Obesity: A rare consensus among scientists on what doesn’t explain why we’re fatter

THE NEW YORK TIMES – A select group of the world’s leading researchers who study the obesity met recently in the gilded halls of royal societythe Academy of Sciences of Isaac Newton and Charles Darwin, where ideas such as gravity and evolution have already been debated.

Now, scientists were discussing the causes of obesity. In the closing session, biologist John Speakman offered this conclusion on the matter: “There is no consensus on what the cause is.”

That’s not to say the researchers disagreed on everything. The three-day meeting was infused with an implicit understanding of what obesity is not: a personal flaw. No panelists argued that humans collectively lost willpower around the 1980s, when obesity rates took off, first in high-income countries, then in much of the rest of the world.

Not a single scientist has said that our genes have changed in such a short time. Laziness and gluttony were not mentioned as obesity factors. In contrast to the prevailing view of obesity, which assumes that people have complete control over their body size, they don’t blame individuals for their health condition, just as we don’t blame people who suffer from malnutrition problems.

Instead, the researchers referred to the obesity as a complex, chronic condition – and were coming together to understand why humans, collectively, have gained weight over the last half century. For this, they shared a number of mechanisms that may explain the global rise in obesity. And their theories, as diverse as they are, make one thing obvious: as long as we treat obesity as a matter of personal responsibility, its prevalence is unlikely to decline.

A nutritional biologist has come up with the idea that all the carbohydrates and fats in our diet today dilute the proteins our bodies need, causing us to eat more calories to compensate for the discrepancy. An endocrinologist spoke of the scientific model behind the low-carb diet approach, suggesting that high-carbohydrate eating patterns are fat-promoting. An evolutionary anthropologist has argued that many lean hunter-gatherer societies ate lots of carbohydrates, with a special fondness for honey🇧🇷

Other scientists have suggested that the problem is the ultra-processed foods, the prepared and packaged products that make up more than half of the calories Americans consume. A physiologist shared his randomized control study showing that people eat more calories and gain more weight on ultra-processed diets compared to whole-food diets with the same nutrient composition. But it’s still unclear why these foods drive people to eat more, he said.

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The mystery is perhaps explained by the thousands of toxins that ultra-processed foods can carry in the form of fertilizers, insecticides, plastics and additives, argued a biochemist. His research on cells has shown that these chemicals interfere with metabolism.

Still others have suggested that the problem may be less what we’re eating and more what we’re not. An animal behavior expert shared her work on the link between food insecurity and obesity in birds. When food becomes scarce, animals eat fewer calories but gain more weight. Human studies have also found a “robust” association between food insecurity and obesity, she said — the so-called obesity-hunger paradox.

By the end of the conference, attendees were no closer to a unifying theory for the global rise in obesity – a condition that has existed in humans since at least Hippocrates, but has begun to spread in times as recent as the launch of the MTV🇧🇷 However, in that short period, the scientists, including many in the room, learned a lot.

They identified over a thousand genes and variants that increase the risk of obesity. They found that body fat is much more than a storehouse of energy and that not all people with obesity develop its associated complications, which include cancer, type 2 diabetes, high blood pressure, heart attack, stroke and premature death.

Scientists have also made remarkable progress mapping how the brain orchestrates eating and adapts to different diets, changing food preferences in the process. But they didn’t agree on what exactly changed in recent history to affect these complex biological systems.

Since that meeting, I have been struck by the profound gap between the debates I have heard and the conversations about obesity in our culture. No scientist has addressed any of the supposed fixes that currently fill diet books and store shelves, with the exception of the carbohydrate debate.

There was no serious dialogue about procedures, applications of diet or intermittent fasting. No one has suggested that supplements could help people lose weight or that metabolism needs a boost. The only speaker who spoke about the gut microbiome argued that, so far, human obesity trials have been disappointing.

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In other words, there were no quick fixes or magic tricks in that London boardroom. And while there was excitement about the incredible advances in medicine in treating patients with obesity, effective drugs and surgery were not mentioned as definitive solutions to the public health crisis.

It's still not clear why these foods drive people to eat more.  The mystery is perhaps explained by the thousands of toxins that ultra-processed foods can carry.
It’s still not clear why these foods drive people to eat more. The mystery is perhaps explained by the thousands of toxins that ultra-processed foods can carry. Photograph: Reuters/Will Burgess

When I asked many of the researchers how they would deal with obesity, given the uncertainties, they pointed to policies that would alter or regulate our environment, such as banning junk food marketing to children, banning vending machines from schools and making neighborhoods more conducive. to walking trips.

They talked about changing the food system so that it also addresses the climate changes – a related crisis that once faced political inertia but is now gaining international momentum. But when it comes to obesity, governments are still accused of interventionism if they try to regulate the sector.

This is in part because, rather than viewing obesity as a societal challenge, individual choice bias dominates. This view is steeped in blame and misunderstanding – and it’s everywhere. People are simply told to exercise and eat more vegetables – the equivalent of fighting global warming by asking them to recycle more and fly less. Diet gurus and corporations spend billions on food and exercise fads that ultimately fail.

When people fail to control their body weight, they often blame themselves. I recently interviewed a man who, following a brain tumor, developed severe obesity—a common side effect for him. The tumor went undiagnosed for months as doctors told him to diet and exercise more. But even today, he told me, the tumor seemed “an excuse” for the old struggle with the scale, so he doesn’t talk about it with anyone.

Other people also mention shame. A recent column from Times of London argued that the fat shaming [zombar ou envergonhar pessoas obesas] is a good solution for obesityjust as Bill Maher went so far as to say that the body positivity movement — a “cheerful celebration of gluttony,” he said — harms people by condoning weight gain.

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Quite the contrary: researchers have repeatedly found that the fat shaming it hurts people and promotes weight gain. At least some of the negative health consequences of obesity are believed to be driven by stigma and discrimination, which results in poorer health care.

Until we see obesity as something that has been imposed on societies, not something that individuals choose, the fat shaming, the magic tricks and bad public policy will continue. Until we stop blaming ourselves and each other and start focusing attention on environments and systems, the global obesity rate will continue to rise – a trend that no country has substantially reversed, not even among children. 🇧🇷 TRANSLATION BY RENATO PRELORENTZOU

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