The weighty issue of weight loss

By Noralyn Dudt

For centuries, obesity has been viewed as a character flaw. Despite decades of research into the genetic and biological influences on body weight, people with obesity continue to be stigmatized,  more so than those with other chronic disease, as if their weight were their fault.

In the latest issue of the European Journal of  Clinical Nutrition, researchers, clinicians and public health experts discussed and argued that overeating is not the primary cause of obesity. Looking at clinical trials and previous research,  they  came to the conclusion that the "process of gaining weight causes us to overeat."

The usual way of understanding obesity is simple : if one consumes more calories than needed to fuel oneself, the surplus is deposited into body fat resulting in weight gain. Because, according to this approach, all calories are alike to the body  and the only way to lose weight  is to eat fewer of them, or burn them  off with exercise.

For a century, this notion they call "energy balance" has dominated obesity prevention and treatment,  from the original focus of calorie-counting in the early 1900s, to the low-fat diet ( targeting the most energy dense nutrient) of the late 1900s, to the recent emphasis on reducing consumption of modern processed foods high in fat and sugar. If this theory is correct, though, it's hard to square with the facts. Studies show that after a three-decade increase, calorie consumption in the United States has plateaued or decreased since 2000. But obesity rates have increased by more than one-third since then, to an astounding 42 percent of the population today. This paradox cannot be simply explained by  sedentary lifestyles -- in fact, many people throughout the globe  have become somewhat more physically active over the past 20 years. So, what's going on?

Suppose we assume that the theory of calories and energy balance is wrong and instead try reversing "cause and effect?"

The scientists' conclusion that  "gaining weight causes us to overeat"  is a reverse of  cause and effect. This reversal of thought puts the blame for the rising levels of obesity on the processed, fast-digesting carbs that flooded our diets during the low-fat diet craze—white bread, white rice, prepared breakfast cereals, potato products and sugary foods. It posits that consumption of these carbohydrates raises insulin levels too high and produces other hormonal changes that program our body to store extra fat. In that light, obesity is not an overeating problem. Rather it is a calorie distribution problem—too many calories from each meal being siphoned off into fat tissue and too few remaining in the blood to satisfy the energy needs of the body. Consequently, our brains make us feel hungrier sooner after eating to compensate for those sequestered calories.  If we try to ignore hunger and restrict calories, the body conserves energy by slowing metabolism.  In this sense,  obesity is a state of starvation amid plenty.

According to this theory, simply cutting back on calories does not work over the long term. It does not address the underlying predisposition to store excessive fat driven by hormones and other biological influences.  Instead,  the focus should be on reducing the surge of blood glucose and insulin after meals with a higher fat low in processed carbs. This way, fat tissue can be coaxed to release the pent- up calories, leading to less hunger. Weight loss occurs without the need for calorie restriction, increasing the likelihood of long-term success.

So, is the carbohydrate-insulin model more correct than the energy balance thinking? Though there have been studies,  there needs to be more definitive research to resolve this controversy. Alternative paradigms for obesity have not been taken seriously.  Two scholarly papers in addition to the one in the European Journal,  aim to build the carbohydrate-insulin model from available scientific evidence. Meanwhile,  despite investing in many major low-fat diet trials ( virtually all failing to show any benefit for the main outcomes), the U.S. government's National Institutes of Health has yet to fund a single long-term low-carb trial of similar scope. One reason for this resistance might be cultural. For centuries,  obesity has been viewed as a character flaw with the obese being stigmatized. Advertisers have been bombarding the obese with ads of how to eat less, what to eat and not to eat. It has become a "religion" in itself with devotees to one weight-loss program or another.

It will continue to be a 'weighty' issue until there's more clarification and elucidation that it's not only how much one eats but it's also about calories and how they are stored in the body.  When one understands that over-processed foods that are  starchy and sugary can actually make one feels hungrier causing one to overeat will be a good start in this battle. It's also a winning battle when one understands that those unprocessed and simply-cooked meals of vegetables with a bit of rice and meat are more satiating and satisfying.

Noralyn Onto Dudt still eats her sweets ( cakes, paradosdos, bibingka and halo-halo) but always counteracts them with lots of vegetables and fruits when she does so,  in addition to an hour-daily walk.