Lou Schuler

Author, Journalist, Presenter

Posted 01/18/2012

Obesity: The Final Answer

 

I recently found myself in a friendly argument over the origins of the obesity epidemic. It (the argument, not the epidemic) started with a post on my Facebook page (scroll down to January 2), which itself came from this article on weight loss in the New York Times Magazine.

The argument was over how much of the rise in obesity can be attributed to genetics vs. environment. Anoop Balachandran, a fitness professional studying for his Ph.D. in exercise science, argues that it’s virtually all genetics, and makes his case on his blog in this post and this one. His biggest point is that the people who are obese today are the people who would’ve been obese anyway, and what we call an epidemic is a rise in their weight, not an overall fattening of the entire population.

No one in my position wants to accept genetics as the final answer. To paraphrase Lt. Aldo Raine, “We ain’t in the excuse-makin’ business. We in the killin’-fat business. And cousin, business is a-boomin’.”

In the past I’ve worked hard to show that genes are part of the problem (in this Men’s Fitness article from 2005 I’m on the record saying it’s 40 percent), but that environment and lifestyle choices still matter. And, for a variety of reasons, our environment has become substantially more fattening since the late 1970s.

For example, take a look at this picture of my siblings and me from the 1970s, and guess how many people in that photo have struggled with their weight. (The answer: five.) Now guess how many ended up obese. (Three.) What do you see in that photo that suggests any of those fit, tanned, and healthy-looking people will end up gaining substantial amounts of weight that they will subsequently struggle to lose? That’s my own family, where everyone played sports, everyone worked out, and everyone has gone through life with a higher-than-average concern about his or her personal health.

But here’s the wild card: Our father (as I’ve mentioned in almost every book and several magazine articles) was extremely fat for his generation. If he was in a room, chances are he was the fattest guy there. Our mom was the opposite: skinny and so focused on weight that several of us worry when our kids are within earshot. She’s said terrible things about some of them, including my son when he was a roly-poly infant whose entire diet consisted of breast milk. What were we supposed to do, deny him the left breast so he’d learn to settle for whatever he could get from the right?

As I said, five of my siblings have inherited my father’s predisposition to easy weight gain, while for two of us, weight control has been relatively easy. Was it all just the luck of the draw? Or was there a range of possibilities for each of us?

Thanks to this paper from a journal called Disease Models & Mechanisms, we have an answer. (Huge thanks to Mike Nelson for the heads-up.) The authors are an international who’s who of veteran weight-loss researchers. Their goal was to explain why conventional explanations of obesity, like the set-point theory, are flawed, and what might provide a more durable model.

If obesity is all or mostly a genetic phenomenon, then the set-point theory would explain it. We all have a weight and a body-fat percentage that our bodies want to maintain, and any challenge to that set point will trigger mechanisms that make weight loss impossible to sustain. There might be a small range — perhaps 5 to 10 percent of body weight — that we can control. The rest was genetically determined at conception, more or less.

The authors poke these holes in that argument:

Why are the most affluent members of poor societies, but the poorest members of affluent societies, most prone to obesity? Why are children who watch more TV most susceptible? Why do people gain weight in specific circumstances (college, marriage, or upon moving from Asia to the U.S.)? I love this quote:

If the set point changes in response to our social class, our marital status, or whether or not we watch TV, then it is not a ‘set’ point.

To replace set-point theory, the authors offer the dual intervention point model. Each of us has an upper and lower intervention point. Your body won’t allow your weight to sink below the latter, or rise above the former. The range between my floor and ceiling seems to be relatively small, which is why my weight rarely goes below my current 180 pounds or above 190. But for someone else, it might be huge.

To quote the authors:

Within the gap between upper and lower intervention points is the space where environmental effects on energy balance hold sway. … More broadly, the model can explain the obesity epidemic as a consequence of increased food supplies driving up food intake, while also explaining why only some people become overweight and obese in this obesogenic environment.

So how much of your weight is determined by genes? According to the authors, our current best guess is 65 percent. The rest depends on the life you live and the choices you make.

 

  • Hi, Lou!

    No one in my natural family was or is the overweight, but I was chubby and/or fat all my life, despite living with my mother who was extremely careful with diet as a type 1 diabetic.

    I’m sure genes make us more or less susceptible, but diet and activity habits still trump genetics. The trick is that conventional dietary habits aren’t the key to staying healthy or fit. Everything in moderation might work for people with those genetics, but other people likely need to be more than moderate in their moderation.

    Roland

  • Jonathan Goodman

    Genetics plays a large part. From my research which isn’t as extensive as Anoops (that guys super smart) it seems as if the number of fat cells in the body is determined by genetics. This can put the person at a huge disadvantage as only the size of the fat cell can increase or decrease. Meaning that a fat person turned skinny won’t lose their fat cells.

    Another point you’re both missing is from a sociological perspective. Overweight parents generally have bad lifestyle habits which are inherited by their kids. We’re all privy to the “our parents word is the truth” belief.

    It’s a lot harder as a child or adolescent to eat vegetables at every meal and avoid starchy carbs at night when their parents are always eating these things and cooking with it. When that kid is an adult the habits are ingrained.

    • Anoop

      Hi Jon,

      Thanks Jon.

      I agree. When they do fat removal surgery which is supposed to take the fat cells “out”, the body fat gain fat in other areas. Another classic example of how body maintains a tight control over your weight.

      About the parental influence: That why they look at adoption studies and identical twins reared apart. But the kids weight resembles more of the biological parent than the adopted parents. The same goes for identical twins. Even the picture in my article of how non-identical twins in the same family looks so different is a good example of how bodyweight varies within the same environment or family.

  • Since I am not a medical researcher or doctor it no doubt takes more than 1 page and a PowerPoint graphic to understand the dual intervention point model. But I still felt that the focus on the intervention points being static floors and ceilings over time is not correct – it’s not the way any mechanical/biological system works.

    (and it seems to presuppose a genetic determinism model)

    To me it makes more systems engineering sense to say that at a given point in time the body has a range of metabolic capability that is used to maintain weight again within a range. This changes over time because of external and internal factors.

    So the body has an ability to process a range of energy input toward the goal of a range of desired bodyweight. But it is more than possible to change – for better or worse – the body’s processing ability. And this would have a cascading effect on bodyweight ranges.

  • Anoop Balachandran

    Thanks Lou for the post!

    I have read that article by Speakman. For me that article just shows what I am trying to say here. The Dual intervention model is basically a set point model with a greater leeway for environmental pressures. Everyone has a set bodyweight range. In people who are obese, they gain a lot more weight than lean people within the SAME environmental pressures. And why do they gain different weight in the same environment? Genes.

    The major argument against set point theory is the obesity epidemic as written in the article. But is there an obesity epidemic in the first place? Sure the obesity prevalence percentages increases shows there is an epidemic. But if you look at the average weight gain, we only see modest weight gains. I see the people who are heavier side of the BMI curve largely also influencing the average weight gain.

    And first learned about this from Friedman in 2003. He even writes that how Flegal – the author of all obesity prevalence papers – says the same about how these huge changes in percentages are in fact just modest weight gains.

    • Tracey Fox

      How interesting! I have struggled with weight all my life. I have gone from a size 16/18 to a size 10/12 without ever going below 65kilos. It is as if my body simply will not release any more weight. Also, I recently lost 5kilos over 4 months or so, without losing any fat percentage whatsoever! Again, it just will not go! At size 10/12 I am still 35% fat, and have only ever been 40% fat at my heaviest at 85 kilos. It feels mad!

      • Anoop

        Thanks Tracey!

        And that is the problem with looking at a few anecdotes of weight loss success and extrapolating to everyone. Nobody wants to hear about the grandiose tales of failure. The negative hits never get counted or talked about. People only hear about the tales of success. In medicine they say, “dead men never tell any tales” . And this is the major problem with anecdotes. In research, they count the negative hits too.

        And then everyone thinks how come she is not able to lose weight?? Must be a problem with her lack of willpower/ discipline.

  • Pure genetics? are you kidding me? Dangerous stuff for an author to promote…justifying the obesity epidemic in fat children by saying “don’t worry kids you’re only fat because your parents are and there’s nothing you can do about it!”

    • That’s not what I said. It’s not even close to what I said.

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  • I really like this article Lou. Whilst choice and diet are the ultimate deciding factor in a person’s weight there is definitely an argument for genetic determination. But I am still a strong believer in a wholesome, healthy diet and regular exercise – a simple but effective mantra to follow!

  • Great post. Even if genetics is a factor, you can still do something about it. Eat less!

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  • Christopher Carr

    Hey everyone,
    you guys all need to go to this site, LEARN SOMETHING LIFE CHANGING NOW!
    http://tinyurl.com/Know-Ur-ABS

  • Mel

    I think genetics has a great deal in your weight. But it’s also a choice. I’m definitely genetically overweight but i try to eat healthy and i exercise a lot. I just built a home gym with a treadmill, elliptical and lots of weights because i know it will be a life time challenge to stay thin.

  • Wow that picture is awful haha! But it really shows how much of an epidemic is going on right now and how society is helpless to fight it. Especially in America where the culture accepts obesity and is so common. Hope were can learn to change our ways soon…

  • Ryan Zielonka

    I love what you’ve been writing recently, Lou. Your latest article in the “Beckham” issue of Men’s Health was spectacular. Can’t wait to see more.

  • Big Kate

    For a different perspective can i suggest that you also read gary taubes book: good calories bad calories
    https://www.nytimes.com/2007/10/07/books/review/Kolata-t.html?scp=5&sq=gary%20taubes&st=cse

    if that’s too much hassle have a look at his articles from the new york times
    http://query.nytimes.com/search/sitesearch?query=gary+taubes&more=date_all

    personally I am following a ZC (zero carb)/Keto Max/Inuit type diet

    I have rarely felt hungry, and if I do so, I eat. Results: fat loss has been sustained, I have loads more energy, not sure how many calories I am eating but its about 1000 and frankly i could eat this for the rest of my life and feel fine about doing it

    for a simple explanation of what is happening consumption of carbohydrates over what is immediately needed leads to insulin production lead to deposition of triglycerides i.e. fat. No insulin allows other hormones to release triglycerides as they normally would for example at night, and thus my blood steam is filled with free fatty acids and glycogen from my digestion process and stored triglycerides.

    If you ingest carbohydrates and you are not capable of producing enough insulin then the excess glucose and fructose cause damage to the liver, eyes, extremities, heart. lungs etc

    To put it another way, I run on diesel but if I am given petrol i burn it immediately as its dangerously explosive, otherwise i try to convert the petrol into diesel for long term storage. If I cant store it, then its like to go bang and cause damage

  • There are a lot of causes to obesity, and I am certainly trying to minimize obesity on my own. I feel the main problem is all the processed foods that make the claim to being healthy. Truthfully though, if it doesn’t grow in the ground, or it isn’t killed by a spear, you probably shouldn’t eat it. Artificial sweeteners are a major contributor too, but I don’t really need to go there, lol, or this comment will be a mile long. Outside of processed foods, I feel that there is very little to do with Obesity as far as genetics go, or perhaps we don’t know enough about it. In my family, which is considerable in size from my grandparents to my nieces and nephews, I have more than 30 cousins, and there are a few physically fit people, some average, and some obese. A mixture of everything with every gender and age group, and I generally find the results come from poor dieting. I will also admit that I have done very little to experiment with the entire family, more or less just making observations.

  • Pinpress

    I just read NROLFL and finally have a name for my GENETIC condition– “non-responder.” Unless you are like this you have no idea how heart-breaking it is to work your ass off only to find that it’s still there. And you’re hungry. And bonking. You should watch this if you want to know where all this extra obesity comes from:

    http://uctv.tv/search-details.aspx?showID=16717

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