Americans are known for having a high incidence of being overweight and of obesity. About 40% of U.S. adults are obese (Sara Berg, MS, “Top Health Tips Obesity Medicine Physicians Want You to Know,” JAMA, January 4, 2024).
The article points out that obesity is “linked to over 200 co-morbidities” (illness associated with obesity such as diabetes, high blood pressure, several forms of cancer, arthritis, high cholesterol, heart disease, stroke, obstructive sleep apnea, and more).
Obesity medicine physicians consider obesity to be a medical disorder with multiple factors causing it. It is not due to a lack of willpower.
Genetics plays a role. Also, the NIH tells us that obesity can be caused by a combination of a “poor diet,” inadequate physical activity, insufficient sleep, and several environmental factors.
These factors may include: lack of availability of nearby parks and affordable gyms, oversized food portions served in restaurants, food deserts (no nearby food stores that sell healthy food at affordable costs), and “Food advertising” that “encourages people to buy unhealthy foods such as high-fat snacks and sugary drinks.”
Highly processed foods should be eaten in small quantities, if at all. Alas, many prepared foods in the U.S. are highly processed.
Some instances of obesity are related to medical disorders such as low thyroid hormone, polycystic ovarian disease, and Cushing’s disease. There are also medications that have weight gain as side-effects. Examples include steroids, some antidepressants, and some seizure medications.
One conclusion from all this information is that people who are overweight or obese should not be shamed any more than we should shame someone for having diabetes, breast cancer, or migraine headaches.
Anyone who is overweight or obese and wants to lose weight should understand that lack of willpower is not the cause of their weight gain. Therefore, willpower is not the solution either. However, if you struggle with obesity, it is up to you to learn about effective approaches.
Fortunately, recent advances in medicine have provided a number of treatments that can help. Examples include weight-loss medications such as the GLP-1 injections, bariatric surgery of various kinds, and management of contributing conditions such as thyroid disease.
Also, increasing physical activity and reduction in calorie intake, getting adequate sleep (hormones released during sleep reduce appetite and modify how our bodies use energy), and mindful eating are all helpful.
For people who want to lose weight and are doing all they can but are not succeeding, they may want to obtain a consultation from an obesity medicine physician specialist.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
