Obesity: A manageable disease with many causes
Losing weight and keeping it off is often seen as a simple question of “energy in and energy out” – how much you eat and how much you move. But science has proven that obesity has many causes, some of which are beyond the awareness or control of the person living with obesity.
“I go to the gym, I eat very small portions, I do yoga. But I am still overweight. People will say to me ‘eat less, move more and you will be fine’. But it is really not that simple”.
For Vicki Mooney, a mother of three living in Spain, asking for help from her doctor was a turning point in her life. It also made her realise that her obesity is not a simple matter of lifestyle but rather a chronic disease with many causes.
Anyone who has been through even a fraction of what Vicki has, knows it far too well – losing weight is difficult. Keeping the pounds off afterwards even more so. Still, it seems to be a widespread belief that people who live with obesity are entirely responsible for their situation.
“Genetics, biology, psychology, stress levels, hormones, the quantity and quality of our sleep, medications, environment, and socioeconomic status can all play a role in developing obesity.”
– Wright SM & Aronne LJ. Causes of obesity.
Click on this link to check your Body Mass Index and find out where you are in the obesity spectrum: https://yourweightcantwait.sg/#bmi-calculator
Much more than in-and-out
The popular narrative implies that if only we ate the right food and exercised in the right way, we would not carry excess weight. While this mechanism of energy in and energy out is true, it’s a dramatic simplification – and hurtful to those affected by obesity. Losing weight does depend on the balance between how much energy we eat, and how much energy we use. But the causes of the energy imbalance are complex and vary from person to person.
Instead, leading scientists agree that people who struggle with excess weight might in fact be living with obesity, which is a chronic disease.
Just like many other chronic diseases, obesity develops over a period of time. There are many reasons for this, some of which are beyond our conscious awareness or control. Our psychology, genetics, hormones, stress levels, the quantity and quality of our sleep, the medications we take and the environment we live in, can all play a role.
To effectively manage obesity, the first step is to identify which causes are playing a role – these causes will vary from person to person – and how some of the roadblocks can be addressed.
- Yumuk V et al. European Guidelines for Obesity Management in Adults. Obesity Facts 2015; 8:402-424.
- Johnson F, Beeken RJ, Croker H et al. Do weight perceptions among obese adults in Great Britain match clinical definitions? Analysis of cross-sectional surveys from 2007 and 2012. British Medical Journal Open 2014; 4: e005561.
- Kaplan L, Golden A, Jinnett K et al. Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION Study. Obesity. 2018; 26:61–69.
- Hall KD, Hammond RA, Rahmandad H. Dynamic Interplay Among Homeostatic, Hedonic, and Cognitive Feedback Circuits Regulating Body Weight. American Journal of Public Health 2014; 104:7:1169-117
- Puhl RM & Heuer CA. Obesity Stigma: Important Considerations for Public Health. American Journal of Public Health. 2010; 100:6:1019-1028.
- Wright SM & Aronne LJ. Causes of obesity. Abdominal Imaging 2012; 37:730–732.