A post about (shhhh….) obesity - a podcast by Donna Psiaki Feldman MS RDN

I have not written about obesity per se in a long time.  Not because it isn’t an issue anymore.  Far from it.  I just don’t see the point of harping on it as a thing.  It’s very negative.  People struggling with their weight don’t need to be reminded or badgered or blamed or made to feel guilty and ashamed.  They know.  Some take action, mostly by dieting.  Sometimes those diets work, frequently not.  Other people have stopped trying; some of them have taken the opposite tact — defiance and body positivity.  Accept me as I am.

The people running Weight Watchers noticed this trend and rebranded the company.  WW, as it’s now called, is focused on health and wellness, not numbers on the scale.  The meetings (optional) are about supportive communities of like-minded people, not about inducing guilt or policing what people are allowed to eat.

This is all fine, as there’s good evidence that focusing on health and fitness rather than a number on the scale is a much better strategy.  In fact, some diet styles by default end up helping people control their weight without calorie counting.  The Mediterranean diet, and other plant-based diets are most notable for this effect.  Many people who switch to vegan diets end up losing weight as bonus.  There’s something to be said for just eating healthy food, and not worrying about whether a potato has 90 or 110 calories.

Nevertheless, the obesity epidemic forges ahead, and is spreading around the world, as societies become more sedentary and rising incomes allow people to eat more food.  A large survey of over 3.6 million people in Britain found that people with BMI of 30 or more had their lives shortened by 4.2 years for men and 3.5 for women.  Cancer and heart disease were the main culprits.  Interestingly, the lowest risk for heart disease mortality was at a BMI of 25; for cancer it was 21.  So being at the higher end of the normal weight range isn’t a bad thing for your health.  By the way, this study simply looked at mortality, not at existing diseases and the impact of those on quality of life.  It also didn’t look at fitness.  That would be useful.  I suspect that, even if you’re slightly overweight, being more fit would be protective.  Just as being normal (or even low) weight, but sedentary and over-fat is definitely not healthy.

It’s My Genes

These days, plenty of people plagued by excess weight are quick to blame their genes, and give up doing anything at all about their diet, even so much as adopting healthier food choices.  It’s in my genes, why bother?  In fact, that’s not correct according to a recent review of the topic.  I was even surprised at the rather bleak picture painted about the lack of good information about genes and weight.  Only two genes have been linked to obesity:



* MC4R, which is specifically associated with morbid obesity

* FTO, which is more widespread



All the other dozens or hundreds of genetic possibilities have not panned out.  In fact, it’s become clear the link between genes and weight is vastly more complicated that just identifying a couple of genes that cause obesity.  Genes are turned on or off in response to environmental cues or to other genes.  For example, a variant of FTO seems to make people more responsive to images of tempting foods.  You would expect those people to struggle more with controlling food intake, and with their weight.  But one study showed that people with that FTO variant actually lose more...

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