Obesity is itself a disease!

Why is obesity so out of control in our country?  Is it just that people are pounding down too many calories?  Should we blame it all on McDonald’s?  Is it due to lack of exercise and physical activity in general?  Is it genetic?  Are some of us just born to be overweight?  A loaded topic for sure!  The epidemiological etiology of obesity on a population level is an enormously complex issue on which a book of 1000 pages could easily be published and would barely skim the surface of this subject.  We know that obesity has been around, albeit in scarcity, for at least 25,000 years, but today it has morphed into a pandemic of epic proportions, especially here in the United States.

We could analyze to death the biochemistry and endocrinology of obesity, but we cannot blame it all on genetics either, i.e. the so-called “thrifty gene”, since the human genome has only infinitesimally changed over the past 25 millennia.  I therefore propose an alternate hypothesis, from an ecological perspective, which examines the causality behind obesity as mostly a product of behaviors and environmental inputs consistent with cultural norms reflecting a modern lifestyle dominated by convenience and technology, a “disease of affluence” if you will.

My argument is best served by a bullet point list of what I believe are the top 10 factors underlying the ongoing proliferation of obesity and the chronic comorbidities associated with it, collectively known as ‘Metabolic Syndrome’ within the culture of enlightened clinicians and nutritionists:

  • A sedentary lifestyle overrun by electronic distractions.

 

  • Highly processed ‘Frankenfoods’.

 

  • Excess carbohydrate and refined sugar intake, especially the dreaded High Fructose Corn Syrup (HFCS).

 

  • The obesogenic consequences of a long-term energy imbalance, i.e. the Laws of Thermodynamics driving hyperplasia and hypertrophy of human adipocytes.

 

  • Hyperinsulinemia and insulin resistance.

 

  • Modern modes of transportation that encourage sedentary habits.

 

  • ‘Convenience foods’, e.g. pizza, fast food and “TV dinners”, emotionally-driven snacking of comfort foods throughout the day, i.e. eating disorders as a form of self-medication for undiagnosed psychiatric disorders.

 

  • Too much stress and not enough sleep, causing ‘fight-or-flight lipogenesis’ via HPA axis dysregulation, and excessive cortisol production in particular.

 

  • Prediabetes and Type II diabetes propagated by visceral adiposity/NAFLD (Non-Alcoholic Fatty Liver Disease) and perpetuated via hormonally-induced metabolic derangement, e.g. insulin and leptin resistance. This means that an individual can appear thin superficially, yet still be carrying dangerous visceral fat around their internal organs, sometimes referred to as “skinny fat”.

 

  • Excess alcohol consumption and smoking.

It is because of all the aforementioned that nothing irks me more than “quick & easy” diet plans such as Jenny Craig (sue me, Jenny, sue me!) or Oprah’s latest fad diet, as she keeps climbing on and off the obesity rollercoaster like a gleeful kid at a theme park.  So what is the best way to lose weight and keep it off?  I’ll be covering that topic in my next blog post.  In the meanwhile, be happy and healthy, folks.  You can’t be one without the other!

obesity-as-a-disease

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