THE C AUSES
by Ted Kyle, RPh
OF OBESITY
, MBA
T
he eternal question about obesity seems to be: what causes it? It’s an important question. Without understanding the roots of a problem, the odds of solving it are pretty small. But this question doesn’t have a single, simple answer. That’s because it’s really a bunch of questions rolled up into one. So let’s break that question down into smaller questions that have more satisfying answers. WHY DO WE HAVE SO MUCH MORE OBESITY THAN WE HAD IN 1980? The short answer to this question is that many things have changed in the world around us that combine to make everybody gain weight. Some people think sugar is the villain – especially in sugary sodas. That’s probably part of it. Some people say it’s all about days spent sitting in front of our glowing rectangles. That’s part of it. But the truth is those are just a few possibilities from a long list of suspects. The Obesity Society tells us that many factors are contributing to the prevalence of obesity. Their infographic (right) gives you a glimpse of some of those factors. If you dig deeper you can find even more. These factors are simply suspects. Any one of them may play a small role. Some of them may play a large role. Definitive proof is lacking to distinguish one from the other. Much remains to be learned. And anyone who tells you that it’s a simple matter of diet and physical activity just doesn’t understand the science of obesity.
“
“
t role in determining ges lar the y pla es gen t tha is line tom bot the t Bu how much fat an individual’s body stores.
WHY DOES THIS PERSON HAVE OBESITY? The short answer to that question is that the main reason is in his genes. The stock answer – because he made bad choices or lives a bad lifestyle – is simply wrong. Plenty of people make bad choices or live a bad lifestyle and never develop obesity. Plenty of people are very careful about their lifestyle choices and yet cannot shake their obesity. Overwhelmingly, a person’s individual risk of obesity is inherited. A 2008 study and commentary found “heritability estimated at 77 percent and a total (i.e., shared and nonshared) environmental effect of <25 percent.” Estimates of the overall heritability of obesity vary – some as low as 50 percent. Some range much higher. But the bottom line is that genes play the largest role in determining how much fat an individual’s body stores.
WHY IS IT SO HARD TO OVERCOME OBESITY? The short answer to this question is that obesity is more than just one single disease. Back in 1971, the American government declared war on cancer and set out to find a cure. Tremendous progress means we’ve come to understand that cancer is a collection of many diseases divided into many different subtypes. Some are curable, some are manageable and some are really hard to deal with. The smartest scientists working on obesity are learning that the same thing is true for obesity. Opening the Blackburn Course in Obesity Medicine in Boston this year, Doctor Lee Kaplan presented a compelling
rationale for moving past thinking that one size fits all in obesity prevention, diagnosis, or treatment. Kaplan started with a simple definition of obesity – excessive fat accumulation that presents a risk to health – and presented an expansive overview of the wide variety of ways that an unhealthy fat mass can become the set point for different individuals. To make his point, Kaplan listed 57 potential varieties of obesity (pictured above) and then explored distinguishing characteristics of some of them. Different pathologies mean that different people respond to different therapies very differently. In bariatric surgery, for example, the average response might be losing about 30 percent of body weight in a given population. But some patients will lose as much as half of their initial body weight. A few will lose very little and eventually regain it. For every obesity treatment, we see a wide variety of responses. Medical nutrition therapy can bring dramatic responses in some people, alongside minimal responses in other people who initially seem very similar. A drug like liraglutide, which typically causes a loss of 5-10 percent of body weight, produces a loss of up to 30 percent in a few outliers.
The reasons for this diversity are only partially understood. Genetics, epigenetics, environmental factors, and behavioral factors all play a role. The one thing that is clear is that thinking one-size-fits-all in obesity is simply wrong.
CONCLUSION
No one treatment works for everyone. No one prevention strategy will be adequate to prevent obesity in the next generation. Dogged pursuit of understanding the complexity of this disease is the key. It’s key for developing targeted strategies that will actually work for preventing obesity’s diverse causes. It’s key for developing targeted treatments to relieve the suffering obesity causes in so many forms. About the Author: Ted Kyle, RPh, MBA, is a pharmacist and health marketing expert and is also Immediate-Past Chairman of the OAC National Board of Directors
Membership Application Why Join the OAC?
The OAC is a more than 52,000 member-strong 501(c)(3) National non-profit organization dedicated to giving a voice to the individual affected by the disease of obesity and helping individuals along their journey toward better health through education, advocacy and support. Our core focuses are to raise awareness and improve access to the prevention and treatment of obesity, provide evidence-based education on obesity and its treatments, fight to eliminate weight bias and discrimination, elevate the conversation of weight and its impact on health and offer a community of support for the individual affected.
1. OAC Membership Categories (select one) Individual Membership:
$10/year
Institutional Membership:
$500/year
Chairman’s Council Membership:
$1000+/year
Are you joining for the first time, or are you renewing your OAC Membership? I am joining for the first time (never been an OAC member).
The OAC is the ONLY non-profit organization whose sole focus is helping those affected by obesity. The OAC is a great place to turn if you are looking for a way to get involved and give back to the cause of obesity.
I am renewing my membership (have joined the OAC in the past).
Donation Add-on Add-on Donation: Make a General Donation Make a tax-deductible donation to the OAC when joining as a member. Your donation helps the OAC’s educational and advocacy efforts.
3.
$5
$50
$10
$100
$25
Other
Why YOU Should Become an OAC Member Quite simply, because the voice of those affected needs to be built! The OAC not only provides valuable public education on obesity, but we also conduct a variety of advocacy efforts. With advocacy, our voice must be strong. And, membership is what gives the OAC its strong voice.
Membership/Donation Add-on Totals: Membership Fee:
+$
Donation Add-on (optional):
+$
TOTAL PAYMENT: $
Payment Information Check (payable to the OAC) for $________. Credit card for my TOTAL, including add-ons, of $ . Credit Card Number:
Discover® MasterCard®
Expiration Date:
Visa® Amex®
Billing Zip Code:
Contact Information
CV Code:
Name: Address: City:
State:
Zip:
Phone:
Email: JOIN ONLINE! To join the OAC online, please visit www.ObesityAction.org and click on the “Get Involved” tab.
Mail: OAC
4511 North Himes Ave. Ste. 250 Tampa, FL 33614
Fax: (813) 873-7838 MagMembership-Fall2016
MEMBERSHIP BENEFITS
2.
BUILDING A COALITION OF THOSE AFFECTED
BENEFITS TO INDIVIDUAL MEMBERSHIP •
Official welcome letter and membership card
•
Annual subscription to the OAC’s publication, Your Weight MattersSM Magazine
•
Subscriptions to the OAC Members Make a Difference and Obesity Action Alert monthly e-newsletters
•
“Bias Buster” Alerts, alterting specifically to issues of weight bias
•
Immediate Advocacy Alerts on urgent advocacy issues and access to the OAC’s expert advocacy team
•
Ability to lend your voice to the cause