The Myths

Obesity is caused by eating too much

Scientific evidence repeatedly shows that this is false.

Decades of scientific research have shown that weight regulation is governed by unconscious processes in the body (similar to breathing or heartbeat) and managed by signals from the brain.

The brain engages in a complex interaction of endocrine, metabolic and nervous system signals, all below conscious control. These signals control body weight, responding to the body’s dynamic and changing energy needs, which are heavily influenced by the environment.

The presence of obesity disease means that some (and/or all) of these signals are not functioning as they should be.

OBESITY IS AN INDIVIDUAL FAILING AND CAN BE RECTIFIED BY THE INDIVIDUAL

Science shows that obesity disease is not primarily or solely about body weight. The results of obesity disease (which includes various other diseases and may include excesses of certain types of fat tissue at certain times during the disease progression) can be very challenging to manage and treat.

The causes of the disease of obesity (which can also be thought of as an Adipose-Based Chronic Disease) are hugely complex and involve many factors.

The body has unconscious biological, physiological and psychosocial responses to any or all of these factors.

1. Our Environment: from our global geographical location to our immediate local surroundings.  
2. Food Systems and Processing: How food is grown, processed, distributed, priced and marketed.
3. Socio-Political Climate: Government policies and social factors influence access to healthcare and heavily influence Factors 1, 2, 4, 7, 8 and 10.
4. Health Inequality: Differences in healthcare access, quality and availability among different groups of people.
5. Ethnicity: Different ethnic groups have varied risks and experiences with obesity-related diseases.
6. Body Composition: The body comprises various tissues, including fat, muscle, and bone. And there are different types of fat cells, which have different biological effects on the body.
7. Childhood Experiences: Early life experiences (positive and negative) create brain changes leading to various biological responses.
8. Gut Microbiome: The bacteria in our gut significantly impact our overall health and can affect our fat tissue storage and mood and emotions. 
9. Endocrine and Immune Responses: These responses determine how at risk for obesity disease our body is. 
10. Intergenerational Transmission of Risk: Obesity disease and genetic risk can be passed down through generations.

Exercise is effective as a primary weight loss strategy

Scientific evidence repeatedly shows this is false.

The science shows that obesity disease is independent of individual weight. The results of obesity (which include various other diseases and may include excesses of certain types of fat tissue during different stages of the disease progression) can be very challenging to manage and treat.

While there are multiple benefits to exercise, including increased muscle mass, improved mental well-being, cardiovascular fitness, insulin sensitivity and others, no data suggests that exercise is effective over the long term as a primary strategy to manage weight and maintain weight loss.

Evidence reviewed by the European Association for the Study of Obesity (EASO) shows that exercise (150 – 200 minutes at moderate intensity) for weight loss can reduce 2-3kg overall.

In addition, EASO shows that exercise must increase to 200-300 minutes per week to maintain any weight reduction over more extended time frames. The body adapts and vigorously defends body weight (for more information, please see metabolic adaptation)

Obesity is a chronic, relapsing disease, and it is important to note that it is not fully understood to what extent losing or gaining weight affects the underlying cellular-level obesity disease. However, it is proven that weight loss can have positive outcomes on other obesity complications and associated diseases such as Type 2 Diabetes or hypertension.

OBESITY HAS ITS PRIMARY CAUSES IN LACK OF PHYSICAL ACTIVITY, AND THOSE LIVING WITH OBESITY ARE LESS ACTIVE

Scientific evidence shows this is false.

Science shows that obesity disease is not primarily about weight, weight is just one outcome of the disease. The results of obesity, which include various other diseases and may include excesses of certain types of fat tissue, can be very challenging to manage and treat.

Decades of scientific research have shown that the vast majority of weight regulation is an unconscious process in the body (like breathing or heartbeat) governed by signals from the brain.

These signals drive multiple biological processes in the body, which constantly adapt and change. Research has shown that the rate at which the body uses energy to maintain vital functions, such as breathing and keeping warm, is similar across populations, whether that population is active or sedentary. The presence of obesity disease means these processes and signals which govern energy balance are not functioning as they should be.

DIET AND EXERCISE (OR COMBINATIONS OF THESE) ARE THE MOST EFFECTIVE TREATMENTS FOR OBESITY

Scientific evidence shows this is false.

As we have learned under the Myths above, obesity disease is very challenging to manage and treat.

What constitutes “successful” treatment or management cannot be solely determined by body weight or BMI, as obesity disease is not determined exclusively by body weight or BMI.

Medical science shows there are a growing number of effective treatments now available to treat and manage the results of obesity disease and its related complications. But, as George Dimitriadis points out in Video 3 for the Big Truth, to achieve the best results, clinicians and their multidisciplinary teams must tailor and combine the treatments according to the most appropriate and best suited to the individual. In other words, the right treatment for the right person at the right time.

Treatments should be focused on improving the health and well-being of the person, as well as managing any fluctuating weight.

Categorising any treatment as a “failure” or “non-response” based primarily on a lack of consistent weight loss is not a realistic expectation or accurate way to measure this relapsing disease.

People living with obesity should have access to a weight management specialist and qualified medical practitioner before, during and after any treatments or weight management programmes.

Some pharmacological treatments can manage or reduce weight significantly for as long as these treatments are continued and can also reduce other complications associated with obesity disease.

For some patients, bariatric surgery can offer a life-changing and sometimes life-saving treatment and longer-term weight management. It can reduce obesity-associated diseases and improve life expectancy and health span.

“…obesity is not merely a risk factor for illnesses such as type 2 diabetes; it is a disease in its own right.”

 

Talha Burki, Lancet article, European Commission classifies obesity as a chronic disease