The Obesity Epidemic
10/07/2014 06:00AM ● Published by Robert Frey
By Thomas A. Borland, M.D.
Obesity has become an epidemic not only in this country, but all over the world. It is now calculated in a formula called BMI, taking weight and height and using it to come up with a number that indicates whether the patient is simply overweight (BMI>25), obese (BMI>30), all the way to super obesity (BMI>50). As obesity has increased, so has diabetes, hypertension, hyperlipidemia, cardiac disease, strokes, and cancer. The result has been an increase in mortality, meaning that future generations of Americans will have shorter lifespans than we enjoy today.
There have been many studies to explain this epidemic, but the true environmental, psychological, and genetic drivers that are making Americans and the world obese are not simple to explain. The recommendation that you just diet and exercise has a greater than ninety-five percent failure rate. The average diet will generally result in a five percent reduction in weight. Adding a weight loss drug adds only another five percent. Most people can expect to lose ten percent of their obese weight, and unfortunately for most, this weight loss will not be sustainable for longer than six months.
Recent research has discovered that obesity is driven up by more complicated processes and hormones. The end result is usually a regain of all the weight lost, plus a gentle increase in obesity. The average American can expect to gain a pound a year from age twenty to fifty. But since an individual’s resting metabolic rate decreases each year of life, there is no chance of losing weight as long as one eats the same amount as the previous year. The good news is that there’s more research focusing on the newly discovered hormones ghrelin and PYY that influence our hunger and on genes that have been discovered to control appetite. Someday there will be a drug that shuts down these defenders of the fat mass set point in each of us. But until that drug becomes available, more and more obese people are turning to weight loss surgery.