Developing a New Understanding of Obesity

Doctor with Stethoscope Holding Red Measuring Tape.Many patients come through my office that are overweight or obese trying to drop weight to lower their risk of heart disease. For the most part, they’ve seemingly tried everything. Following the traditional advice, they try to cut back on their calories and up their exercise. They’ve tried increasing protein, cutting out bread, juicing everything they eat and everything in between. I see them at their most desperate, close to disease, knowing that their weight is a problem and yet seemingly unable to lose their extra pounds.

A number of research studies have come out recently examining where obesity comes from and why people become obese. They’re emphasizing what most physicians are only now beginning to acknowledge: that gaining weight and losing weight isn’t just about calories in and calories out. Obesity is the result of a complex list of changes that happen in the body, some of which we have little control over. But don’t feel like your weight is written in stone. There are some steps you can take whatever your weight to get your health back on track and some new possibilities on the horizon that might completely change the weight loss game.

Genetics Are Important

When people first proposed that genetics had something to do with weight, there was general outcry. Most physicians and scientists thought the transfer of obesity through families was mostly about the eating and exercise habits parents passed on to their kids. While research has shown that definitely plays a significant role, new studies in genetics have also found that many genes are potentially involved in determining someone’s weight.

A recent study looked at genes from more than 300,000 people and found that more than 60 genes seemed to be linked to BMI and about 30 were linked to where that weight sat. Being pear shaped lit up a certain version of those genes, while being apple shaped lit up another version. This study shows that there isn’t one gene for obesity, except in very rare genetic disorders. But at the same time, genes can influence how likely it is you’ll become obese during your life. Your weight isn’t written in stone, but gaining the pounds may be easier for you than your neighbor.

Your Bacteria Are Important

Investigation into how the trillions of bacteria that live on and in our body affect our health is a brand new field that has exploded over the last five years. We still understand next to nothing about how these microbes benefit us or contribute to disease. What’s clear is that these bacteria are influencing our bodies in ways we could never have imagined. Studies have linked gut bacteria to obesity, asthma and even mental health. One study out recently even found that the variation within species of microbe may be important in determining how they affect your health.

While we still don’t know what this research will reveal about weight loss, one thing that is clear from the research is that food matters, but maybe not in the way we thought. Rather than being just about calories, food type also determines which bacteria set up shop in your intestines, which may then govern how your body gains weight. Healthier diets high in vitamins and minerals, fiber and healthy fats, and fruits and vegetables foster healthier, more diverse populations of bacteria than diets high in refined sugar and flour that are low in fruits and vegetables and that lack important vitamins and minerals.

Hormones Are Hard to Change

Research into weight loss has also revealed that the body regulates weight using hormones in a way that can be hard to change. That’s why pounds lost on a diet are often regained soon after. How these hormonal patterns are set up to determine benchmark body weight is still an area of active research, but some data is showing that it may start as early as infancy. The best way medicine has found to change those hormonal patterns is through invasive gastric bypass surgery, but that can’t and shouldn’t be done on everyone who needs to lose weight. Chances are good that changing these hormones without surgery will be a new frontier in treatment for those who are obese.

Where to Start

It’s undeniable that losing weight and keeping it off is one of the hardest things anyone can do. Diet change and exercise are still the best ways we have to lose weight, but they’re inadequate. Here are my thoughts on where to start when it comes to losing weight.

  • Start by eating better, not less. Cutting calories can drop your weight in the short term, but you’re looking for long term health. Switching out soda, potato chips and cookies for seltzer, vegetables and fruits is often enough to drop a few pounds. The bump in vitamins, minerals and fiber is good for your health and the better food will also benefit your gut bacteria.
  • Look at exercise as a long-term investment. Even if you don’t lose weight when you start exercising, remember that you’re still helping your heart by lowering your blood pressure and increasing good cholesterol. You also lower your risk of osteoporosis and falls later in life by increasing muscle mass. Exercise is less about losing weight and more about investing in your health for the long term.
  • Try different approaches. With individual factors like genetics, bacteria and hormones playing such a significant role, weight loss is clearly not a one size fits all approach. If something isn’t working for you, drop it and try something else. While your best friend might have lost 100 pounds doing one thing, she’s a completely different person.
  • Take a holistic look at life. Many other factors also influence weight loss, like the amount of time you sleep at night or the amount of stress in your life. When thinking about weight loss, try imagining the healthiest version of yourself, someone who sleeps seven to nine hours a night and who doesn’t sweat the small stuff. Trying to bring yourself into alignment with that vision is also likely to help your weight and change your eating and exercise habits.

Losing weight is a daunting task, but it can be done and losing even a few pounds can make a difference.