Obesity Epidemic A Sign of Prosperity

Over the last several posts I have discussed a few aspects of obesity that I think are important in understanding the condition.  There is no doubt that obesity is a multi-factorial issue in adults--I've always contended that.  But I do not feel that way when it comes to kids, because children often do not have the same mental factors, which I believe play such a strong role in chronic obesity (the factor most involved in the I-just-can't-seem-to-lose-weight-no-matter-what-I try-syndrome).  More on this in a future post.

But we already defined obesity--a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems--so the question should now be: How has obesity become epidemic?  How have so many people gained weight to such degree as to be detrimental to their health?  The numbers today are harrowing--in the U.S. no state has a prevalence of obesity less than 20%, with some states having 30% or more of their population obese.

This is a fairly new phenomenon, as the numbers in the U.S. have gone through their most dramatic increase only over the last twenty years.  This is one reason I do not buy into the genetic or hormonal-cause theories.  Gene pools don't change that quickly, especially not with regard to a trait that has neither survival nor reproductive advantages.

One major benefit we are experiencing as a result of the current obesity epidemic is that we have learned quite a bit about human physiology, particularly the changes in autonomic function.  What is particularly interesting for me is to see the body's response to an extreme change in condition--an excess weight gain.  It shows, once again, the incredible intelligence of the human body.  The body responds to to a perceived stress in a very predictable way, it tries to reestablish balance, and it does so through the autonomic nervous system (ANS).

These observations have some in the field excited that they have now found the real underlying cause of obesity.  ANS changes and their associated hormonal imbalances are not the cause of obesity.  Emotional or economic stressors are not the cause of obesity.  While these issues are likely factors in the long-term maintenance of obesity, the reason why "weight stays relatively constant," they are not in and of themselves what causes obesity.  Taking in more energy than what is used is the primary cause of obesity.  This phenomenon is predominantly due to one or more of the following factors: 

• Eating more than is needed (we've all done this at one time or another, so it shouldn't be too hard to conceptualize how it could happen repeatedly, leading to a form of conditioning)
• Eating nutritionally-poor foods (more than occasionally)
• Chronic inactivity (which includes constantly challenging oneself)

Yes, hormonal issues like hypothyroidism can cause weight gain, so can medication side-effects, and genetics probably leaves some people more susceptible than others.  But these factors are not responsible for 20-30% obesity rates in the U.S.  No way.

So, once again, how has obesity become epidemic in the U.S. and other western societies?  As far as I can see, obesity is a consequence of prosperity.  When food is abundant, when we do not have to grow, hunt, trap or kill our own food sources, when high-energy foods (not in vibrancy, but calories: think pizza) is just a phone call away, 24-7, what do you think is going to happen?  Poor nations don't have obesity epidemics.  Oh they may have obese people...but not an epidemic.  Think about it.  Obesity is mostly a condition of abundance.

Obesity is also a consequence of population growth.  The more mouths we have to feed in rich, industrialized nations, the more we have to manufacture foods that will preserve long-term storage, transport and shelf-life.  Simple as this: To feed millions of people, foods are tweaked to prevent their perishing, and as a result we get chemical- and preservative-laden foodstuff, as well as the now prevalent, yet highly controversial, genetically-modified organisms (GMOs).  Ingesting these food-like substances, as I like to call them, in large quantities or over long periods can lead to excessive weight gain.

Sorry to foolish skeptic, but sodas do cause weight gain, plain and simple. It's no surprise to me that obesity has run concurrently with both American power and prosperity in the world, but also with the explosion of the food industry, particularly processed  foods (and junk food, and fast food, and soda consumption...)

As I've hinted in a previous post, I also believe a very strong mental component is involved in the obesity epidemic.  No doubt the psychological makeup of society is contributing to this massive inflation.  The coddling of the obese by searching for an it's-something-outside-of-you cause is no small factor in making obesity an epidemic.  Next post, I will discuss weight loss and what I think is a better approach to decreasing the prevalence of obesity in modern society.

Some Evidence on Obesity Model

I've been getting harangued for weeks by a severely wounded ego-centric proponent of the I'm-so-desperate-to-be-right approach to intellectual discourse, that I am finally giving in and providing some support for my thoughts on obesity. The blog stalker has insisted that I prove the validity of my thoughts on obesity, and so I will provide some evidence, but let it be known that this is the last response I will make to the ramblings.

In the most recent issue of the International Journal of Obesity [Volume 35, Issue 10 (October 2011)], no less than every article supports my position:

• On the causes of obesity:

Overweight and obesity are the results of an enduring positive energy balance, that is, when energy intake is larger than energy expenditure. Hence, overweight and obesity prevention requires effective intervention programmes targeting behaviours that contribute to both sides of this energy balance. These so-called energy balance-related behaviours include dietary behaviours (for example, consumption of fruit and vegetables, or sugar-sweetened beverages), sedentary behaviours (for example, television (TV) viewing or computer use) and physical activity behaviours (for example, sports or active commuting to school).

Interesting, calories in vs. calories out (boldface emphasis mine), and not one thing about hormones or genetics. That's because it's science, stupid.

• On parents needing to get involved because increased physical activity (PA) at school only is met with greater inactivity outside of school:

The PA of children seems to compensate in such a way that more activity at one time is met with less activity at another. The failure of PA programmes to reduce childhood obesity could be attributable to this compensation.

Duh!  Parents are responsible for their children especially when they see them blowing up.

• That feeding your child crap disrupts their physiology to such a degree as to promote obesity:

Lower insulin sensitivity at childhood may predict subsequent total and central adiposity gain at adolescence. These findings enhance the role of insulin sensitivity as a target of obesity prevention already from the first decades of life.

Or in other words, don't let your children eat junk food.

•  That fat parents breed fat kids:

Children whose both parents were overweight or obese both before pregnancy and after 16-year follow-up had a strikingly high risk of overweight at age 16 years...parents’ long-term overweight (BMI 25 kg m⁻² before pregnancy and after 16-year follow-up) was the strongest single predictor.

I almost can't believe that anyone would need proof of this.

• That drinking sufficient water helps decrease and/or maintain healthy weight:

Consuming the recommended daily amount of water for children could result in an energy expenditure equivalent to an additional weight loss of about 1.2 kg per year...water drinking could assist overweight children in weight loss or maintenance, and may warrant emphasis in dietary guidelines against the obesity epidemic.

• That hormonal changes are the result of fat deposition (obesity) and not the cause:

Too much abdominal (visceral) fat increases an individual's risk of developing insulin resistance and other metabolic disorders. In a Perspective, Hug and Lodish discuss the unexpected finding that blood levels of a hormone produced by visceral fat, called visfatin, correlate with obesity.

Okay, that particular study is from a different journal, but I couldn't resist (and one more from same journal)

But back to the International Journal of Obesity:

Conclusion: Hormone (serum visfatin) levels are influenced by body fat content in obese children

•  On overeating being one significant factor in obesity:

An association between children's body mass index (BMI) and overeating has been established...overeating, impulsivity and reward responsiveness were significantly associated with childhood BMI. Mediation analysis revealed that impulsivity and reward responsiveness equally and significantly predicted BMI indirectly through overeating.

The single most idiotic argument I've heard is that overeating is not a cause of obesity--precisely why this will be my last response to such nonsense. I cannot discuss an idea with someone if we don't speak the same language.  Denying the most basic knowledge we have about physiology puts us on different planets.  Conversation over.

• That eating fast food (FF) regularly leads to obesity:

The teenagers who ate at FF restaurants consumed more unhealthy foods and were more likely to have higher BMISDS than those teenagers who did not eat frequently at FF restaurants. 

• That prosperity leads to obesity:

Ethnic minority groups in Western European countries tend to have higher levels of overweight than the majority populations for reasons that are poorly understood. ..Conclusion: Contrary to the patterns in White groups, the Dutch ethnic minority women were more obese than their English equivalents.

It's only poorly understood because the right questions aren't being asked.  Essentially the study shows that culture alone isn't definitive.  However, I propose that it's the change in culture, particularly entering an environment where conveniences abound.

• That junk foods promote overeating due to chemical and high sugar content:

...higher preferences for sweet and fatty foods compared with the other two groups. Food preferences were also related to all overeating measures, which in turn accounted for a substantial proportion of the variance in BMI...The associations reported in this paper are important from a public-health perspective because of the abuse potential of sweet-fat foods and their strong relationship with obesity.

And that's that. As I've said before, Mr. Stalker, I don't do peoples' research for them. But because you showed such diligence in asserting yourself, I thought I would finally accommodate. I didn't have to go far for supporting articles--one journal, sir, was all I needed. That's because what we know about obesity isn't in need of an overhaul, therefore most of what I put forth is BASIC. What is needed is a halt to the notion that the individual isn't responsible for his or her own weight, and that they are powerless because of their genetics or hormones.

So as I said, I'm done. I will post a few more promised pieces on obesity in the future, and then I move on.

Obesity: Primarily a Food Choice Issue

I've gotten to experience something very interesting over the last couple of weeks.  Resulting from my posts on childhood statin recommendations and parental responsibility for childhood obesity, I've gotten numerous replies, comments and tweets that have both commended and criticized my views.  Being all for intelligent discussion, I've welcomed the responses; but something has become very clear to me: People who are attached to a particular point-of-view will fill any holes with their own interpretations and opinions,quite apart from anything that has ever been said or implied.  It's an interesting phenomenon.  So as promised, I will continue presenting my viewpoint on obesity in general, and specifically, childhood obesity, so I can fill those holes myself, and keep my thoughts from being assumed by others.

Let me begin with the obvious: What is obesity?  From Wikipedia:

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.  Body mass index (BMI), a measurement which compares weight and height, defines people as overweight (pre-obese) if their BMI is between 25 and 30 kg/m, and obese when it is greater than 30 kg/m

Wikipedia is not necessarily the end all be all as a reference source...but, in this case...well, it's right.  Weight gain, which can lead to obesity, is caused by taking in more calories than you burn, period.  It doesn't happen from eating one tootsie roll, despite a tootsie roll being an unhealthy food-like item, or from eating one French fry, or even thirty on a Saturday night for that matter; nor does it come from eating a Twinkie, or a bag of chips, or drinking a soda.  No, gaining excessive weight, and developing obesity, comes from eating lots of crap over and over again.

It is what one does repeatedly that matters, so, in that regard, obesity is a calorie issue.  But yes, there is more to it, although I would argue very strongly that the most important factor is overeating.  As a rule, Americans eat too much.  Listen, I am an American.  I eat at restaurants.  My observation is that the portions served in most restaurants are more than most people need under most circumstances.  I also observe how others eat, and can say quite confidently that most people aren't leaving their plates half-full.  No, most people put it away--all of it--plain and simple.  And this (as a habit) leads to excessive weight gain.

Here's some basic nutritional physiology: Take in more calories than you expend, you gain weight.  Expend more calories than you take in, you lose weight.  When intake and output (over time) are relatively equal...you maintain weight, no gain, no loss.  Duh.  It blows me away that some people actually try to argue against this simple fact.  Why not, then, argue against the Pythagorean Theorem while you're at it?

Listen, it doesn't make sense to try to disprove what we already know about any science.  If it's an established principle, why try to reinvent the wheel?  Oh no, the Law of Gravity is wrong, and that's why we can't unify all theories on physical forces.  No serious thinker would go that route.  Instead they would take what is already known and try to formulate a theory around that.  Freakin' duh!   So why do some self-proclaimed experts attempt it with nutritional physiology?

There is no doubt that food types matter when it comes to weight gain and obesity.  It doesn't take a brain surgeon to understand that French fries are a worse food choice than broccoli.  And it doesn't take a theoretical physicist to understand that eating wholesome foods, as a habit, is better than simply cutting your French fry intake in half.  Freakin' duh!


What amazes me is that some people think that somehow my previous posts suggested that I advocate a low calorie diet.  When have I ever said that?  Let me be perfectly clear: I've never said anything about a diet of any sort.  When I speak of "diet," I speak in terms of how one eats, the types of foods one eats, and NOT a freakin' fad diet (and that includes Atkins, or rehashed Atkin's-like theories).  I simply cannot be any clearer.  The types of foods you eat matters, and how much of them you eat matters too, and how much you burn with physical activity also matters a whole hell of a lot more than your mutated skinny genes (and you thought those were just clothing trends).

Interestingly, the notion that calories in vs. calories out and food type both contribute to obesity presents somewhat of a conundrum to people battling weight.  Some will say, "I don't eat junk food, and I just cannot seem to lose weight."  Then you eat too much, is my answer.  No, I don't eat too much.  Then the types of foods you are eating are poor choices.  No, that's not it either.  Okay, then what is it?  It's genetics.  Oh, you mean fatness runs in your family.  Well, no...I have a gene.  But nobody else in your family is fat?  Well yes...both my parents.  Listen that's called nurture--what you were exposed growing up, your learned behaviors--not necessarily genetics, or nature.  All you are doing when you blame it on your genetics is pulling yourself out of the equation, and I'm sorry, but that just doesn't cut it.  Genetics, hormones, lack of sleep, blah, blah, blah...yes, okay, they contribute...but not more than your food choices do, both in quantity and quality.

I'm going to discuss hormonal factors in weight gain in the next post on the subject, as well as list some factors that are primary in the development and maintenance of obesity.  Just remember that food choices matter--the types of foods you eat (whole, natural foods that you prepare yourself are best), as well as how much you eat.  Denying basic physiological principles isn't going to make one dent in the obesity epidemic, so the fools doing just that are merely perpetuating the problem.

Obesity Goes Where the Money Goes

I wanted to address something I touched on last post--obesity as a condition of prosperity.  The obesity epidemic that we are witnessing today in western society is only possible in an environment of abundance.  I am not talking individual wealth here, but prosperity of nations; and American obesity statistics, and pretty much that of the rest of the world, support this claim.  Obesity is rampant in North America and Europe, with Japan and South Korea having the highest rates in the east.

But wait, what about the rising powers of China and India?  They are experiencing rapid economic growth, but have they an obesity epidemic?  According to a recent report, extreme fatness is making its way to India.  As India's economy grows, the middle class increases as well, and western fast food companies are smelling opportunity like they haven't since, well, 1950s America.

And which demographic do you suppose the fast-food industry is targeting?...You got it--youngsters.  Let's go to the Hop... Reports disclose that one in three children in private schools in New Delhi are obese compared with one in ten in government schools.


"Obesity is emerging in India which has serious implications for metabolic health in the future," says researcher Seema Gulati. "Schoolchildren are attracted to the way it (junk food) is advertised," she said. "They feel it is something that is high status. They want to try it out."

Exactly...convenience, good taste, high status, western, bourgeois, you know...you've been there America, but now look atcha: 30% obesity in most states.  That's not overweight...that's obese...and it's crazy.  And I'm certain the trend will continue in the East, as Asian countries get more powerful.

Brazil is there already, and India is on its way...China anyone?  We'll see.  A major 2010 study called "The Rise of Asia's Middle Class" by the Asian Development Bank warned that in the next 20-30 years Asia will be faced with "an increasing number of chronic diseases on a scale previously unseen".

Obesity is a natural consequence of prosperity.  As money flows, so does the drive for convenience, and nothing more convenient than ready-made food for the go.  Wealth comes from work--lots of it--and this means limited time.  We Americans know that lifestyle all too well--the burning candles, chasing sensory stimuli and seeking greater and greater conveniences--and how it can lead to greater excesses.  Ultimately these excesses cause problems, like rising chronic diseases and epidemics of addiction: food, drugs, sex, and so on.

Hey I'm not knocking any of it...just pointing out the truths of the bigger picture.  We can waste time looking for new and novel causes of obesity--heck, lots of money to be made there--but if we really wish to make a dent in the obesity numbers, then understanding how the condition arises and develops over time is a hell of a lot more useful than trying to create new fantasies about genes and hormones, especially as we see it unfolding in other cultures mirroring our own.  Let's put two and two together, find real solutions to help those that truly want them, and then maybe we might even pave the way for others to understand and resolve their own issues.  But it won't happen anytime soon if we continue to foolishly blame outside forces when the problem is completely man-made.

Hate to be the One that Tells You, but...

In my recent obesity debates, I noticed a disturbing trend among many proponents of fantastical new theories on obesity, which included some doctors: They were adopting a "obesity is far too complex to blame a singular (or few) product/action" position. As I remarked in an earlier post, I think this poorly thought out opinion only perpetuates the problem.  No less erroneous than the genetic theory of obesity, denying the obvious simply gives the obese person a reason to pull themselves, and their lifestyle habits, out of the equation. As a result, it ensures that obesity will remain a lucrative disease entity in need of a cure (à la cancer).

Case in point: In response to a recent report coming out of the Yale University Rudd Center for Food Policy & Obesity, that has showed soft drink manufacturers to be stepping-up advertising to children and teens, particularly blacks and Hispanics. The American Beverage Association, whose members include soft drink companies, disputed the study's findings. Said the group's Chief Executive Officer Susan Neely in a statement,

"This report is another attack by known critics in an ongoing attempt to single out one product as the cause of obesity when both common sense and widely accepted science have shown that the reality is far more complicated."

Uh huh...listen up obesity enablers: Aspects of obesity may have some complexity to them, but how it originates physiologically in the individual isn't complex. Any right-minded person not driven by profits or ego (doctors...) simply cannot deny that imbibing ten teaspoons of sugar (contents of one can of soda) will lead to metabolic and hormonal changes that ultimately cause obesity.  If you're this person, forgive me but...you're an idiot.

Obesity and Natural Selection: Some Thoughts

Just read a great article on human evolution and how advantageous traits are likely selected for over time.  It got me thinking again about the genetic theory of obesity.  Now you all know how I feel about this subject--I pretty much find it a convenient excuse to absolve obese people from their personal responsibility.  Put another way: Gene or no gene, you've still got to eat well, exercise, and practice discipline.  Hey, we all have to that.

But reading this article in the September issue of Scientific American (I know I'm behind...cut me a break...I've got kids) titled, How We Are Evolving, got me thinking that obesity very well may have a genetic link.  According to recent research, most traits that provide genetic advantage or disadvantage likely take tens of thousands of years to disseminate throughout a population, not the thousands of years a high frequency mutation was once thought to dominate natural selection.  I won't get into the science here; read the article to get the details--it is excellent.  Suffice it to say that the data shows evolution to be a long, drawn-out process, as natural selection takes time.

Okay, so what about obesity?  Well, let's just say there is a gene, or genes, that increase one's susceptibility to becoming obese; we might just find that that genetic makeup actually does lead to enough of a disadvantage that it eventually gets selected out of the human genome.

Think about it like this: obesity offers a disadvantage by making a person more susceptible to illness and disease--like many cancers, heart disease, stroke, and the list goes on and on.  Up until now it hasn't conferred enough disadvantage to be selected out of the population--that is, obese people can still pass on their genes.

However, as more of the population gets obese--34% of all adults in the U.S. and 300 million worldwide--less and less may find the opportunity to reproduce.  What do you mean, Campos?  Just a thought, but when approximately 20% of our children here in the U.S. are obese...that's a BMI over 30!...there may come a time when these people are just not considered reproduction material.

Biologically speaking, organisms seek out the most fit individuals with which to mate so that the possibility of passing on one's genes increases.  That's the idea anyway.  As the numbers of obese individuals increases, as well as society's disdain (just read the news!) for obesity, you might just see more of these people ostracized sexually.  Not large numbers right away, mind you--this is where the article got me thinking--but over time.  Could be tens of thousands of years.  Remember, natural selection works slowly.  I mean, things would really have to change societally for this to be considered no big deal.

And yes, obese mating with obese is always a possibility, but that will simply raise the risk, in my opinion, for the genes to become selected out.  This, of course, all predicates on whether a genetic cause (susceptibility?) of obesity actually exists.

My advice to everyone is, once again, gene or no gene, you can prevent obesity by doing the right things.  If my thoughts are correct--and sorry, you and I will never get to know--then you'll be assuring your genes get passed on to future generations by removing and preventing obesity in your life.  Just a thought, anyway.

Exercise In, Genetic Excuse Out

Short and sweet.  I've never bought the bull that obesity is genetic.  Too easy, removes personal responsibility or accountability, and dishonors all overweight people by telling them its beyond their control.  I make the point in my book, The Six Keys to Optimal Health, that even if genetics has a role in obesity, one is still bound by the laws of physiology--more calories in than out...weight gain; more calories out than in...weight loss; equal calories in and out...maintenance.  Gene or no gene, that's the truth.

A new British study confirms my point: Exercise cuts a person's genetic predisposition to obesity by 40%.  Well, no freakin' shit-take mushrooms. 

Researchers looked at over 20,000 people in Norwich, England and focused on genetic variants known to increase the risk of obesity.  Most people had inherited 10 to 13 of these variants from their parents.  Those obesity inheritors that exercised had 36% less weight gain per genetic variant than sedentary inheritors, and each additional obesity-susceptibility variant increased the odds of obesity by 1.1-fold.   This risk, however, was 40% lower for active people compared to inactive people.

In a nutshell: Fat genes or not, exercise obliterates obesity.  No more excuses.

Obesity & Weight Loss: A Multi-Factorial Issue

I recently had the question* posed to me, "If there is an easy answer to weight loss, why is our country filled with so many unhealthy, overweight people?" I think this is a fabulous question since the answer certainly uncovers some of the hidden factors behind obesity.

First, obesity is a consequence of an addiction to food. I'm not talking about merely being overweight, here--I mean obesity and, most certainly, severe obesity. Being overweight can be the result of a number of things: eating the wrong foods (eating many meals out, for instance), neglecting exercise, twelve-pack of beer every weekend, and so forth; bad habits, if you will.

Obesity, however, has an addiction component. Obese people are drawn to food either for sensory pleasures (taste) or emotionally. Emotional eaters eat when they are stressed out, pissed off, hurt, elated, embarrassed, and any other number of emotional stressors that lead one to escape. So food, therefore, is a way for some people to avoid these uncomfortable feelings, whether they are conscious of it or not.

An eating addiction is like any other addiction: a combined enjoyment and escape. Drinkers have it, smokers have it, gamblers have it, and sex addicts have it--it's a momentary checking out, a retreat from unpleasant feelings, whatever they may be. Often, it's a totally unconscious act; the addiction becomes habit.

So, as I said in my New Year's Resolutions article on weight loss, the first step is a true heartfelt desire for change. Some people aren't inspired to lose weight; they attempt it because of societal pressures. Only true inspiration leads to actions that will endure the pain and pleasures of undertaking a weight-loss endeavor. Anything else will fail when it gets too tough. That's one reason some people can't lose weight.

Next, a realistic game plan must be constructed. This is where our topic of The Biggest Loser comes in. A healthy strategy must be implemented and carried out, like any venture, be it business, financial investing, family planning, or weight loss. Without a reasonable or healthy plan, not only is failure likely, but complications can arise.

At the very least, the person losing weight runs the risk of putting it all back on again. This is the part of the strategy that requires lifestyle changes. Without them, the whole endeavor ends up momentary, and it's exactly why Biggest Loser contestants have such a high rate of weight regain (and here).

Finally, and most importantly, the mental component to the addiction must be balanced. Essentially this means finding the pleasures and pains associated with the eating addiction for each individual. There is no cookbook here, if you'll forgive the pun; it's individualized and specific. That takes work. People who lose weight without clearing the mental component that leads them to gravitate toward food in the first place, find themselves back off the wagon when emotional crisis hits. Think Oprah's battles and struggles with weight--she's an admitted emotional eater. Yeah, fail to address the emotional component and long-term weight loss will be unattainable.

To further complicate matters is the necessity of food for energy conversion and nutritional needs. So it's easy to see that obesity is a multi-factorial issue that needs attention to a number of components. I hope that answers the question of, "If losing weight had an easy answer..." I think it's not so much that the answer evades us, it's just that we approach it from such simplicity, AND many people are missing the forest for the trees by looking for very complicate answers (genetics, hormonal disorders, etc.). Let's observe Okham's Razor and see that the simplest solution is probably the most correct. But obesity does have a number of sides that need attention, and that's why so many people are struggling with it.

*Thank you Jeanne M. for the great question.

Not the Answer

Some medical experts are so perplexed by the obesity epidemic that they are now grasping at straws. Take the latest study looking at the effects of fast-food advertising on childhood obesity to get a glimpse of the newest far-fetched fantasy--blaming businesses for people's poor decision making, and then trying to regulate them. That's what happened in New York City this year with mandated calorie count menus, and we may now see Federal regulation of television advertising for fast-food restaurants.

The study on childhood obesity--afflicting nearly one third of all American children--will be published this month in the Journal of Law & Economics. It looked at TV advertising, finding that as much as 23 percent of the food-related ads kids see on TV are for fast-food restaurants. Some estimates have children seeing tens of thousands of fast-food commercials every year. The study then used a statistical test which assumed fast-food ads lead to obesity, but made calculations to address other influences such as income and the number of nearby fast-food restaurants. They also took into account that some children might be obese despite their television watching habits. The conclusions of the study were that banning fast-food TV ads would reduce childhood obesity by 18% in young children and 14% in older children--basically five to six out of every hundred kids.

Oh heavens. OK, these kinds of studies make my stomach turn. What a bunch of nonsense motivating and perpetuating this type of research. Do television ads drive people toward consumerism? No doubt. Do television ads geared toward children influence their buying habits? Absolutely. Does eating fast-food repeatedly make people fat? Without question. Does banning fast-food TV ads really make sense in our pro-commerce society? Not to me it doesn't. Another recent study showed that watching television in general increases the risk of childhood obesity. Should we ban television? As a matter of fact, plenty of studies point to television as a source of idiocy in its worshipers. Should we ban television to reduce idiocy? Should we ban alcohol because of the numerous deaths it leads to, or the violence, or the promiscuity, or the running naked through sporting events? Yeah, they tried that once--it was called Prohibition. It didn't work.

Instead of perpetuating this victim mentality that seems so pervasive in our culture, why not be honest with ourselves and say it like it really is: children are obese because their parents are either ignorant or child abusers. No way a child learns to eat McDonald's every day on his or her own. They learn from, and are enabled by, their parents. You know it's true. I know it's true. So why the hell is the federal government funding a study to find blame with the fast-food industry? Where's the personal responsibility? I don't like pop music; and I think much of today's rap music teaches kids poor life lessons; but I don't want to ban it. And any attempt to do so is usually met with massive resistance.

So why this attack on fast-food restaurants? Simple. Because when people (adults) have no self-control of their own--they overeat, eat crap, don't exercise--they can't fathom forcing self-control upon their children. So instead they blame. Blame everybody but themselves. OK, post calories on menus; then people will have nobody to blame but themselves, because posting calories won't give people self-discipline. Printing warning signs on cigarette packs hasn't stopped people from smoking, nor has printing warning signs in bars kept people from drinking. So banning TV commercials won't lower the childhood obesity numbers. Only banning fast-food altogether will do that. Throw in a ban on Coca Cola and television, as well as mandating five days of exercise for every child, punishable by jail time for failure to sweat sufficiently, and maybe...just maybe...childhood obesity will decline. But is that really the world we want to live in?

Parents Are Responsible for Child's Weight

This post is about weight loss.  It's about basic physiology, and personal responsibility (ooh, dirty words).  I recently tweeted a bunch on a subject I wrote about three years ago.  The number of responses I received was incredible.  The subject was on giving the cholesterol lowering medication, statins, to children.  In 2008, the American Academy of Pediatrics, recommended screening children as young as two-years-old for high cholesterol.  If a child is found to have high cholesterol, the Academy recommended putting him or her on statins to prevent future cardiovascular disease.  My response today is the same as it was three years ago--it's a freakin' crime!

I know too much about physiology and human health to accept this as a treatment option for children, let alone the first line of defense.  Statins have side-effects, and they are also based on a faulty premise--that low density lipoproteins (LDLs) are the most important factors in cardiovascular health.  While definite contributors, LDLs are simply not as important as high density lipoproteins (HDLs) when it comes to cardiovascular risk.  To consider giving drugs that most people take for a lifetime to children as a preventative is purely irresponsible.

But, really, the criticisms I encountered weren't about points I made on statin use in children.  They were mostly directed at a particular line, an idea,

"Childhood obesity? Excuse my language, but...that's effin' child neglect and abuse by lazy, undisciplined, ignorant parents."

Now many people said, "Bravo! Thank you for telling it like it is."  Many others, however, felt it was callous, off-base and out-of-sync with the real causes of obesity.  Some tweeters informed me that my understanding of basic physiology was prehistoric, and that my solution to the obesity problem (I didn't know I had actually given one) was short-sighted and erroneous.  So in the next few posts I will attempt to clarify my thoughts on weight loss/weight gain, the obesity epidemic and parental responsibility as it relates to the weight--and health--of a child.

I am actually going to start with my thoughts on parental responsibility.  I contend that if you as a parent are not responsible for your child and his or her health, then who is?  This question is only obvious to those parents who share this philosophy, and won't be to those believing (either consciously or subconsciously) that health is the responsibility, and byproduct, of something outside themselves.

Every parent will say that they take full responsibility for their child, but far too many act otherwise.  What you do your children will do, period.  They eat what you eat, they think like you think, and they care for themselves in the same way you care for yourself.  How is your child's weight, then, independent of you?  Oh, you didn't shove the cookies down his or her throat...but did you buy them?  Maybe you thought it was harmless to feed your child cookies as a baby...I hope you know better now (Plenty of tweeter critics claimed to not feed their children junk food...listen, your obese child is eating junk food--WAKE UP!)

Parents of heavy children have lots of support for their innocence.  The concept that "your illness is not your fault" is preached by many doctors, psychologists, talk show hosts, media celebrities and support groups; and while it's true that illness is not a fault, it certainly isn't true that we have no hand in how our health plays out.  More importantly, though, everyone has the potential to achieve and maintain great health, no matter what the current circumstances.

When health issues arise, the most important thing to do is determine where changes need to be made.  Whether talking about major lifestyle modifications--like quitting smoking, or changing food habits, or exercising--or simply getting checked by a professional, change is an absolute necessity in correcting any health problem.  How soon you make that decision can mean the difference between life and death.  Symptoms are your body's way of telling you something needs attention.  Ignoring them is the worst possible approach you can take toward your health.

Obesity, as a morphological symptom, is a major change--and it just doesn't happen overnight.  Once parents see it unfolding, they have a responsibility to act (neither children nor teens can make this decision on their own) and create change.  For parents of chubby or obese children, this also means how you decide to change.  A child isn't going to change independently from his or her parents.  Are you going to change your diet to a more healthful one?  Are you going to eat less, and decrease your intake of junk foods, fast foods and sodas?  Are you going to work out, play sports with your kids or take fitness classes together?  Your child isn't going to change without you--you've got to change as well.  And simply dishing them off to Little League will not do either, as building their confidence before they compete in groups will be paramount to their psychological health and well-being.  The bottom line is that parents must get actively involved in the obese child's life, if they are to stand a chance of losing weight.

For new parents, it simply begins with creating good habits from the very start--the foods you expose your children to, the activities you share, how much television you watch, and so on.  You control the environment, and your choices contribute to your children's bodies, and their health.

Obesity is reversible, that's a fact.  How you see things, and how you approach the world determines your chances of overcoming (or your child overcoming) obesity.  Too many people lose weight to make it a hopeless situation.  Blaming obesity on genetics, hormones, depression, lack of health insurance or anything else will not change the fact that everybody is capable of being either obese or anorexic, and everything else in between; it just comes down to one's habits in determining where one will weigh on the scale.  You have the power to change anything with regard to your health, or that of your child's.  Understanding this, and fully embracing it, is the only way to create lasting changes.  Denying it will only get you the same, which is definitely your prerogative, but don't act as if you have no hand in the matter.

More O-BS-ity Madness

OK, OK...now that genetics is out as a cultural crutch for obesity, here goes something to quickly take its place.  Get this: Childhood obesity might be linked to the common cold virus.  Yes, yes, the common cold.  Not lifestyle behaviors, but a virus.  How's that for quick thinking?

A recent study to be published in the September 20 issue of Pediatrics showed that some children infected by adenovirus 36 (AD36), which causes the common cold and slight gastrointestinal upset, were an average of 50 pounds heavier than children who hadn't been infected by this particular strain.  The study, small and rife with coincidences, is the latest in "take-the-blame-off-the-patient" obesity hypotheses.

The study looked at 124 children between the ages of 8-18, with more than 50% (67 total) considered obese based on body-mass measurements for their age and gender, and found that nearly one in four obese children had been infected with AD36, compared to only 7% of non-obese children.  In total, the numbers are 15 and 4 respectively--this makes a study?  Further, within the entire group of obese children, those who were AD36-positive weighed about 35 pounds more than obese children who hadn't been infected with AD36.

I repeat, this makes a study?  Now granted, the authors do not claim to have proof, but I laugh at the absurdity of the notion from the start.  Why not study the link between biting one's fingernails and developing hemorrhoids?  Seriously.

OK, I get the rationale, but come on!  Whether or not, a child has been infected with adenovirus does not remove the necessity to watch the diet and to be active, plain and simple.

But we musn't blame people. Why the hell not?  Why perpetuate the ultimate problem: the lack of knowledge, understanding, discipline and responsibility?  Here's why.  Hypotheses lead to further studies, connections lead to rationales, and rationales lead to drug and vaccine development--think anti-depressants.  New drugs for epidemics means a shipload of money.  The public gets a new wonder drug, doctors get more business, and government gets to look like it supports the public health by endorsing poppycock.

So the rest of us get a good five years of having to hear how people are fat because they'd at one time caught a cold; a particular cold; a fat cold.  And we get to pay even more for their health care, because it's not their fault and everyone should be entitled to be an ignorant, irresponsible and undisciplined glutton.  We support you...literally.

Now before I get accused of being insensitive to obese people, remember, I'm the first to say be whatever you want to be.  I have nothing against obesity, ignorance, irresponsibility or a lack of discipline, because I know that everyone has these same characteristics somewhere in their lives.  In fact, I have said in this very blog and in my health articles that I am more an advocate for people loving who they are as they are, even if obese, as long as if they want to change, they take the responsibility to do so on their own.  No BS, no excuses, just take the leap and accept the glory and the blame.

But I do not support removing personal responsibility from one's physical health and well-being; and I definitely do not support the use of so-called science to find further reason to move the blame away from the individual.  To answer one of the study's authors, who thinks we should "move away from assigning blame, and broaden the way we think about obesity," I say, it help much less to give people another crutch to simply rationalize reality: It takes hard work and a drastic change in lifestyle to lose weight and keep it off.  You've got to cut the sodas, work out, and keep the overeating in check.

Trying to pass off the notion that obesity is somehow caused by exposure to the common cold is irresponsible, and in my mind, an obvious attempt at creating the next blockbuster drug.  It's a free market, yes--but will it change the world's obesity profile?  Fat chance.

Obesity Paradigm Wrong

Just finished reading an article that was as good an analysis on obesity as I think you'll find today.  The latest issue of Scientific American featured a piece titled, How to Fix the Obesity Crisis, and it does a great job of explaining the multi-factorial complexity of today's obesity epidemic.

The article discusses the numerous metabolic, genetic and molecular process that might be involved in the mechanism of developing obesity, but it focuses on the behavioral approaches to breaking mental patterns involved in overeating and poor food choices.  The history on the obesity epidemic is pretty good, too.

Where I think the article fails is that it still approaches obesity from the same mechanistic thinking that has been unable to figure out the malady to begin with.  This sentiment can be summed up by the line,

"Maybe someday biology will provide us with a pill that re-adjusts our metabolism so we burn more calories or resets our built-in cravings so we prefer broccoli to burgers."

Continuing to hope for a magic bullet that will allow us to live a faulty life style consequence-free is foolish. That IS the problem!  I'm going to leave my full assessment for a later time, because I think the article is worth reading.  But stay tuned.

Omega-3 Imbalance Leads to Obesity Inheritance

Finally a genetic excuse for obesity that actually makes sense.  Researchers show that an omega fatty acid imbalance can lead to obesity.  But even more interesting is that this imbalance, and the associated obesity, can be passed on from generation to generation.

A recent French study looked at the role of omega intake and fat deposition in mice.  Four generations of mice were fed a 35% fat diet with an omega imbalance now common in much of the developed world--that is, a high ratio of omega-6 fatty acids relative to omega-3s.  The results were progressively fatter mice at birth, generation after generation.

In my book, The Six Keys to Optimal Health, I discuss the importance of bringing the omega balance to 1:2 omega-6:omega-3.  Currently the typical imbalance in western cultures is 15:1 in much of Europe and up to 40:1 in the United States.  Omega-3s are important to many functions including cholesterol balance, blood pressure, reducing heart disease and stroke, preventing blood clots, preventing diabetes and much, much more.

Omega-3 fatty acids are found plentifully in fish and flax oils, although fish liver oils are a more potent source.  Omega-6s, on the other hand, are high in vegetable oils, breads, grains and poultry--things we eat copiously in the typical American diet.

But what about passing fatness on to successive generations?  Experts believe that the link between omega imbalance and obesity is epigenetic; in other words, the imbalance in mothers influences an offspring's genes during development.  Whoa!  That's right--the omega-6:omega-3 ratio in the breast milk of American women has gone from an average of 6:1 to 18:1.  Holy milkshakes!  Exactly.

I recommend a few things to bring the omega ratio back into healthy balance.  First and foremost is reducing your intake of high omega-6 containing foods.  So breads, high carbs, vegetable oil--cut 'em.  Then I suggest you supplement with a good omega-3 fatty acid.  I carry a great brand in my Los Angeles, Beverly Hills and West Hollywood chiropractic office.  Check this article for all the information you need on omega-3 fatty acids.

Stop the cycle of obesity in your family--get your omega fatty acids balanced.  And don't think it's too late for your children, either.  Feed them well (healthily, not in hordes), get them moving, and give them omega-3 fatty acids--that should break the inheritance pattern.  Remember, health starts in the home.  Now how's that for epigenetics!

Fast Food Fascism

I don't mean to be obnoxious...well, OK, yes I do, but I couldn't help but notice today while lunching at The Cheesecake Factory the young girl at the table across from me enjoying a pizza (a large one solely for her) and a very large coke. Wow! As I watched this intriguing display of gluttony, I wondered: Health officials are really banging their heads trying to figure out the childhood obesity epidemic? Duh!!!

I, for one, do not blame the makers of junk food for the epidemic--temptation is all around all the time; discipline is a virtue. So I don't really applaud any research that proves junk food leads to obesity, like the latest study out of Columbia University and UC Berkeley, which showed that fast food restaurants near schools increase obesity rates. You don't say. That's where our research dollars are going? And do you think video arcades near schools lead to more sore thumbs? May I repeat--Duh!!!

Even worse is that the esteemed opinion of the researchers is that banning fast food restaurants will decrease obesity? Will it? Not without also banning Doritos, or Pop Tarts, or Dominos, or Frosted Flakes, or wait...how about Coke?!?! That's right, is the government ready to ban the biggest culprit of obesity in the modern world, soft drinks? Seeing that Coca Cola is one of the biggest companies on the planet, I doubt it.

Fast food is the new tobacco. Like smoking yesterday, indulging in fast food is getting blasted from all angles. Instead of calling it like it is--an educational issue, an upbringing issue, a cultural issue, a discipline issue--let's just play victim and blame the fast food itself. People don't get fat, buckets of chicken do.

It's not that I am so enthralled with fast food that I must defend it, or the businesses selling it; I just don't like the government stepping in and minimizing my choices of eateries. I don't personally make Taco Bell my first choice in grub, but I'll eat it in a pinch. And it's not like there's no benefit to fast food. You know if you're starving and have very little time, a Whopper will do--you know that. You know that if you are starving after your late night bar shift, you'll eat a damn Big Mac--don't lie to yourself.

So stop trying to feed me this useless science that says we need a ban on fast food. Maybe instead they can do fast food profiling like they do with antihistamine sales in pharmacies now (you know they do that, right?). Anyone entering Mickey D's will need to give up his or her ID card and have their fatty-grub usage tallied. More than two visits per month and you'll only be allowed the McSalad. Sound good? Yeah, not to me either. I guess we'll just have to kiss the neighborhood KFC goodbye.

Ockham's Razor**

What's the best way to combat an obesity epidemic? Have insurance companies--or better yet, the government--pay for gastric bypass surgeries. You heard me right, let somebody else pick up the tab for one's disregard. At least that's what some crackpot lawmakers want to do.

According to a recent story, the obesity epidemic may throw a wrench in President Barack Obama's universal health plan. I couldn't agree more. Throw in a few professional patients, and a few more prescription drug addicts, and I think the President's plan is in for a world of hurt. How do I know? Because that's exactly why health care costs are currently out of control. We're all paying for the "sick care" of the relatively few.

But fear not--one New Hampshire politician has it all figured out. Turns out all of State Senator Bob Clegg's health troubles went away following his gastric bypass surgery in 2007. The surgery helped him deflate from a whopping 380 to a respectable 240 lbs. Not bad, Senator, not bad. So he believes this must be the answer: Government funded gastric bypass--or at least have the surgery covered by private medical insurance. He's so convinced of it's effectiveness, that he authored a bill in January 2008 requiring New Hampshire insurers to offer surgery as a treatment option, just as the state's Medicaid program for the poor does. Apparently other states are looking at the "Live Free or Die" credo of New Hampshire and taking it literally. But to take it one step further, some think that the law should be extended federally.

All I can say is, "Oy vey!" Senator, Senator, Senator...you are wrong, dead wrong. Why should taxpayers pay for an elective surgery? Let me be frank, sir: Obesity--despite what some enablers in the medical and psychology field may wish us to believe--is not a disease. Not. It's a condition. One that is mainly the result of lack--lack of information, lack of understanding, lack of discipline, lack of responsibility, and lack of accountability.

In my book, The Six Keys to Optimal Health, I say very clearly to people battling their weight, "You have the power to overcome obesity; it's in you." I also say run--don't walk--away from anybody who tells you that you are not in complete control of your weight. Run! Run from New Hampshire, and run from Senator Bob Clegg cuz' that man's dangerous. Implying that obesity is a disease that needs surgical intervention* (paid for by you and me in taxes and insurance premiums) is the road to hell. Here's the laugh: Clegg's impetus to pull the wool over New Hampshire's eyes was that he had to pay $20,000 out of his own pocket. His rationale: he's saving the state $3,000 per month in doctor's visits.

Hey, I've got no beef with that...if it were reality. But it's not. Clegg could have lost the weight himself through diet and exercise. No? Don't think so? Sorry, The Biggest Loser proves it. That T.V. show has single-handedly buried any hope for the "I just can't lose weight no matter what I try" set...definitively. Have you seen the show, Clegg? It's incredible. Slap in the face of perpetual victims. If anybody reading this hasn't seen Biggest Loser yet--one of the best shows on T.V. as well as an unexpected public health phenomenon--you simply must. If you can't stomach T.V., then at least check out the website, especially the before and after photos. Disease my arse. The contestants of the show do it purely with diet and exercise--the only way to lose weight effectively. I hope the former Senator's dangerous bill gets no farther than New Hampshire.

*I'm not against gastric bypass surgery, at all. I just don't want to pay for yours, as I'm sure you don't want to pay for my penis enlargement.

**Thank you to a great client and regular reader, Kelly D.