The Myths

Myth 1

OBESITY IS A LIFESTYLE AND NOT A DISEASE

There is more and more scientific research providing evidence to the contrary.

The Lancet (June 1, 2021 https://doi.org/10.1016/S2213-8587(21)00145-5 states: “Obesity was first included in the International Classification of Diseases in 1948. The misconception that obesity is a lifestyle choice that can be reversed simply by exercising willpower has become cemented in the minds of the general public and much of the medical profession. But over the past 25 years or so, most particularly the last decade, momentum has been steadily building towards an acknowledgment that obesity is not merely a risk factor for illnesses such as type 2 diabetes, it is a disease in its own right.”

In 1997, the World Health Organization (WHO) also recognised obesity as a chronic disease.

Research now shows that obesity is a very complex condition influenced by factors like genetics, changes in gene function, environmental factors, ethnic background, reasons for eating, brain processes, and body makeup.

Many recent studies show that certain types of body fat are strongly connected to various health problems like abnormal cholesterol levels, insulin resistance, high blood pressure, heart disease, and negative changes in heart structure.

For more information, see:

Dr Andrew JENKINSON: The greatest myths

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Transcript

So what are the greatest myths regarding obesity?

I think the biggest one is that it is a lifestyle choice. It isn’t. It’s a combination of genetics and also the environment that you happen to be born into. If you have a combination of obese genes, but also you live in a Western food environment where there’s too much processed food, then it’s almost preordained that you’re going to really struggle with obesity.

If you’re then given the advice by your doctor or a nutritionist to lose weight by dieting and starving yourself and calorie restriction, you will actually end up, you know, training your metabolism to make it more efficient and you’ll end up even heavier.

So this this is the biggest misconception regarding obesity.

Myth 2

Obesity is caused by eating too much

Models such as The Energy Balance Model (EBM) outline that the brain is the organ mainly responsible for weight regulation. The EBM shows the brain as engaging in a complex interaction of endocrine, metabolic and nervous system signals below conscious control. These signals control body weight, responding to the body’s dynamic and changing energy needs, which are heavily influenced by environment. 

 

Myth 3

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

Science shows that without treatment, obesity is very difficult to reverse.

The causes of obesity-related chronic diseases are complex and involve many factors.

These include:

  1. Our Built Environment: refers to our surroundings like buildings, parks, and roads. The design of these areas can affect our physical activity and food choices.
  2. Food Systems and Processing: How food is grown, processed, and distributed impacts what we eat and its nutritional value.
  3. Socio-Political Climate: Government policies and social factors influence access to healthcare, quality of food, and opportunities for exercise.
  4. Health Inequality: Differences in healthcare access and quality among different groups of people.
  5. Ethnicity: Different ethnic groups have varied risks and experiences with obesity-related diseases.
  6. Body Composition: This is about the amount of fat, muscle, and bone in our bodies.
  7. Childhood Experiences: Early life experiences can shape our health, eating habits, and activity levels.
  8. Gut Microbiome Changes: The bacteria in our gut can affect our weight and overall health.
  9. Endocrine and Immune Responses: How our hormones and immune system work can influence obesity.
  10. Intergenerational Transmission of Risk: Obesity-related risks can be passed down from generation to generation.

    For more information, see:

    A man sitting in a chair talking to a doctor.

    Myth 4

    Exercise is effective as a primary weight loss strategy

    Science shows that without treatment, obesity is very difficult to reverse.

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

    A synthesis of the available evidence from the European Association for the Study of Obesity, EASO (link to EASO website) shows that exercise (150 – 200 minutes at moderate intensity) for weight loss may achieve an overall loss of 2-3kg.

    A 2 – 3kg loss for most people living with obesity is not sufficient to affect their obesity status and obesity-related complications.

    In addition, EASO showed that to maintain weight loss, the level of exercise must increase to a high level of moderate intensity (200-300 minutes per week).

    For more information, see:

    Myth 5

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

    The body will engage in metabolic adaptation for the environment in which it finds itself. Basal Metabolism – the rate at which the body uses energy while at rest to maintain vital functions such as breathing and keeping warm – is similar across populations whether that population is very active or sedentary.

    For more information, see:

    Myth 6

    Diet and exercise are the most effective treatments for obesity

    There are a growing number of effective treatments now available to treat obesity 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 should tailor and combine the treatments according to the most appropriate and best suited for their patients. In other words, the right treatment for the right patient at the right time.

    Patients should always consult a qualified medical practitioner prior to embarking on a weight loss programme.

    Some pharmacological treatments can offer clinically significant weight loss, potential reductions in the complications associated with obesity weight and maintenance for as long as these treatments are continued.

    For some patients, bariatric surgery can offer a life-changing and sometimes life-saving treatment, long-term weight loss and reduction in the incidence of Type 2 diabetes and overall mortality.

    “… momentum has been steadily building towards an acknowledgement that obesity is not merely a risk factor for illnesses such as type 2 diabetes, it is a disease in its own right.”

     

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

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