obesity

Weight Loss and Food Choices

Posted on by cherylwongnd@gmail.com

Over the last century, we’ve seen experts promote vastly different types of diets for health. The USDA has issued dietary guidelines for over 100 years. From the 1900s to 1940s, they established food groups based on protein, carbohydrates, and fats, and recommended a diet primarily based on carbohydrates. From the 1940s to 1970s, many essential vitamins were discovered, which led to establishing Recommended Daily Allowance (RDA) values and a focus on meeting those values. From the 1970s to 1990s, there was a large emphasis on avoiding saturated fats, cholesterol, and salt.  The most recent dietary guidelines, published in 2015, recommends a diet high in vegetables, fruit, whole grains, low- or nonfat dairy, seafood, legumes, and nuts; and low in red or processed meats, low sugar-sweetened food and drinks and refined grains, and moderate consumption of alcohol (in adults). Since many changes have taken place over a relatively short time, it can be difficult to heed advice that reveals the long process of understanding nutritional science. And because nutrition is personal, there are far-reaching opinions of what one should or should not eat.

Half of the American adult population has a preventable chronic disease, and over two-thirds of American adults are overweight or obese. Given this scenario, of course our altruistic friends and family, our neighbors, our mailwoman, and internet experts will want to share their own experience of what diet worked for them. In the same time that the USDA has been issuing dietary guidelines, popular opinion for how to lose weight has ranged anywhere from smoking cigarettes instead of eating sweets or drinking only a shake for each meal to swallowing tapeworms. Obviously, just because it works for one person, doesn’t mean it will work for another, or that it’s even safe to begin with. Now in the nutritional ethos, we are told to eat mostly proteins and vegetables, OR avoid all animal products, OR just drink bone broth, OR avoid all grains, OR be gluten free, and on and on. Although any of those options sound easier and preferable to swallowing parasites, all the varying and adamant advice can be confusing, or worse, discouraging from even trying at all.

Let’s work our way out of some of the confusion by clarifying or debunking some mainstream myths.

Myth: Weight loss absolutely occurs when energy expenditure exceeds energy intake. This is mostly true when what goes in actually comes out. However, that doesn’t always happen and not all calories are created equal. When we eat mostly vegetables with plenty of fiber, calories almost don’t matter for maintaining weight. The China Study by T. Colin Campbell showed that people in rural China ate 20% more daily calories than American counterparts, but were able to maintain healthy weights and health measures because most of the diet was composed of plants. (For losing weight, it may be helpful to limit portion sizes.) There were no processed foods in the diets studied. Many processed foods have preservatives that slow the function of the liver, or are difficult to process and are stored instead. This may help explain the phenomenon of being malnourished and overweight. Even when consumption of calories is limited, food quality influences metabolism and nourishment.

The idea that weight loss and gain is only determined by calorie consumption and expenditure is damaging to behavior for a number of reasons. One reason that we hinted at already is that it allows people to eat food regardless of food quality or category as long as it is below their calorie expenditure. It can lead to the belief that you can eat anything you want all the time and just exercise excessively. Or you may start to deprive yourself of food, leading to a variety of issues including a dysfunctional relationship with food, irregular eating patterns, or eating disorders. A woman I used to see years ago who was trying to lose weight wouldn’t eat breakfast and lunch partly because of this belief, and partly because she could use work as an excuse to not eat. By the time she got home, she would indulge for dinner with whatever food or snacks were available all through the night, and she kept gaining weight. Adding food for breakfast and lunch was actually important for her to start losing weight.

Therefore, what matters more than calories is eating many servings of high quality, well-prepared vegetables daily. However, this doesn’t mean that portion control is not a factor. Limiting the size of your plate or bowl and eating until satisfied or between 60% to 80% full contributes to retraining the central nervous system and visceral organs. Also, eating at regular times will stimulate metabolism and help with digestion.

Myth: There is one healthy way to eat. This idea makes it difficult to write dietary guidelines that are supposed to be general rules for everyone. Yet, having dietary guidelines sort of promotes the idea that there is only one healthy way to eat. In fact, in the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, many, but not all studies showed beneficial health outcomes from consuming whole grains, dairy, seafood, and legumes, even high amounts of these foods made it into the 2015 dietary guidelines. Not surprisingly, different people have different capacities to tolerate or process certain foods. More and more studies are starting to distinguish optimal diets on an individual basis. A recent study showed that blood sugar levels in 800 prediabetic people could significantly alter even when people ate identical meals. Some could eat bread with no sugar changes, while others blood sugar would spike after eating bread. Another person’s blood sugar could spike after eating a tomato. The results varied dramatically. Also, studies have shown that certain genes favor improved glycemic control. We can also expect to understand personalized nutrition more as more research comes out about differences in the microbiome.

Eating on an individual basis can get tricky. Our first inclination may be to try out a myriad of diet assessment and treatment protocols. Some of these are the GAPS diet, FODMAPS diet, Blood Type Diet, Genotype Diet, Ayurvedic dosha diets or Chinese 5-elements diets, etc. These can be useful tools when applied appropriately, but they can be hindrances to eating timely healthy meals with others. They can be time consuming to prep, confusing to follow, and damaging to our appreciation of food. Through these methods, if utilized inappropriately, we may also develop an unhealthy fixation with food and its effects. Also, if everyone in your family assumes they do best on a different diet, does it make sense to cook 4 or 5 meals? Heck no! It’s necessary to be aware of how healthy eating based on the individual can be taken to an unhealthy extreme, but it doesn’t have to be this way. If the general assumption is that everyone tolerates certain foods differently, people will have more freedom and opportunities to eat healthfully. We would be more apt to be aware and know how we react to certain things at an early age. Assuming that everyone responds to foods differently would prioritize having a healthy variety of foods at each meal. Shifting popular opinion to “there are many healthy ways to eat” will produce a healthier population.

Myth: I’m the kind of person that tolerates processed foods and desserts. Despite the variety of ways to be healthy, there are some hard facts about what all humans should or should not eat. We should eat vegetables and fruits. Every study ever shows that people are healthier with high amounts of daily vegetable intake. Most studies show people are healthier with high amounts of fruit intake, though not all. On the other end of the spectrum, high sugar and refined grains intake is associated with increased risk for cardiovascular disease, diabetes, cancer, and poor health outcomes. 47% of added sugar is consumed from beverages. High sugar/high fat diets have been shown to lead to high insulin and high blood pressure. Yet, low fat diets are also not effective for weight loss. (This is another example of the downfalls of having a microscopic focus when it comes to food. Instead of looking at the larger picture of what foods are consumed, we whittle down foods to only calories or fat, which distract us from what it really means to eat healthfully.) Increased salt consumption, which is also associated with poor cardiovascular outcomes, primarily comes from eating mixed processed foods, burgers and sandwiches. Processed foods also contain a number of preservatives that are still not well studied. Though many of these chemicals are approved by the FDA, many cannot tolerate them. And as mentioned earlier, these chemicals are often not metabolized fully, and stored in fat cells. Furthermore, there continues to be more evidence of endocrine disrupting chemicals in food. These foods alter the hypothalamic-pituitary axis (which we discussed in the Physiology of Obesity). Ultimately, these chemicals change the rate of metabolism over time.

What works?

If you came to my Inflammation lecture, you’ll know that a good place to start is eating a whole foods, plant-based diet. With the assumption that there is not just one healthy way to eat, eat mostly vegetables and fruits; and if you tolerate them, some grains, legumes, dairy, seafood, nuts, seeds, and meat; less alcohol and processed foods; and avoid refined sugar and sweetened beverages. This is not that different from the current dietary guidelines (except I recommend more than 2-3 cups of vegetables per day) Most people will benefit from these general suggestions. Studies have determined that less than 10-30% of all Americans (depending on age group and sex) eat enough vegetables per day (only 2-3 cups) according to the 2015 Dietary guideline suggestions. These numbers have declined since 2001. 80% of Americans also don’t meet the requirement for fruit consumption (1.5-2.5 cups). For those who need more specific guidelines, there are a couple diets that have been studied to help with weight loss. (Keep in mind that many diet protocols have not been studied.) The Mediterranean diet has shown to decrease weight, blood pressure, and cardiovascular risk. Another diet associated with decreased risks of chronic disease and increased longevity arising from a culture is the Okinawa diet. The common theme is to eat a plant-based diet creating a culture of eating with people in your community and celebrating food.

Other suggestions: Eat at regular times, eating dinner no later than 2 hours before bedtime. Eat until you are 80% full. If you’re trying to lose weight, eat until just satisfied. Eat with people. Eating with people also shows improved cardiovascular risk.

 

References

  • Campbell TC, Schurman JC, Campbell TM. The China Study. BenBella Books, 2004.
  • Frazão, Elizabeth. America’s Eating Habits: Changes and Consequences. Agriculture Information Bulletin No. (AIB-750) 494 pp, May 1999. http://www.ers.usda.gov/media/91022/aib750b_1_.pdf accessed 1/6/15
  • Gower, B. Obesity Week 2015; Los Angeles, CA. Abstract T-OR-2108, presented November 3, 2015.
  • Khoury M, Manihiot C, Gibson D, et al. Evaluating the associations between buying lunch at school, eating at restaurants, and eating together as a family and cardiometabolic risk in adolescents. Canadian Cardiovascular Congress; October 24, 2015–October 27, 2015
  • Tobias DK, et al. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015. Published online October 30, 2015. http://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587%2815%2900367-8.pdf Accessed 1/8/15
  • USDA. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. Feb 2015. http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf accessed 1/6/15
  • Willcox DC, et al. The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S.
  • Zeevi D, et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015 Nov 19;163(5):1079-94.

The Physiology of Weight Gain

Posted on by cherylwongnd@gmail.com

Managing weight in the body is like orchestrating a complicated symphony that takes on a life of its own. The conductor could be likened to the hypothalamus, the brain’s thermostat for temperature, energy expenditure and energy storage. It signals which instruments to play at certain times and amplitudes. These instruments are the glands and hormones of the body that carry out the conductor’s will. When weight management is optimal, the hypothalamus and all its players move in sync, each fulfilling their relationship to one another, each contributing to the greater functional whole. But sometimes, the glands and hormones, the hypothalamus, or fat cells can be dysfunctional. They may play too loudly, too many notes, or simply not work in relation to the other players. When this occurs, the symphony is like a runaway train. The hypothalamus will try to keep up or slow the players down, but ultimately, new norms will establish, and the conductor loses control of what the greater functional whole was. In this article, I will go into more detail about the key players in the physiology of weight gain so that we can gain an understanding of what we have going against us when we try to lose weight.

The first thing to understand is that fat is composed of fat cells called adipocytes. These cells have the function of storing fatty acids in periods of low energy expenditure and to be able to mobilize fatty acids when the body needs energy. Through decades of research, we now know that they are more dynamic and more complicated than that simple function. Adipocytes produce many products that have a wide-ranging effect in the body. They also actively respond to a variety of hormones.

Secondly, excess fat can be composed of either adipocytes that are too big (hypertrophic) or too many adipocytes (hypercellular). Hypertrophic obesity typically occurs in adulthood. It is associated with an increased risk of cardiovascular events, but it usually responds well to weight loss efforts, which also decreases cardiovascular risk. Hypercellular obesity is more difficult to address. It usually begins in childhood or in morbidly obese individuals.

So what are these adipocytes doing in the body? What are the signals that help them perform optimally? Like every cell in the body, adipocytes undergo a process of becoming a mature cell and are under surveillance to assure proper function. If they are misbehaving, a healthy immune system will eliminate a dysfunctional fat cell. Pre-fat cells become mature fat cells by various transcription factors, or biochemicals that influence genes. They have the ability to influence the development of healthy fat cells and to signal the demise of dysfunctional fat cells. We’re starting to realize that they are particularly important in the role of keeping weight off after weight loss. By keeping these transcription factors active, we are essentially restructuring the fat cell makeup of the body. At the same time, dysfunctional and hypertrophic fat cells have some influence on the immune system by secreting biochemicals to ensure their survival. Some of the molecules they produce will inhibit immune complexes from detecting and destroying them. These adipocytes are especially prevalent around visceral organs.

Besides the internal biochemicals to which fat cells respond, healthy adipocytes secrete influencing molecules as well. Of the many chemicals adipocytes secrete, most fall within the following categories. Some increase inflammation, some are involved in the clotting cascade, some regulate appetite, and others moderate insulin sensitivity. If you came to my Diet and Inflammation lecture, you will know that pro-inflammatory chemicals can contribute to various diseases. Interestingly, inflammation is a consequence of obesity, not a cause of obesity. The signals involved in the clotting cascade increases the risk of cardiovascular events such as stroke, thrombotic emboli, and heart attack. Adipocytes produce leptin, which is a hormone that communicates to the hypothalamus that you are no longer hungry. If a person has more adipocytes or larger adipocytes, you would think they would have plenty of leptin to depress the appetite. Though it’s true they do have higher levels of leptin in the blood, receptors to leptin no longer respond to high concentrations. Tissues with leptin receptors in the brain and elsewhere develop a leptin “resistance” similar to insulin resistance in people with Type II diabetes. Eating a diet high in fructose (found in processed foods with high fructose corn syrup and a diet comprised of only fruits) decreases circulating levels of leptin in rats. Lastly, healthy adipocytes secrete adiponectin, a blood protein that has many functions in the body. It is found to be decreased in people with Type II diabetes. It affects increased uptake of glucose, increased mobilization and breakdown of fatty acids, protection of blood vessels, and increased insulin sensitivity. So it’s easy to make the connection between having a composition of dysfunctional fat cells  and being susceptible to diabetes.

There are many hormones at play in the physiology of weight gain. We’ve already talked about leptin and its ability to suppress appetite to signal to the body that there are enough fat stores and to decrease caloric intake. Its counterbalance is ghrelin. Ghrelin is a hormone produced by the stomach lining that signals to the hypothalamus that we are hungry and to start activating digestion. These function of these two hormones can give some insight to how sleep plays an important role in weight gain. Short sleep duration is associated with increased production of ghrelin and reduced production of leptin. This makes perfect anecdotal sense. If you’ve ever had to pull a late night or an all-nighter, you probably have experienced being extremely hungry especially for carbohydrates in the days following. Eating patterns can also have an effect on sleep. One study showed that night time eating lessened the production of melatonin (the hormone produced at night to induce sleep), increased cortisol production (a hormone that has vast effects on maintaining energy to handle daily stress), and increased morning levels of leptin. Increased morning levels of leptin depresses the appetite and makes one not want to eat breakfast. This pattern may be prevalent in obese individuals who also experience insomnia. This is a particularly damaging cycle to be in because it shifts the appetite to an irregular eating pattern in relation to sleep, in a way that disrupts sleep. And less sleep will disrupt hormonal patterns that effect both appetite and metabolism.

Cortisol has a complicated role in weight gain. The many roles it plays is still uncertain. As mentioned above, cortisol is secreted in periods of stress. It is also secreted daily to function as a hormone that helps us stay alert and function throughout the day. It has wide effects on the immune system. It will suppress inflammation, which is a tool the immune system uses to combat disease. Therefore, it is very useful in conditions with unchecked inflammation, yet at the same time will depress the immune system and can cause increased likelihood of infections and poor healing. Cortisol also influences glucose uptake after eating. It increases stomach acid and appetite. With chronic daily stress, too much cortisol can lead to peptic ulcers, or overeating. But it also has an effect on the hypothalamus and neuroendocrine system in the digestive tract that is not yet clear. On the other side of emotionally charged biochemicals, endocannabinoids, those that are external and those that are internally produced, will stimulate appetite and increase the absorption of nutrients. It has a strong affect in the hippocampus, the site of memory and the limbic system (emotional component of the nervous system that contributes to feelings of anger, joy, sadness, fear, worry, and grief). Though it is unclear, this connection may help to explain why there is such an emotional component to overeating.

Weight gain in Menopause is a common phenomenon. Research shows there are metabolic and appetite regulation functions of estrogen besides its nonreproductive effects on the brain, cardiovascular system, and bones. (Estrogen is like the embodiment of “the woman of the house”–multitasking and keeping all systems in check!) Studies show that deprivation of estrogen signals the brain to be in a hunger state and can cause overeating. It also signals to the hypothalamus to depress metabolic activity. Deprivation of estrogen doesn’t only mean not producing as much. Instead, it may be a consequence of an overabundance of proteins that convert estrogen to other compounds or it may mean that there is impaired response at the target tissue (impaired estrogen receptors). Remember, it always takes at least two to communicate. In this case, you have something producing the message, estrogen is the message, and something to receive the message. Furthermore, once the ovaries retire during menopause, they sort of pass the torch in regards to estrogen production. Fat cells are the major producers of estrogen after the ovaries quit. It is worthwhile to consider if a proliferation or growth of fat cells plays a role to maintain homeostasis around menopause. So far, it is not recommended to use hormone replacement therapy as a way to treat weight gain due to its increased risk of clotting and emboli and developing endometrial, ovarian, and breast cancers. Rather, there are ways to optimize peri- and post-menopausal hormonal states through diet and physical activity.

I’ve focused primarily on the physiology and function of fat cells. By doing so, I’ve neglected to explain how exercise effects adipocytes. After blood glucose levels are depleted for energy, the liver and muscles will make more glucose for muscle energy expenditure. There is a slow way and a fast way to produce glucose. During strength training and focus on anaerobic exercise, the body will utilize the fast track, which is responsible for the lactic acid feeling or sore muscles after working out. During aerobic exercise like long distance running and swimming, the body mostly utilizes the slow track of glucose production. The body is constantly breaking down fatty acids (stored in adipocytes) during these activities. The best way to encourage fatty acid breakdown is by exercising regularly with a combination of resistance activities and aerobic activities.

When losing weight, adipocytes either shrink or shrink in numbers. This will result in less leptin production. Remember leptin tells the body that you’re full. So there will be a period of three to twelve months when one will have increased desire to eat because their signals of being full are less. It will also contribute to decreases in thyroid hormone causing lowered metabolism and decreased muscle tone for a period of time. The decrease in leptin is lower than in a person of the same size that was not losing weight. This is because the conductor thermostat, the hypothalamus is still at the slower tempo and it is trying to maintain what was normal before. So during weight loss, it is important to take extra patience (one  to two years!) to establish a new normal–a symphony with a faster tempo.

References:

  • Birketvedt GS, Florholmen J, Sundsfjord J, Osterud B, Dinges D, Bilker W, et al. Behavioral and neuroendocrine characteristics of the night-eating syndrome. JAMA. 1999 Aug 18. 282(7):657-63.
  • Hamdy O. The role of adipose tissue as an endocrine gland. Curr Diab Rep. 2005 Oct. 5(5):317-9.
  • Harrell CS. Gillespie CF. Neigh GN. Energetic Stress: The reciprocal relationship between energy availability and the stress response. Physiol Behav. 2015 Oct 9 pii: S0031-9384(15)30139-6. doi: 10.1016/j.physbeh.2015.10.009.
  • Martinelli CE, Keogh JM, Greenfield JR, Henning E, van der Klaauw AA, Blackwood A, et al. Obesity due to melanocortin 4 receptor (MC4R) deficiency is associated with increased linear growth and final height, fasting hyperinsulinemia, and incompletely suppressed growth hormone secretion. J Clin Endocrinol Metab. 2011 Jan. 96(1):E181-8.
  • Shapiro A, Mu W, Roncal C, Cheng KY, Johnson RJ, Scarpace PJ (November 2008). Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding. Am. J. Physiol. Regul. Integr. Comp. Physiol. 295 (5): R12370-75.
  • Stachowiak G. Pertynski T. Pertynska-Marczewska M. Metabolic Disorders in Menopause. Prz Menopauzalny. 2015 Mar;14(1):59-64.
  • Taheri S, Lin L, Austin D, Young T, Mignot E (Dec 2004). “Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index”. PLoS Medicine 1 (3): e62. doi:10.1371/journal.pmed.0010062

Obesity’s Impact on Health and Society

Posted on by cherylwongnd@gmail.com

It’s no secret that putting on extra pounds has more profound consequences than not fitting into your favorite jeans or looking fit in a bikini. As we covered last month, over two-thirds of the nation is overweight, and over one-third of children and adolescents are overweight or obese. Though it’s not clear exactly how added weight contributes to the development of various diseases, it’s clear that it accompanies some uncomfortable, some serious, and even some fatal signs and symptoms.

Obesity is associated with a 2-fold increased risk of cancer, a 4-fold increased risk of cardiovascular events, and a 6 to 12-fold increased risk of all-cause mortality. When broken down into body systems, extra weight can be related to, and exacerbate other issues. In the respiratory system, it can lead to sleep apnea, predispose one to respiratory infections, and be associated with the onset of asthma. In the cardiovascular system, it is associated with high blood pressure, hardening of the arteries, and increased cardiovascular events such as a heart attack or stroke. Comorbidities (conditions present at the same time) of obesity related to digestion include gallbladder disease, liver disease, and gastroesophageal reflux disorder. It is associated with metabolic and immunological disorders such as diabetes, skin infections, and complications to surgeries such as infections or clotting. One of the major symptoms we see of overweight and obese people is musculoskeletal pain and osteoarthritis, especially related to low back, hip, and knee pain. In women, it can also be related to infertility, anovulation, and polycystic ovaries. In men, it is associated with hypogonadism (reduction of testes function). Often, obesity is present alongside many cancers including breast, prostate, colon, and bladder cancer, to name a few. But worse of all, and the most difficult aspect to treat is the psychological impact often resulting in depression and decreased energy.

How is it that such a common change in the body can be the accomplice to such life changing conditions? Weight and body composition is just another gauge in the body. Like body temperature, heart rate, and blood pressure, they are dynamic measures that give us insight to the internal state of the body. But unlike our vital signs, these measures generally fluctuate over longer periods of time, have many factors that contribute to them, and they have an insidious and wide range of effects on body systems. In this way, weight is more similar to poor energy and poor sleep, although these are more difficult to measure. The trouble with these general symptoms is that often, we find ways around addressing them in order to get on with our lives. If you have poor energy, you can just drink another cup of coffee or add an energy drink to the mixture. If you have poor sleep, you can try taking a benadryl, a glass of wine, or maybe get some prescription sleep aids. These ways of addressing poor energy and poor sleep don’t really address it. It just covers up their effect on getting through the day in the moment, but the next day presents with the same problems. And the longer these problems remain, the worse they get. Weight gain is like this. You start to gain weight a little at a time, and one must be attune to its subtle effects and take action quickly to keep it in check.

Factors that contribute to being overweight and obese include genetics, demographics such as background, age, and sex, socioeconomic status, cultural factors, hormones, dietary habits, activity habits, smoking cessation, psychological factors, and medications. Other than known ethnic groups that tend towards obesity such as groups of Pacific Islanders, the Pima Indians of Arizona and some Hispanic populations, genetic profile is not a sole contributor to obesity. This may be inferred by the increasing weight we see among immigrants of developed countries, when compared to their native counterparts. A prime example is Ghanaians and Nigerians who become overweight or obese after immigrating to the US. Some studies confer that a cultural or socioeconomic factor is more dominant than even dietary habits or activity level, though socioeconomic status and education can substantially influence lifestyle factors. One of these studies looked at type 2 diabetes risk in people who worked more than 55 hours per week comparing only socioeconomic status. The risk of developing Type 2 diabetes only increased in those in the low-status category, and the increased risk was nearly 30%. A couple of large studies of kindergartners have shown that the 20% increase in obesity rates of children between 1998 and 2010 were concentrated in those from families of lower socioeconomic status.

In Chinese medicine, extra weight is a combination of stagnant energy and dampness. Here, you can think of stagnant energy as heaviness, lethargy, aches and pains in the muscles and joints, weakness in the muscles and joints, and lack of motivation. Dampness can be viewed as an explanation of the physical characteristics of weight gain such as heaviness, ability to permeate all tissues, ability to give rise to accumulation and transformation into heat (i.e. inflammation). Factors that contribute to stagnant energy and dampness include diet choices, irregular eating, overwork, overworry, anger, inactivity, and irregular sleep. Foods that produce the most damp are sugar, dairy, and cold foods. Why is this? These foods interfere with optimal metabolism and contribute to inflammation. Cold foods require the body to take extra energy to warm it up while processing it, leading it to absorb and metabolize less effectively. Fresh, unprocessed, whole foods will provide the body with optimal nutrition, and require less energy to break it down. Irregular eating damages the rhythms of the digestive tract. The digestive tract has its own complex nervous system that relies on time triggers. The parasympathetic nervous system in the digestive tract is activates proper digestion. Rest and relaxation promote the parasympathetic nervous system, which is why overwork and overexertion can interfere with proper digestion. Other emotions can get in the way as well. And of course, good energy depends on regular activity and good quality sleep.

The rise of obesity has its effects on society as well. The cost of managing obesity in the US amounts to 20.6% of national expenditures on health. On average, an obese person spends nearly $3000 more annually than a nonobese person on medical bills. And Americans spend about $134 billion every year on weight loss products and services. Besides fiscal consequences, it alters society’s expectations. There’s a note of exasperation and hopelessness when it comes to addressing weight loss. It becomes more convenient to blame weight gain on genes. What’s worse is that many companies benefit from this perception–their survival relies on society’s surrender to obesity. What’s the point of trying to lose weight if we don’t have any control over it? It feels like it doesn’t matter whether to indulge in processed convenience food or not. It certainly makes life easier sometimes. We can take control over weight gain and the foods that contribute to weight gain by glorifying foods, using them to celebrate events, creating the most exaggerated versions of unhealthy foods. We see this at places that call themselves “The Heart Attack Grill,” or when a favorite TV character advocates eating a hot dog wrapped in pizza, covered in cheese. This becomes normal. It becomes fun. It becomes not fun to stray away from this norm–even self-depriving. Against all of these pressures, what’s the point of trying to lose weight?

The effects of obesity on society produces a vicious cycle of creating an increased susceptibility to obesity in the US. Many capitalize on the psychological effects of obesity by creating a market for addressing obesity and for creating a steady increasing supply of consumers. Economically speaking, this sector in health care has grown substantially over the last 50 years and continues to grow. We hear a lot of muddled information in the media about weight loss and how to attain a healthy weight. We clearly understand that increased convenience foods, increased fast food establishments, lack of access to fresh whole foods, and increased sedentary lifestyle all contribute to our nation’s epidemic. But we still lack the cultural infrastructure that encourages everyone to be conscious of healthy lifestyle habits, which promote healthy weight at an early age. The increase in childhood and adult obesity starts to be misinterpreted as character attributes such as apathy, laziness, and destructive behavior. We don’t see it for what it partly is, which is society’s shortcoming to support the individual in their pursuit of well being. One message we’re constantly exposed to is how skinny is attractive, and dieting and losing weight should just be normal status. Interestingly, recent studies from the US and UK have shown that people who think of themselves as overweight are more likely to gain weight. On the other hand, another message we’re receiving is that any weight, whether, overweight or obese, is acceptable, and even encouraged. This perception is a healthier one to take up to a limit. It doesn’t negate that obesity is still a medical problem. Overall, being aware that society plays a role in difficulty losing weight can be helpful when identifying obstacles to weight loss.

We’ve seen some examples of how extra weight can exacerbate multi-system conditions. Another aspect to consider is how these multi-system conditions exacerbate obesity. Short sleep duration increases the risk of obesity in children and adults. There is also evidence that functional gastrointestinal disorders such as irritable bowel syndrome either share a similar etiology or may even exacerbate weight gain. Weight gain can throw off hormonal regulation, but it can also be a sign of an endocrine cause. Weight gain is a common effect of long standing hypothyroidism. Lastly, depression is associated with an increased risk of becoming obese especially in adolescent females. Any discomfort that compromises one’s energy level will contribute to the inability to take care of oneself. It’s important to address the health and wellbeing of an individual before weight gain and obesity becomes a concern.

In the next article, we will try to gain an understanding of the physiology of obesity.

References:

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Weight Loss Introduction

Posted on by cherylwongnd@gmail.com

Summer is almost over. Dreams of fitting into that summer dress or those jeans are starting to be a far-off memory. Losing weight was supposed to help with your back, hip, and knee pain. It was supposed to take the burden off your cardiovascular system and your renal system, and lower your blood pressure, your cholesterol, and blood sugar levels. It was supposed to help with your sleep, mood, and libido. Fall will be here in no time, and you can just about hear those donuts and jars of apple cider calling your name. “Well, there’s always next year,” you may tell yourself and your doctor.

We hear too often that if only we could resist food temptations, if we had more self-control, and more self-motivation to exercise, then we could lose weight. Yes, eating a high-calorie diet, and leading a sedentary lifestyle are well-known causes of weight gain. But obesity and weight gain can be a much more nuanced issue. Billions of dollars are spent on weight loss each year in the US, yet 68.8% of adults in the US are overweight or obese, and the number keeps rising.(1) Obesity is a national problem, which infers that there are factors at play beyond the individual’s actions. Shining a light on the various factors that contribute to obesity is worthwhile, both for understanding the process of gaining weight and for constructing a plan to healthfully lose weight.

In this series of featured articles, we will be focusing on weight gain and its impact on health, the physiology of obesity, weight gain and diet, exercise, habits, stress and other factors, body image, and the psychology of weight gain. A few volumes of textbooks should be written on this subject matter. I’ll spare you that here, and try to keep these articles detailed yet pertinent so that this information can be utilized effectively. I will try to organize the information so that you can skip to sections of each article that pertain to your specific health issues. My hope is to offer a more comprehensive and healthy approach to losing weight, and to ultimately create a platform for people to support each other in their health goals.

References:

  1. National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health. http://www.niddk.nih.gov/health-information/health-statistics/Pages/overweight-obesity-statistics.aspx