Understanding Obesity
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Over 30% of Australians are obese1 and the same level exists across most of the developed world, it is an epidemic of modern-day life.
All scientific models that have tried to explain the accumulation of fat throughout our life span have weaknesses and do not fully describe what individuals can experience in their lives. The fact that the food industry has created a new obesogenic environment of easy calories that can overwhelm our biology is evident to all.
From a historical perspective, for millennia humans were hunter gatherers, expending a lot of energy to obtain a meal and living in sustained periods of food shortage. This is the lifestyle that the body’s weight control mechanisms have adapted to over a long period of time. Have you ever tried to lose weight and found it quickly comes back? You’re not alone, we are a genetically diverse species and some have the genetic code to survive in times of food shortage, unfortunately right now, food is everywhere.
In the last 100 years, industrialisation of western countries has occurred leading to a rapid change in the environment in which we live. Obesity does not come down to gluttony or poor self-control it is that the weight control centre of our body- the hypothalamus- is defending our fat stores because that is how we have survived as a species in the past.
The main two models currently discussed for weight control are the set point and settling point models:
Set point- weight is pre-determined by our genetics and any attempt to change weight will result in the body’s weight control mechanisms guiding a person back towards that set point.
Settling point- weight is determined by the balance of calories in and calories out.
Besides genetics, there are other reasons why weight cannot be lost with diet and exercise such as joint pain, insulin resistance and medications to name a few. These problems cause a vicious cycle to develop making further weight gain inevitable despite best attempts at a healthy lifestyle.
Weight loss surgery breaks this cycle of weight gain, disrupting the body’s biological mechanisms to store fat allowing people to live a healthy life. Despite new medications entering the market, surgery with lifestyle change remains the most effective long-term option for weight control.
1. Australian Bureau of Statistics. National Health Survey- Overweight and Obesity 2019.