Addressing the Stigma of Obesity

I just watched a fascinating documentary on PBS called “The Truth About Fat”. The documentary helps to de stigmatize obesity. It also teaches 1) that while exercise is fantastic for cardiovascular health and longevity it does not lead to weight loss, 2) that consumption of foods high in fat, salt and sugar (which soothe the reward system in the brain) leads to a decrease in dopamine receptors in the brain making us want/need more of these foods, 3) that the level of the hormone leptin in our system dictates whether we feel hungry or full, 4) that being too thin leads to bone loss and fertility issues 5) the propensity for obesity is genetic, and 6) that weight loss is achieved by burning more calories than we consume.

This last point is one that my primary care physician has been telling me for years. That it doesn’t matter which diet plan we choose (high fat, low carb or low fat, high carb to name a couple), weight loss depends upon eating fewer calories than we ingest. The problem with relying on exercise to lose weight is that you have to do a whole lot of exercise to burn relatively few calories. For example, a 30 minute swim burns 150 to 280 calories and a 45 minute walk burns 240 calories, whereas a Sonic Mini Blast (my indulgence of choice) is 510 calories.

Scientists are working to uncover the basis of the link between obesity and epigenetics by focusing on the methylation patterns of several obesity-related genes. It is becoming increasingly evident that individual differences in susceptibility to obesity depend on epigenetic factors. The hope is to prevent progress of obesity in individuals showing susceptibility to obesity at a young age as well as to develop therapeutic approaches.