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
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.
Genetic
Factors
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 Paradox
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
Factors
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.
Metabolism
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.
Eating
Disorders & Medical Conditions
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.
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