is no need to consume any more food.
- Ghrelin has an action opposite to leptin. Ghrelin is produced by cells in the gastrointestinal tract. It triggers the hunger (hunger cramps).
They have a common factor though. They send the signal to the same part of the brain – hypothalamus. Now, the brain can only listen to one of them at a given time.
a resistance of another kind…
In the presence of high insulin levels, ghrelin continues to be secreted.
It tells the brain to continue eating more food.
Once we are full, leptin should be able to message back to the brain to stop eating. But, since the brain is already in communication with ghrelin, it cannot hear leptin.
As a result, more leptin is released. If this continues, over a period of time the cells in the brain become leptin resistant. This is how we end up overeating when we eat food supersized with sugar.
To sum up….
- Higher the insulin secreted, more is the proportion of what we eat gets stored as fat.
- Leptin gets suppressed in the presence of insulin/ghrelin, causing us to eat more.
- We enter the vicious cycle of eating more to satiate ourselves and keep getting fat.
People who are insulin resistant have 5-7 times more insulin in their blood than people who are insulin sensitive.
Insulin resistance is often referred to as a metabolic syndrome. People with insulin resistance have increased waist size. They suffer from high blood pressure and high blood sugar. Insulin resistance leads to cardiovascular disease and type 2 diabetes.
Are you insulin resistant? Check for these signs now.
- Large Waist to Hip ratio
- Very Low energy levels
- Feeling hungry all the time
- Desire to eat food constantly
The Chicken and Egg Parody
There is a lot of debate on what happens first – Type 2 diabetes, obesity or insulin resistance.
To uncover this mystery, we need to look at the human evolution. I am talking about the time before the agricultural revolution. For thousands of years, meat was our primary source of energy from food. Meat doesn’t contain any carbohydrates. It’s an excellent source of protein. It also has saturated fat.
In the last few decades, this primary source of energy has shifted to carbohydrates. We are eating carbohydrates in proportions that our body is not designed to process. Eating high amounts of carbs leads to insulin resistance. Insulin resistance creates a perfect cocktail of medical conditions.
- Large Fat deposits in abdomen region
- Increased blood pressure
- High blood sugar levels
- Irregular cholesterol levels, etc.
This is called the metabolic syndrome. Obesity is an after effect of metabolic syndrome. What follows next is cardiovascular disease and type 2 diabetes.
Even our children are not spared from obesity. Today, about one in five school-going children (aged between 6 and19) is obese. Obesity in children has immediate as well long-term effects. It has a bearing on the physical, social, and emotional health of the child.
These children are at higher risk of suffering from chronic health conditions like:
- Sleep apnea
- Bone and joint problems
- Type 2 diabetes, and
- Risk factors for heart disease.
Morbid obesity is a severe form of obesity. Individuals with a BMI of 40 or more fall in this category of obesity. Morbidly obese individuals may have trouble breathing or doing any physical activity. They are at far greater risk of life-threatening diseases that include:
- Clogged arteries
They may also develop sleep apnea, gastroesophageal reflux disease (GERD), gallstones and osteoarthritis.
Usually, morbidly obese individuals are unable to make much progress through dietary interventions alone. They may have to turn to surgical options like Liposuction and Bariatric surgery.
Let’s see what the future holds for us…
In 2009-2010, there was a study conducted on obesity. This study was based on data collected from adults ( 18 years and over) between 1990-2008. According to the study, it is projected that by 2030 about 51% of US population will be obese.
Healthcare cost associated with obesity is currently estimated to be about $200 billion. Based on these projections, in next 2 decades, healthcare cost may run into a trillion.
Are healthcare professionals treating symptoms?
To begin with, the government and healthcare industry is misdirected. Treating disorders and medical conditions associated with obesity is a wrong approach. Instead, doctors should try to find the root cause of obesity and treat it.
Simply telling the patient to eat less and become active is not effective.
What should be done to manage obesity?
In conclusion, the root cause of obesity is insulin resistance. It’s not something that you and I have consciously brought on ourselves. We don’t get fat by simply overeating.
It’s the insulin resistance that needs to be treated first. Insulin resistance can be treated by making subtle changes to the diet. Duration of the treatment can range from few weeks to months – depending on how long it has been left untreated.
Prevention is better than cure…
Though the 2015–2020 US Dietary Guidelines is better than previous recommendations, most people still eat as per 1977 guidelines.
Firstly, there should be initiatives to drive awareness of obesity. Besides that, healthy eating habits need to be encouraged from early childhood.
Maybe I am overweight but not obese…
If your BMI is between 25-30, it is quite possible that you are in early stages of insulin resistance. You might be someone who is steadily putting on 1-2kg/2-4 lbs every year. If you don’t take corrective actions now, becoming obese won’t take long.
If you reduce your daily calorie intake, it might help you to drop an inch or two. But, it does not address the underlining factor for gaining fat.
The most common underlining factor for obesity is insulin resistant. Genetics may influence, only to a certain degree.
Unless you treat insulin resistance, it’s highly unlikely you will able to keep your weight off for long-term.
Surely, you will lose some initial weight by reducing your food intake. But do you think you can sustain for long by constantly cutting down on calories?
Moreover, you will quickly gain back the lost weight when you stop dieting. This is what happens with the biggest losers. 90% of people who lose a lot of weight in a short period, regain it back in a year.
Studies have shown that insulin sensitivity can be improved through:
- Low carb diets
- Fasting protocols (intermittent fasting, alternate day fast, 5:2 diet)
You need to be careful though when switching to a new diet program. If you have never been on a diet plan before, avoid trying any of the above as your first diet plan.
Whenever you switch to something new, your body undergoes stress. This can last from few days to a couple of weeks. You would need to train your body before trying anything extreme.
You haven’t accumulated all this fat overnight. So the idea of losing weight overnight is absurd.
First, start with the basics. Make a list of all the foods/meals that you eat throughout the day. Now mark the foods that are rich in sugar, refined grains, and starch. Your goal should be to cut down these “fattening carbohydrates” one at a time, each week.
Once you have removed junk from your diet, it should be easy to move on to more advanced nutrition protocols.
Bottom Line: Obesity is an epidemic that is steadily consuming the world. You can either chose to continue with your current lifestyle and bet your health on lady luck or make some practical changes in your lifestyle and eat healthy foods. The choice is yours.
While doing my research, I came across these great books. Check them out if you want to take this knowledge one step further.
What action will you take today to turn around this epidemic? Let me know, in the comments below.