Obesity - much more complex than you think

 

For a long time the cause of obesity was purely thought to be eating too much and moving too little. While this certainly also is the case, the cause of obesity is not that simple. Besides over-consuming calories, there are several other causes that contribute to weight gain. To tell someone who is obese to just “diet and exercise” or to “improve willpower” is to oversimplify the issue. It shows that the person does not fully understand the complexity of obesity. 

To truly treat obesity we need to look at obesity the way we look at other medical conditions. We need to begin with troubleshooting to gain understanding of the whole picture of a person. Once we understand what contributes to obesity for this specific person we can make a plan that can be sustained long-term.   

 

On top of simplifying obesity, there is also weight bias in our society. What is weight bias?

 

“Weight bias is negative attitudes, beliefs, judgments, stereotypes, and discriminatory acts aimed at individuals simply because of their weight. It can be overt or subtle and occur in any setting, including employment, healthcare, education, mass media and relationships with family and friends. It also takes many forms – verbal, written, media, online and more. Weight bias is dehumanizing and damaging: it can cause adverse physical and psychological health outcomes and promotes a social norm that marginalizes people.”

(Source: https://www.obesityaction.org/action-through-advocacy/weight-bias/)

 

Weight bias can be found among our friends, family, and also healthcare professionals. Every individual has a responsibility to improve this in our society. 

 

Causes that contribute to weight gain and obesity

Apart from our current lifestyle such as consuming more energy (calories) than we spend, too much stress, too little sleep and so on, the following things can play a role in weight gain and obesity. The top of the list is most common and the bottom least common. 

 

Psychological factors such as depression, bulimia and others.

Medication use, such as corticosteroids, prednisone, and insulin.

Hormones, for example hypothyroidism, polycystic ovarian syndrome (PCOS) and Cushing’s syndrome.

Hypothalamic issues from trauma damage or tumors.

Genetic causes such as Prader-Willi Syndrome and Carpenter Syndrome among others.

 

How our current lifestyle contributes to weight gain

 

Excess energy

Our society today has developed at a very high speed. Our bodies have not. Our bodies are not meant for sitting still at a desk for most of the day. Our bodies are not meant for an endless supply of food. Consuming more energy than what we spend will make our body store the excess in the form of fat. 

Stress

Our bodies have the fight or flight system built in which was very useful as we were hunting for food and our survival depended on it. The fight or flight system produces adrenaline and the hormone cortisol, which is a stress hormone. Today we mostly do not have the same type of physical threats to us. Most of us are not chased by a bear when out picking berries right? However, our bodies have not changed.

We have a different type of stress today. It is more of a psychological nature but it also wakes up our fight or flight system and produces cortisol. The biggest problem with today’s type of stress is that it is more constant and can last for very long periods which end up hurting us.

Our bodies produce cortisol in instant bursts as something we consider stressful happens. However we also have a daily rhythm in how we produce cortisol. We tend to have higher cortisol levels in the mornings and lower in the evenings.

 

This is why checking your cortisol level via a one time blood test may not give you a good picture of what is going on. Let’s say you are also not comfortable with needles, then your cortisol level will become elevated right at the moment of drawing the blood. The good way to check cortisol levels is to do it via the hair. This will give you a much more overall accurate picture of your cortisol levels. Make sure this is done via a physician who knows this and has access to a lab that can perform these tests. The centimeter hair that sits closest to your scalp will reflect approximately the last month. 

 

Having constantly elevated cortisol levels can lead to an increase in abdominal fat. This can further lead to inflammation and interfere with hormones. Cortisol will also send signals to your brain that can increase your cravings for food and especially food rich in sugar. If you eat a diet high in sugar, this could also increase your cortisol levels and you end up in an evil circle. 

 

There are also medications that contain corticosteroids which have a similar effect as cortisol in our bodies. 

 

Sleep

Not getting enough sleep for what you need is unfortunately common today. It is also something that can contribute to weight gain as when we do not sleep enough our hunger hormones rise. This makes us want to eat more. On top of that, lack of sleep triggers cortisol production and we end up in the evil circle once again. 

 

Yo-yo dieting and crash diets 

Yo-yo dieting is a way to describe going on a diet, lose weight, stop diet, gain weight, going back on a diet, and repeat over and over. Just like a yo-yo, your weight goes up and down repeatedly. A crash diet is away to describe a very restrictive diet that makes you lose weight but that you cannot sustain long-term. The first problem with both of these is of course the fact that it is not working for you long-term. This in itself will cause you stress. 

There is also a serious side effect from these types of diets and that is that your hunger- and satiety (feeling full) hormones stop working properly. When you restrict your food intake a lot for several weeks your hunger hormones will go up and the satiety hormones will be low. This means that you will feel very hungry, at the same time as your metabolism (energy burning) will decrease. In the end, you will gain back the weight that you lost and many times you will gain more than before starting the diet. This is not only unhealthy physically, but it will most definitely affect you psychologically in a negative way. 

 

Our culture is very much built around food. We eat for so many reasons and eating is many times the center of our social lives. When we see foods that are high in fat or sugar that we like we are built to produce hunger hormones. The insulin in your blood can rise and this also creates a craving for something sweet. This means that if you have this type of food sitting out on your countertop or on your table and you see it, the hunger hormones will do their best to convince you to eat it. 

 

No knowledge, tools, or support 

These are some of the things that contributes to weight gain. Does this all feel overwhelming? I have said before that losing weight is not about willpower. So how are you going to change your situation? By getting help. Together we will analyze your personal situation, identify what would be the best course of action for you and make a plan that works long-term. Anything else would be to cut you short of the chance of improving your health.

It is important that you have knowledge about what is going on, it is important that you get the tools you need to change, and most of all it is important that you have support. This is my mission and my ability as a dietitian, so please do not hesitate to reach out to me to see if we could work together. 

 

Ulrika