The Truth about Our Weight
According to the World Health Organization (WHO), the percentage of obese humans globally has doubled in the last 28 years. In 2008, the WHO reported that approximately 1.5 billion adults were overweight and at least 400 million were obese globally. These numbers are projected to reach about 2.3 billion & 700 million, respectively, by 2015. More staggering facts - one quarter of American children are obese & the burden placed on the US health care system to ($147 billion per year) is predicted to increase to $192 billion by the end of the decade (Lustig, 2013).
Many people believe that the rise in obesity over the last 30 years is due to an energy imbalance: too many calories in (overeating) versus not enough calories out (through physical activity). This rationale inherently places the blame for obesity on the obese, however, more & more medical practitioners, including Dr. Robert Lustig, are starting to realize & a growing body of research shows that this is only one small part of the problem.
There is a lot more going on behind the curtain than has historically been recognized. Obesity is a combination of several factors: physics, biochemistry, endocrinology, neuroscience, psychology, sociology, & environmental health, all rolled up into one problem & the factors that have driven the rise in obesity over the last 30 years are “almost as myriad as the number of people who suffer from it.” “Obesity is a biochemical alteration in the brain promoting leptin resistance with resultant weight gain & secondary changes in behavior to maintain energy balance.” Therefore, obesity may not be caused by overeating & laziness, but rather those characteristics are the result of biochemical changes occurring in us. (Lustig, 2013).
Health Implications of Obesity
The good news is that people don’t die of obesity & that fat does not have to be your fate. The bad news is that people do die because of the effects many metabolic diseases have on the body’s organs & systems that often associate with obesity. The cluster of such metabolic diseases including type 2 diabetes, hypertension (high blood pressure), lipid (blood fat) disorders, cardiovascular (heart) disease, and of course, obesity is known as metabolic syndrome. Obesity doesn’t kill, metabolic syndrome kills (Lustig, 2013).
There are other obesity-associated metabolic diseases including nonalcoholic fatty liver disease, kidney disease, and polycystic ovarian syndrome. And even more medical conditions are associated with obesity, including orthopedic problems, sleep apnea, gallstones, & depression.
Understanding the Four Components of Our Weight
There are four different body compartments that we measure when we calculate our weight (Lustig, 2013). It’s important to keep this in mind when assessing whether or not you’re at a healthy weight.
- Bone
- The more you have, the better & longer you live.
- Muscle
- More muscle is better. Muscle takes up glucose & means better insulin sensitivity.
- Subcutaneous (derrière) fat
- Visceral fat (abdominal fat around the organs)
- This kind of fat increases your risk for diabetes, heart disease, stroke & more
Nutrigenomics & Epigenetics: Obesity May Begin Before Birth
One other factor to consider as contributing to obesity epidemic could be due to interaction of nutrition and chemical exposures during vulnerable periods in development (ie: in-utero). Nutrigenomics is the study of the relationship between diet & genetic behavior; the relationship between diet and the expression of one’s genes as it produces health or not. Nutrition is able to profoundly modify gene expression and genetic variations. The way this happens is by epigenetics (the environment alters gene expression (turning it on or off) resulting in altered epigenetic signals and increased susceptibility to obesity and other disease later in life.
Environmental agents and or nutrition act during development to:
- Alter pathways responsible for control of adipose tissue development
- Increase the number of fat cells
- Alter food intake and metabolism
- Alter insulin sensitivity & lipid metabolism
A diet rich in phytonutriens communicates with our genes influencing them positively, but a diet lacking them can communicate negatively, influencing disease expression.
Beware of the following which can have negative outcomes on our health:
- Trans fats
- High fructose corn syrup
- Artificial sweeteners
- Refined carbohydrates
- GMOs
- Common allergens
Principal hormones with obesity – it’s all about the balance!
- Insulin
- Anabolic “storage hormone” & “energy balancing hormone”
- Body won’t use fat for fuel with insulin in the blood because signals there is sufficient energy/glucose
- Produced in the pancreas & induced by elevations in blood sugar
- Stores excess glucose as glycogen (in the liver), but also as fat
- Inhibits both fat release and burning
- Increases appetite
- Key is to keep insulin balanced
- Glucogon
- Released from alpha cells in the pancreas
- "Fat-utilization hormone”
- Opposite action to insulin – “spending or breakdown hormone from the pancreas”
- Tells body to breakdown fat (triglycerides)
- Inhibited by high levels of insulin
- Stimulated by protein intake (important to eat lots of protein to lose weight & balance hormones)
- Ghrelin
- Appetite hormone, saying “please eat”
- The first food-intake stimulating signal from the stomach
- Conveys info to hypothalamus to
- Stimulate appetite
- Enhance use of carbs
- Reduce fat utilization
- Increase gastric motility
- Increase acid secretion
- Leptin
- See description below
Understanding Fat Cells
- Fat cells are metabolically active (not inert)
- Produce a variety of inflammatory chemicals & leptin (the satiety hormone that plays a role in body weight regulation by acting on the hypothalamus to suppress appetite and burn fat stored in adipose tissue)
- Optimal leptin reduces appetite and induces fat burning
- If leptin drops, hunger is triggered
- Obesity, inflammation, high cortisol (brought about by chronic stress), & high insulin increases leptin resistance
- Leptin resistant animals grow obese quickly
- Commonly, obese people are leptin resistant, so mechanism doesn’t work to control appetite
- Inflammation promotes the binding of C-reactive proteins with leptin, impairing leptin transport across the blood brain barrier & leptin signaling at the cellular level. Therefore, the hypothalamus doesn’t recognize leptin signaling
- Also, excitotoxins (ie: MSG) also bind to leptin receptors on hypothalamus, contributing to leptin resistance
- Goal: restore leptin sensitivity – allows receptors to hear message at lower levels
- Do this by reducing inflammation (fish oil, ginger, curcumin, antioxidants)
- Manage dysglycemia by controlling carb levels in the diet
- Reduce cortisol if elevated (ie: de-stress)
Toxicity, Thyroid & Obesity
Toxicity is a huge component of weight management & plays a role in whether or not we’re able to lose the pounds to regain our health. Mounting evidence from over the past decade suggests that certain chemicals may be playing a role, too. These “obesogens” as they are known may be altering our metabolism and fat cell development, making it harder to maintain a healthy weight (Environ Health Perspect, 2012). 80,000 new chemicals have been introduced since 1900, most of which have not been tested for safety or synergistic action.
Weight gain & toxic load can frustrate attempts at weight loss by:
- Impairing the liver
- Impairing the thyroid
- Damaging the mitochondria (energy production sites in our cells)
- Increases inflammation & oxidative stress
Examples of obesogens include the following:
- Internal toxins
- Bacteria, virus, yeasts
- Metabolic waste
- External toxins
- Food additives, chemical solvents, petrochemicals
- Heavy metals, pesticides
- Antibiotics
- Alcohol
- Commercially raised produce & animal products
- Sugar
Common Signs & Symptoms: Ways to Assess your Weight &/or Body Composition Health
- Body Mass Index (BMI): BMI is one common way practitioners & the general public tries to “measure body fat based on height and weight” (www.nhlbi.nih.gov) such as the calculator here. However, there are limitations to this measurement in assessing health as BMI tells you how heavy you are for your height, but it technically doesn't measure body "fatness," let alone what type of fat. For example, if you have a very muscular build, you could have an overweight BMI and still be healthy (WebMD).
- Despite this limitation, resulting BMI calculations between 20-24.9 are considered in the healthy weight range. BMI of 25-29.9 corresponds with overweight, 30-39.9 with obese, & 40+ with morbidly obese.
- Waist to Hip Ratio: You can measure body composition (particularly checking for the location of fat on the body) & weight health by using a tape measure to measure the circumference of the waist (at the top part of your hip bone and navel) & dividing that number by the circumference of your hip at its widest point while the feet are together.
- 1.0 or greater for men is considered a risk factor for heart disease (one of the diseases included in metabolic syndrome) 0.8 or greater for women is considered a risk factor for heart disease
- Waist Circumference: A large waist circumference on its own is associated with an increased risk for cardiovascular disease & an indicator of metabolic syndrome.
- 35 inches+ for women40 inches+ for men
Holistic Approach to Weight Management
To lose weight & keep it off, a diet & lifestyle change is necessary to improve metabolism, detox, & increase nutrient reserves.
The dietary focus for weight management:
- Regulating blood sugar & carbohydrate utilization
- Supporting liver & cell detox
- Supporting adrenal function
- Supporting elimination of toxins via the bowel, kidneys, & skin
The lifestyle focus for weight management is to include one or all of the three best exercise promoters of fat loss into your daily routine:
- Resistance training (ie: weight lifting)
- Interval training (ie: aerobics, biking, jogging)
- Flexibility/Core training (ie: yoga, stretching)
References:
Blum, S. (2013). The Immune System Recovery Plan: A Doctor’s 4-Step Program to Treat Autoimmune Disease. New York: Scribner.
Enig, M. & Fallon, S. (2005). Eat Fat, Lose Fat: The Healthy Alternative to Trans Fats. New York: Penguin Books.
Leidy, H.J., Bossingham, M.J., Mattes, R.D., & Campbell, W.W. (2009). Increased dietary protein consumed at breakfast leads to an initial and sustained feeling of fullness during energy restriction compared to other meal times.
Lustig, R. (2013). Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity, & Disease. New York: Penguin Books.
Murray, M. (2005). The Encyclopedia of Healing Food. New York: Atria Books.
Murray, M. (2012). The Encyclopedia of Natural Medicine. New York: Atria Books.
National Health and Nutrition Evaluation Survey. (2010). 97% of people in US deficient in EFAs abd 60% deficient in Magnesium. Emailed to Ed Bauman on 09/29/10.
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