Image: Illustration by Bryan Christie
In Brief
- Modern epidemic: For millennia, not getting enough food was a widespread problem. Nowadays obesity is a global burden that affects one third of Americans. Another third are overweight.
- Obesity is complex: Researchers have developed key insights into its metabolic, genetic and neurological causes. But this work has not amounted to a solution to the public health crisis.
- Behavior focus: Using techniques that have proved effective in treating autism, stuttering and alcoholism may be the most valuable for either losing weight or preventing weight gain.
- Next steps: Behavior studies show that recording calories, exercise and weight; adopting modest goals; and joining a support group increase the chances of success.
More In This Article
Obesity is a national health crisis—that much we know. If current trends continue, it will soon surpass smoking in the U.S. as the biggest single factor in early death, reduced quality of life and added health care costs. A third of adults in the U.S. are obese, according to the Centers for Disease Control and Prevention, and another third are overweight, with Americans getting fatter every year. Obesity is responsible for more than 160,000 “excess” deaths a year, according to a study in the Journal of the American Medical Association. The average obese person costs society more than $7,000 a year in lost productivity and added medical treatment, say researchers at George Washington University. Lifetime added medical costs alone for a person 70 pounds or more overweight amount to as much as $30,000, depending on race and gender.
All this lends urgency to the question: Why are extra pounds so difficult to shed and keep off? It doesn’t seem as though it should be so hard. The basic formula for weight loss is simple and widely known: consume fewer calories than you expend. And yet if it really were easy, obesity would not be the nation’s number-one lifestyle-related health concern. For a species that evolved to consume energy-dense foods in an environment where famine was a constant threat, losing weight and staying trimmer in a modern world of plenty fueled by marketing messages and cheap empty calories is, in fact, terrifically difficult. Almost everybody who tries to diet seems to fail in the long run—a review in 2007 by the American Psychological Association of 31 diet studies found that as many as two thirds of dieters end up two years later weighing more than they did before their diet.
This article was originally published with the title How to Fix the Obesity Crisis.
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64 Comments
Add CommentOh, God. I hate knowing this.
Reply | Report Abuse | Link to thisMaybe you guys should give me more confidence to help me diet.
As someone who has dieted many times, for me, a major contributing factor is finding affordable "good for you" foods in the grocery store. Limit dairy and take corn syrup and excess sugar out and you are basically left with 1/2 the outer perimeter of the store: meat, a portion of breads, and produce. Go organic and you are left with the most expensive of the remaining choices.
Reply | Report Abuse | Link to thisI have quit diets due to the cost. I have also found local farmers markets to be more expensive than the grocer. As long as it costs more and is inconvenient to eat right, people will be overweight and obese.
Most of the "scientific" literature on this subject is completely unhelpful. For some reason, the medical profession has allowed themselves to fall into belief that is almost religious in nature in some principles that just aren't true. It should be obvious from the increase in the problem despite how hard people work at it. I love the quote from Gary Taubes something to the effect that a fat person can be assumed to be someone for whom eating less didn't work.
Reply | Report Abuse | Link to thisIf you are really interested in solving this for yourself, read his new book Why We Get Fat. And good luck!
In my opinion, from watching numerous television programs about people trying to lose weight--we seemed to have failed in educating the public on matters of nutrition and food labeling. One person after another always seems so shocked to learn how many calories are in their favorite snack(s). I find it difficult to believe that one person could eat the same packaged food item for years, perhaps every day and never once have looked at the label or wondered what the heck sodium silicoaluminate is just out of curiosity!
Reply | Report Abuse | Link to thisFurther, parents are being led astray by advertisers. Being made to believe that children don't like vegetables or whatever a healthy family might consume for dinner. We should give them something yummy out of a box or can instead. Feel good about giving our kids a slice of plastic process cheese--there's a cup of milk in every package.
Back in the day--toddlers were weaned off the bottle and introduced to the food that the rest of the family was eating for meals--real food back then..We didn't go off and cook them a separate meal of chicken nuggets and fries.
We all need to get back to basics. Our lives are busier than ever so it's easy for us to be sold the idea that convenience food is better and quicker than anything we could realistically cook in the 15 minutes we have to spare at dinner time. It's a heap of hooey.
In both Canada and the US, there are so many politicians or higher powers in positions that clearly represent a conflict of interest. People/families connected to food giants like McCain etc...sitting in/on health/food/inspection positions/policies.
It's almost impossible to know what is good for us anymore and no wonder so many people are consuming countless calories.
meatman--I find your comment very interesting. I refuse to eat anything out of a package and often wonder how people can actually afford to eat the "convenience" foods? A box of a dinner type item may cost $10 or more plus whatever else one might serve with it. For $10, I can feed my family of 3 with a pretty generous meat portion and freshly steamed/stir fried veggies etc, rice--(we're rice people) but potatoes are also economical. Honestly, I think that I would double my grocery bill if we were to eat mostly convenience/pre-packaged foods!
Reply | Report Abuse | Link to this"The basic formula for weight loss is simple and widely known: consume fewer calories than you expend."
Reply | Report Abuse | Link to thisCan it be any simpler than that? No matter what happens, don't put too much food in your mouth.
That being said, I wish I could lose 10 pounds. That's all I have to lose. By American standards, I'm already lean and when I tell people I need to lose 8-10 pounds they look at me like I'm nuts. I'm athletic, and when you're over 50, every pound you feel every pound you drag around the tennis court, especially sprinting to the net. I can take the weight off, but I get fatigued, have headaches and start craving food. What is the scientific cure for that?
Agreed. My wife and I concentrate on "perimeter shopping" first and then move into the packaged foods for "goodies" (those rare items we allow ourselves and daughter to eat). The cost of purchasing and making your own food is so much less than what you'd pay if you went packaged. And, meatman, don't bother with the organic. It doesn't buy you anything except for higher costs that actually do more harm to the environment.
Reply | Report Abuse | Link to thisAnother issue: time. For some people, making food at home might not be an option. As most Americans are only one paycut away from true serfdom, they're doing everything they can to keep their jobs, including working more and more hours. Who has time to cook? It's one of the side effects of greed-a-listic, sorry, capitalistic society. Most suffer so a few can reap all of the rewards.
The mysterious self-destructive psychology of dieting is precisely why I refuse to "diet." Rather, I put in my mouth what is absolutely required to survive and have a healthy body.
Reply | Report Abuse | Link to thisI consider fast food like cyanide, and refuse to even eat a bite of it. Often, I will have a nutritious organic salad for lunch and skip dinner; and I drink a gallon of bottled water PER DAY (that I fully researched to know it is not filtered tap water but actually from the source and meets strict guidelines for purity). In fact, by drinking water throughout the day and night, I cleanse my body of impurities and accelerated my weight loss, losing almost EIGHT INCHES in my waist in the last two years!
Fast food and junk food is slowing poisoning the body, robbing years of life, stealing quality of life in retirement, making one appear prematurely aged, and making one look just plain ugly. Fast food execs are getting FILTHY RICH off the complete lack of discipline and addiction to junk foods by the majority of people living across the globe. Every dollar spent on junk foods is a dollar that goes toward a life of luxury for some fast food exec who is laughing all the way to the bank at YOUR EXPENSE.
This is not rocket science, people, wake up and pay attention to this article! You are being used and discarded by greedy people who are manipulating your human biology to simply remain rich. If everyone stops buying unnutritious foods, 98% of all products in the grocery store will go bad, and trillions of dollars in food industry sales will go up in smoke. Isn't that economic cataclism far preferable to dying from these killer chemicals that "food" corporations have the audacity to call "foods"?
I am a male, 5'9" tall and weigh 145 pounds. Several years ago I ballooned to 165, but I solved that: I ate less. Problem over. (And when I was 165 I could tell that my body was working harder to move those excess pounds.) I still eat potato chips and drink a couple of beers a week. Seldom drink soft drinks. Works for me.
Reply | Report Abuse | Link to this...by building a house, you start from the basement, NOT from the roof!
Reply | Report Abuse | Link to thisDieting… is like building a house starting from the roof!
As former obesity scientist, I have to admit that Science helps building houses from the roof! In other words, Science ‘feeds’ confusion and insecurity. Take as example, the Low Carb-Low Fat debate! (see book (Eating healthy and dying obese') with a chapter, which reads: SCIENCE ‘FEEDS’ CONFUSION…
Indeed, the body needs CARBS (50-60% of the daily caloric intake), as it needs FATS (25-35% of the daily caloric intake)! The main problem is to know, FIRST OF ALL, the TOTAL DAILY PERSONAL ENERGY (CALORIC) EXPENDITURE (TDPEE): which represents the OWN 100%! As well known, the TDPEE differs from person to person... and not only because of the lack of physical activity, but simply, because of the different BASALMETABOLIC RATE (BMR)! And it is the BRM, finally, which determines how many calories an person burns at rest or by any physical activity! Thus the metabolic rate corresponds to the engine capacity (cc.) of a car...the higher the cc....the more gasoline is needed!!
Thus BMR=CC.!!!
UNFURTUNATELY nearly 100% of the people DON'T know their own REAL BMR, but,if any, an approximate value, which is a calculated value! So a person can eat 2000 kcal a day and remain slim, whereas a second one, by eating the same amount of calories. will gain weight!!
The book mentioned earlier on shows:
how to measure the own BMR,
why dieting you regain weight by eating less calories than the value of your BRM,
how to lose weight eating fast food
why you can gain weight ‘eating healthy’,
…and more
Read also a comment posted in Super Size Me homepage of Morgan Spurlock (see link below) http://super-size-me.morganspurlock.com/forum/posts/id_74/Eating-healthy-and-dying-obese/
Enjoy your meal!
Leoluca Criscione, Switzerland
It is not surprising that posting calorie counts on restaurant menus has not resulted in a change in consumer food-buying habits. Impersonal information of this sort rarely changes behavior. But understanding and addressing what actually motivates people might.
Reply | Report Abuse | Link to thisAt the Institute of Medicine’s Summit on Integrative Medicine and the Health of the Public, Don Berwick talked about what people actually want from their health care. (http://www.imsummitwebcast.org/) He said that deep down, people don’t actually want “good health care” or even “health” itself, notions that are vague and impersonal. What people really want is to be able to engage in the things that make life meaningful to them. A skier wants to ski and enjoy the great outdoors on the mountainside. A runner wants to be able to run well and experience the joy therein. A mother wants to be able to care for her kids and live in the love of those relationships.
A change in health-related behaviors will happen when people make the connection between their health and their life, between their health and their own personal goals and desires.
While a single restaurant menu can’t establish this kind of personal connection with each and every diner, we could move in that direction. We could relate food to activity.
So a better return on investment might be to list what duration of activity it would take to burn the calories off in any given menu choice. I think people would more readily relate to the idea of climbing stairs or walking than they would to an abstract caloric number.
The other day I saw an ad that had just such an image about exercise. It showed a pint of ice cream with the middle of it cut out and in that hole was a flight of steps going through the pint up to the sky. It said, " One pint means climbing 2500 steps." I immediately understood the implications.
I think using these types of strategies will more easily motivate people to make better choices and become healthier.
Christopher McDougalls' book,"Born to Run", points out that human beings evolved as the planet's only 'persistent hunter' that can run any four footed animal into heat exhaustion. Sweat glands and achilles tendons to return energy each step testify to this. realage.com reports elderly runners are 40% less likely to die of age related causes. Everyone has no time not to exercise. It's the only real health care plan available. Also, running reduces the appetite on a continuing basis. I lost 80 pounds this way, will lose another 20 this season.
Reply | Report Abuse | Link to thisI always viewed successful weight maintenance (which may begin with losing weight) as a synergy between quality nutrition and cutting calories. This couch potato generation is on board with the trillion dollar food industry in opposing me there.
Reply | Report Abuse | Link to thisHowever, given a choice, quality food must trump empty processed food every time -- even if the latter has less calories. Health, quality of life and longevity is driven by what we use to fuel our bodies. Ruining the economy by refusing to buy food stuffs that account for an amount perhaps greater than our national deficit is no patriotic excuse unless one is committed to dying a "patriot" on their couch with a bag of chips watching Oprah.
I often think of a crude remark by someone; they said that at least poor people in Bangladesh have the most effective weight-loss program of any country. To this ignorant remark, I asked: "Surely distended stomachs are a sign this so-called 'weight loss' program is nutritionally inadequate somehow?" to which I got silence. Indeed, silence is golden.
Merely starving oneself cannot achieve the desired results. And eating a steady diet of low calorie junk food is, well, nutritionally close to the equivalent to starving oneself except that some on fast food diets have that bloated look as an added benefit. Carrying weight in the belly and face is all the rage if the arms and legs are skinny (indicating one is "in shape" by McDonald's standards). Anyone who understands the value of good nutrition found in quality foods (such as fish rich in Omega 3's caught wild and sustainably in Alaska Bay which I happen to love) on a healthy immune system knows this can't be good.
Want to stop the obesity crisis? Stop eating crap..Drop the fructose/glucose garbage. Stop believing that fruit juice is healthy. Stop thinking that eating all sorts of grains are good for you when they are refined to death and thus high glycemic loading on the body. No fibre in your diet means rapid intake of carbs and sugars equals Diabeter Type II down the road. All this nonsense about saturated fats? A load. No one has been able to show ANY scientific evidence of a link between naturally occuring fats and heart disease..none. Trans fats? Ban them as a toxin which they are. There IS evidence of their deleterious affects on cardiac health. Carbohydrates..indeed...a correlation with heart disease, high triglycerides, high ldl cholesterol, Diabetes Type II. So? What is the answer to the obesity Crisis...Well, it is answered right here. Eat fruits, vegetables and lots of both. Don't drink fruit juices. Don't eat a lot of bread. Do eat a lot of fibre from many sources. Eat meat and don't go crazy about eating only lean or fat free foods..it makes foods unsatisfying and thus you end up eating junk to make up for it. Eat fish and chicken and beef and pork and lamb and green things and fruits, take your D vitamins..and enjoy your life. You will lose weight...I ought to know. I eat all these things and lost 27 kg and kept it off. Easy to be in control but not by starving oneself but by switching to liver healthy foods ( in other words..low carbohydrate ) Try it out...what do you have to lose? By the way.. for those that are Diabetic Type II...the diets that you are likely on will not make you better but a low carb and high fat and meat and vegetable will keep your blood glucose in control...check it out at Dr. Briffa.com and see what I have learned from him.
Reply | Report Abuse | Link to thisIt's been proven over & over that weight is based on calories in, calories burned. Burning 100 calories less a day will put on 10 lbs in a year. Why haven't scientists, instead of focusing on food, examined the effects of the ongoing mechanization of every day activities as a major contributor to obesity? Pick whatever activity you want -- from leaf blowers & snow blowers to automatic tail gate lifts. The energy expenditure from every day living have diminished progressively over the last 20 yers. A mere 1/2 hour a day of sweat-pouring heart beating exercise will offset even modest overeating. But, instead, people delude themselves with leisurely strolls with the dog & lacksadaisical bike rides. Medicine & science should focus on ways to increase routine daily energy expenditures (e.g. experiment with wearing weight jackets or whatever) and investigating the neuroscience of learning to love heart-beating, sweat-drenching activity. If individual dieting, being lectured & nagged on food were going to work to curb the obesity epidemic, it would have already done so. It's time for some new thinking on the topic. Time for some new thinking on the topic of weight control in modern society.
Reply | Report Abuse | Link to thisAnd -- out of curiosity - has anyone studied the correlation between the mass introduction of genetically modified foods and the increase in obesity?
What makes weight loss difficult. Hmmmmm. Let me think. Oh yeah, it's *hunger*. Hunger is a very powerful signal, kinda like the feeling you get when you can't breath, maybe not quite that intense but you get the point. Weight loss is easy if you don't get hungry. The real root of the obesity evil is sugar (both complex and simple)and it's abundance. Low blood sugar levels make you hungry. Most obese people suffer from a metabolic disorder which is complex but basically the body has difficulty processing carbohydrates efficiently. I'm surprised pharmaceutical companies haven't come up with a drug to regulate leptin.
Reply | Report Abuse | Link to thisI forgot to mention insulin. Eat a lot of sugar, insulin secretion drives blood sugar down. People with metabolic disorders suffer when too much insulin is secreted driving blood sugar too low making them hungry. Yeah, this is a simplistic explanation. Diet and exercise is the best medicine though. I agree.
Reply | Report Abuse | Link to thisDieting is not about how many calories you consume to how many you burn, but more importantly the quality of food that you eat. Dieting is nothing more than a sales term. Living a healthy life style is what we in American need to learn how to do.
Reply | Report Abuse | Link to thisThe health and fitness industry should be blamed more than anymore for this pandemic. We cannot rely on the government of our politicians. They are to caught up in how to "manage" cost, rather than reducing the cost. Reducing cost will take hard work, but it will only come with a change in the American Lifestyle.
www.athleticfx.net
www.renegadetraining.com
Make basic changes. For instance, just stop eating anything fried or sauteed. And together with that, get into exercise. Lots of exercise. Bicycling is one of the best. But surfing is probably the most fun for a big guy. I've seen these big Samoans surfing on longboards and having a ball. The thing about surfing is that a person can do it all day long.
Reply | Report Abuse | Link to thisHiking is good, but if a person is seriously overweight it can be very hard on the knees. That's why I'm a big advocate of bicycling for big people. It's lots of work, and you can do it for the hours you need to.
I don't know you, so I don't know how big your problem is. But here's a fun fact. If you are one of those people who just love to eat, get hungry all the time, and put on weight easily, there IS an upside.
Reply | Report Abuse | Link to thisThe good part of that is that you are probably high ghrelin. Ghrelin is the hormone that regulates appetite. But it also makes a person gain strength and handle extreme physical exertion better. If you are high ghrelin, then if you put go for it, you will find you are able to handle physical punishment better than normal folks.
So try. It will work for you. It will take years, but it will happen.
I am a 52 year old who was until 18 months ago, at least, in the same position as you. I did, and still do, tonnes of exercise but couldn't get rid of the 'last' 4-5kgs.
Reply | Report Abuse | Link to thisIn my anecdotal opinion the two factors that changed this were firstly rigorous ("Stalinist") adherence to a diet free of processed food, added sugars and most fats (except things like a bit of olive oil/flaxseed - only achievable by eating an awful lot of vegetables and fruit. This resulted in sufficient weight loss - muscle as well as other tissue within 3 months or so. The second factor was a significant increase in resistance exercise e.g. free weights/other gym activities and a corresponding decrease in cardiovascular activities, particularly running. After another few months, I had the muscle back (in fact more) as I now weigh only a couple of kilos less than my starting point but my measurements e.g. waistline are what I've been striving for since adolescence. I have now been like this for almost a year
In fairness I must add that the decrease in running is not entirely of my choice as I have a slightly degenerative knee problem. However in its place I have added high intensity cycling - hillsprints/intervals.
A final note - this type of regimen is probably unsuitable for most people as it requires adherence to a strict exercise and dietary regime (relatively easy now) and a major change to the type of exercise I was doing. However I suspect for better or worse that you ay be similar in outlook/personality to me(?).
There a just a few basics which will not change. Why not apply them instead of debating them? I know it is easy to say when you are there. So thats tough. The alternative is to remain in your old patterns and face a lower quality and lengths of life. Thats fine too, if the rest are not burdened inappropriately by an individuals lifestyle. We do live in a free society and I am all for giving us choices. But we also get to live with the consequences.
Reply | Report Abuse | Link to thisThe basics:
1. Eat right works better than eat less. The latter comes with the former. The argument that it is too expensive is completely ridiculous. My cooked whole grain breakfast (1/2 cup of oats, barley, spelt, rye, quinoa, flax and sunflower seeds) bought at the Whole Foods Pharmacy Priced Grocery Store in bulk is less than 50 cents plus a few almonds. Have it with anything else you like, i.e. an egg. How much is a sack of lentils or wild rice and how far does it go in terms of supplying you with energy? How long does it take to get an apple in the grocery store an bite into it vs. waiting in line at MCD? Just cut the excuses or live with he fat. Sugar in the ned is worse than the fat. Some of the latters are perfectly OK. Refined sugar and starches never (that is a NEVER) are.
2. Move. How about selling your TV and cancel cable if you are short of cash and time. You would be surprised how much time there is for exercise. You are tired? Try light exercise gently pumping oxygen into the brain. Now you are truly thinking. What was the statistic of the average American spending time in front of a TV or other screen? Which goes especially for children with an alarming rate of obesity.
3. Markets work. I agree - nothing changes behavior as swiftly as monetary punishment. Why do smokers pay more for life insurance but obese participants in the pool do not. I thought this was all about statistics. Same goes for health insurance. If we know what the average costs are, why is it unfair to distribute them accordingly? Why do we have a tobacco tax but not a corn starch/syrup sugar transfat tax? Yes I understand politics, agriculture and lobbying - but in the end - again - are we free adults which have a say and a vote?
i just returned from a monthlong trip to the land down under. they smoke, drink non lite beer like water, eat butter, cheese and red meat and never heard of tofu. they arent much more active than we are, but when I returned to the US i was amayzed at how fat everyone is.
Reply | Report Abuse | Link to thisyet they have a longer life expectancy with a better quality of life and a lower rate of lung cancer.
well i can tell you the difference between the two countries. america... put down the genetically altered, processed food, throw away the stupid tofu burger, fake butter, fake cream, fake milk and everything "low fat", "low sugar" "diet". go back to eating real food.
once your body processes the real food then you will have enough energy to get out and do something.
move your asses, 1hour 3 days a week & eat clean mon-Thursday. no fried, processed, etc... junk = no. Take it ez on weekends. Live like this, live well.
Reply | Report Abuse | Link to thisOkay, summa theologica...
Reply | Report Abuse | Link to thisFirst, you weren't born with much of a governing mechanism for food. Your ancestors were lucky to get enough to eat and they were lucky if they were fat enough to have babies and survive famines.
Two, you were bred for efficiency. The "heros" were people who were able to thrive on the low quality diet available and still grow up smart and handsome and brave. Guess who everyone wanted to be like. Guess who they bred with. That's why we have so many good looking people now. They grow up fast and strong and then they top over into fat and soft.
Third, you aren't going to be able to control your weight until you understand what you need to do. Conventional theory doesn't help, it's not complete and some of it is wrong.
Fourth, how to do it: Eat bulky, low calorie diets. Eat more unsaturated fat than saturated fat.You can't just use monosaturated to replace the overstock of saturated fat in your cell walls that is causing insulin resistance. Use unsaturated. Eat some soybean oil to get your "essential fatty acids". Eat pork and chicken and fish more than you eat beef and lamb. Cut down on your meat and fat portions. Don't eat too much iron containing food. Be sure to eat magnesium containing food, magnesium is in chlorophil like iron is in hemoglobin. Use soup and vegetables to fill up but use fats and meat for flavors. Cheese and fruit juice are not virtuous foods, don't use a lot of them. Get some exercise. Running is for kids. Don't buy sodas, sweets and high calorie deserts on a consistant basis and don't stock them at home. Buy them when you are in restaurants. At home, eat plainly but eat large amounts of lower calorie, fiber filled food. Eat your fruits raw and whole or blendered. As you age, add psyllium to your diet. Don't buy psyllium with sand or sugar in it, buy the pure stuff. Take some vitamins and mineral supplements. Decide to be happy, remember that you are living better than the royalty of a hundred years ago. And keep on trucking because you are the descendants of thousands of years of the best mankind could produce.
Humans evolved to run ... run long distances ... run game to exhaustion to easily kill and eat. We also survived on fruit and berries in between kills of high protein and fat. We needed these high density calories to feed our growing brains. We save extra calories as fat to carry us through the times when finding food was tough.
Reply | Report Abuse | Link to thisWith farming, we no longer run. With industrial farming, we don't even walk.
Humans need 2000 to 2200 calories to live. We are very efficient so running a mile only burns an extra 100 calories. Look at a cookie as another mile that you have to burn. Donuts become DO-NOTs ... five or six miles for the short joy of a donut ... trade offs.
There is some sense of justice ... those who exercise and watch what they eat live longer, healthier, more active lives ... at least on average ... and those that don't ... well don't.
But living this life is a little harder and you do miss out on some GREAT meals ... just ask Oprah.
You won't be helped by anorexia, guy who gets headaches. Your body is telling you that you are going to far. Relax. Have a sandwich.
Reply | Report Abuse | Link to thisI have been a dieter for the past 30 years, starting in my late twenties. I weighed 240 LBs at my worst and diagnosed as pre-diabetic in 2003 (blood glucose at around 120). I am 5'8". I currently weigh 160lbs - i.e. normal, and my fasting blood glucose averages around 75 (i.e. very healthy). The solution was definitely not behavioral (ever seen a wild animal go to counselling), and did not include any signficant exercise which always made me feel hungry - i.e. was aways counterproductive. Never counted any calories. As Gary Taubes says very well in his "Why we Get Fat" book - the question is not that we get fat by eating too much it is that "we eat too much because we are getting fat". The issue is one of a fault with the mechanism that controls fat accumulation. Essentially once one learns to control their insulin levels then dieting becomes really quite easy with minimal behavioral effort. The current government sponsored advice, which is also implied by this article, has the cause and effect reversed and until mainstream nutritionists and the media understand that then the current metabolic epidemic will continue. Carbs seem to lie at the heart of the issue, and carbs are entirely optional (i.e. there are NO essential carbs). Once we eliminate the so-called common-sense guidelines that we must balance calories-in with calories-out and eat low fat high carb diets then we are doomed. Read Gary Taubes book - it really should be considered essential reading by anyone seriously interested in these issues.
Reply | Report Abuse | Link to thisCris
My lifestyle is grass fed meats, organ meats (liver, kidneys, heart), omega-3 eggs, and wild caught seafood. I use lard for cooking (not hydrogenated or partially). Would like to obtain grass fed chickens and eggs but these are almost impossible to obtain. Herbal teas and distilled water for drinking.
Reply | Report Abuse | Link to thisWhy has the scientific community and the public ignored the body transformations going on all around them? There are many tv shows this. The cure is HCG and it has been around for 30 years. There are no side effects and the the results are great. Athletes know all about it, doctors do, the FDA and the list goes on. It amazes me that the public and scientists seem to be in the dark ages.
Reply | Report Abuse | Link to thisI believe stress is a major factor with over eating. It also makes it difficult for the body to lose weight. When I reduced my stress levels and my cortisol I found I was less hungry. A happy body wants to be lean.
Reply | Report Abuse | Link to thisTry HCG, it has worked perfectly for those in-the-know during the last 30 years.
Reply | Report Abuse | Link to thisAsk your doctor about HCG, it will do the trick. No negative side effects and lasting results.
Reply | Report Abuse | Link to thisI just read this article in the print edition. I'm a little disappointed that it turned into an ad for Weight Watchers halfway through. I had to check the cover several times to make sure I wasn't reading Vanity Fair.
Reply | Report Abuse | Link to thisWow! Not a mention of all the research available in Gary Taubes' book, Good Calories, Bad Calories. (Seven years, 100 pages of end notes and references!) It is amazingly absurd to think that counting calories or increasing exercise will cause long term weight loss. Can anyone control daily diet to within 10 or even 100 calories per day? 100 excess calories per day results in almost ten pounds per year weight gain. As for exercise, read Taubes' new book, Why We Get Fat: And What to Do About It. Regarding exercise, he describes a 1989 study of sedentary subject who were trained to run a marathon over a period of 18 months. Weight loss? Men averaged 5 pounds, women averaged zero. A review of multiple trials of exercise to lose weight done by an Obesity Research Center in NY concluded "decreases, increases, and no changes ... have been observed."
Reply | Report Abuse | Link to thisI could not be more disappointed in this article. The "In Brief" concludes certain actions "increase the chances of success". What is left out is that the increase is trivial.
a wonderful cover illustration. wow we're gonna learn something new here................not! a huge waste of space in an otherwise interesting magazine. No new information on obesity or how to lose weight. why bother if you cannot write something we haven't already heard? Extremely disappointed.
Reply | Report Abuse | Link to thisHave nit read Gary Taubes book. But it sounds like Michel Montignac's book "How to eat yourself slim" If you do not want to read it: here is the summary (and it works): We eat to much sugar. Makes us into monster insulin pumps. For body to store fat you need insulin in blood stream. Complex carbohydrates and less carbs regulate insulin output to normal. Avoid all ingredients with high glycemic index. In the beginning do not mix carbs and proteins. Steak and salad --> coffee with cream. Shredded wheat --> coffee with skim milk.
Reply | Report Abuse | Link to thisStick with it for 6 months and you loose the hyper hunger. You loose the addiction to sugar. Your head also does not drop onto the table from a nap attack after an after lunch cookie (whole oatmeal of course).
This is not an ad for Atkins diet. You do that, you turn into a calcified Roman statue. Variety has always been a good choice. Nature provides 40.000 feel good enzymes, vitamins, minerals, etc. Eat all the colors nature has to offer and you will (on average) do very well. Get chart with Glycemic Index for foods (Cornflakes are a killer)
Too expensive? Dandelion leaves could be for you. Or: Think paying your own medical bills.
lol at these comments. Is it possible to discuss anything popular without product placement?
Reply | Report Abuse | Link to thisFully agree nfiertel ! Plus it is the diet not excercise that is the main driver. Excercise is good and it makes a body fit but it's the diet.
Reply | Report Abuse | Link to thisSee Staffan Lindberg MD, Lund Univ Sweden. But Scientific Amercan may nou risk stepping out of the mainstream.
My comment is an entire blog response. Thanks for getting us to think. http://hitgirl.wordpress.com/2011/01/23/the-obesity-epidemic/
Reply | Report Abuse | Link to thisMr. Freedman's disappointing article on obesity demonstrates a poor understanding of the clinical factors, the epidemiology and the basic science underlying the current causes of obesity. However, the most egregious issue is his attempt to redeploy the tired and behaviorist model fostered by support groups, e.g., weight watchers as the only effective intervention against a growing problem of obesity. Blithely ignoring ample evidence that these measures only work with those individuals who are willing to put up with the demands of severely regulating their eating patterns. Recent studies show that the results of posting nutritional information in fast food restaurants has not proven to be of significant value.
Reply | Report Abuse | Link to thisFreedman's attempt to exhume the mummified notion of Skinnerian conditioning is our last line of defense against this growing health menace reveals a painful unawareness of cognitive research-- his assessment of the values of fMRI and other brain studies is banal, misguided and way off the mark.
Obesity is a complex syndrome, fed in part by underlying biochemical, physiological and, of equal importance, cultural factors that Mr. Freedman has seen fit to ignore. Alas, Americans are not rats in a Skinner box who are willing to trade off greasy hamburgers for vegie pellets as an alternative to getting a shock for making the wrong food choices.
The lack of consensus in these comments just underscores the lack of knowledge we have regarding a viable treatment
Reply | Report Abuse | Link to thisDiet and exercise is still the way to lose weight. I lost 23 lbs. in 46 days. That's half a pound everyday. I maintained 2,000 cal. daily diet and burned 4,000 cal. by jogging, climbing stairs (12 floors) and weightlifting.
Reply | Report Abuse | Link to thisAt 9 cal./gm of fat, 2,000 cal. deficit burned 222 gm of fat or roughly half a pound weight loss a day. My body is now lean and hard. I'm now developing my abs to get a 6 pack.
If you consistently burn more cal. than your intake, you will eventually lose weight or else you will violate the 1st law of thermodynamics. If you did this and still didn't lose weight, you will surely win the Nobel prize in physics.
Dear Mr. Freedman, First, thank you for sharing your research with others.
Reply | Report Abuse | Link to thisI am surprised there is NO mention of Adrenal Gland issues like fatigue and over-activity. I imagine you are aware that Cortisol is a life sustaining stress hormone essential to the maintenance of homeostasis. If off balance it wreaks havoc on the Immune system and Metabolism including brain/memory function.
Moreover, this health issue goes easily undiagnosed for months sometimes years as mine did. No diet or exercise can fix this circumstance until it has been properly diagnosed and essentially resolved.
On another note:
In the last 10 years (starting age 35,) my way of losing weight and sustaining a size 6 was eating smaller portions every 3-4 hours. Unfortunately with hyperactive adrenals, I am now a size 12 and do not recognized my body. I am beating the odds though, watch and see! :O)
I am eager to spread the word b/c I know this health issue goes undiagnosed for many women and men and is a major underlying cause of so many other health issues including obesity. I hope you spread the word with me! Please feel free to respond/correspond and question as I would never wish this health problem on anyone!
Sincerely,
Janet
You are right on. I get the feeling that the author of the article has not read Gary Taubes.
Reply | Report Abuse | Link to thisSparcboy,
Reply | Report Abuse | Link to thisIf you are interested, try reading Gary Taubes' book "Good Calories, Bad Calories." Or his newer book "How we get fat" or whatever it is called. Try a low carb diet to lose the extra 10 lbs.
I nominate you to write an article for Scientific American. I'm assuming that you are including refined carbohydrates like flour and rice in with "sugars"?
Reply | Report Abuse | Link to thisStay on a 2,000 cal. daily diet, jog 1 hour everyday and do 1 hour weightlifting every two days. Do this consistently for 60 days. Weigh yourself everyday. I bet you would lose weight.
Reply | Report Abuse | Link to thisIts good to do something about obesity after the fact.
Reply | Report Abuse | Link to thisBut there is an article in the Feb 2 2011
Which deals with before the fact
" More Bone (and Less Fat) Through Exercise "
Basically vibrations direct stem cells to transform into bone rather than fat
" After a stem cell differentiates, of course, it can no longer be anything else: once a fat cell, always a fat cell; once a bone cell, etc. "
Kids these days are so protected, they aren't allowed to run around. Add computers, and its a disaster
That's a beautiful statement. My real weight loss began when I stated seeing myself as a cyclist. As much as I want to avoid health problems, I get a lot of motivation from seeing myself biking La Route Verte or Pacific Coast Highway!
Reply | Report Abuse | Link to this"Not rocket science..." is exactly correct. This article is genius. They key is motivation & emotion my friends: Eating and weight disorders / dieting disorders are probably the ultimate proof that Zajonc's "Thesis of Independence" is correct, i.e., emotion is independent from cognition ( I believe it's stronger than cognition). Combine this with Sylvan Tomkins' "Affect theory" and his Einsteinian point that affect is the primary motivator of human behavior, and the points in this article make more sense as to why the overweight/obesity epidemic is still increasing. Correct me if I'm wrong?
Reply | Report Abuse | Link to thisWonder if any of you have read the book Rethinking Thin by Gina Kolata. The premisses of Freedman are questioned in the book. All well documented: so is it true that deadrate and costs are actually true? If not; than the whole discussion about health isn't really the issue. I would say: let's get on the real issue so everybody can live healthy at every size. Sure than you talk about healthy foods and healthy living, but not with an eye of conflict but with a heartful felling with each other.
Reply | Report Abuse | Link to thisJust a technical comment on the BMI chart in this article: SciAm is a US-based publication, but this chart should also be published in standard SI metric units for your international readers. Perhaps SciAm could take on the mission of educating the US public on the international standards for measurements in science and technology. Thank you.
Reply | Report Abuse | Link to thisWhen I wanted to loose weight it was quite simple - eat less, exercise regularly (aerobic, not anaerobic) and, when you get uncomfortably hungry between meals, have a light low-calorie snack. And never eat until you are full. No fad diets or special menu required. Of course all this requires self-discipline and hard work. You can't loose weight without them. Its that easy. And NEVER make excuses for yourself, thats loser talk.
Reply | Report Abuse | Link to thisPithy and brilliant, Dr Jagadeesh!
Reply | Report Abuse | Link to thisRegarding "How to fix the obesity crisis." Any relevant discussion about the obesity epidemic should at least address Gary Taubes' conclusion in his book "Why We Get Fat": "The only thing we absolutely have to do if we want to get ..fat out of our fat tissue and burn it - is to lower our insulin levels and to secrete less insulin to begin with." Does the public know that we don't use the energy from consumed fat until our carbs are metabolized first? And that exessive carb intake causes hyperinsulinemia and insulin resistance, which decreases the opportunity to burn fat, causing more and more weight gain? If the public knew this, much of the population would begin to think differently about the 6-11 servings of carbs that the government recommends. If the public gains confidence and belief in the under-reported science in the popular media of obesity and fat regulation, and begins to eat fresh produce and meat instead of products, then we could sustain weight loss and begin to reduce obesity rates (not to mention reducing diabetes, heart disease and cancer). A discussion of behavioral changes without addressing the differences in fat and carb metabolism is peripheral to the issue at hand. Moreover, for the editor to hope for a "pharmaceutical answer" and suggest that this article offers the "best supported" "available solutions" shows, at least here, a lack of confidence in basic science and a lack of faith in humanity. We don't need a pill - we need good basic science, well communicated, and a return to our natural diet, the diet we shared before this epidemic began. If that proves unsustainable, then science can make advances in production, not pills or "behavior modification." Thanks.
Reply | Report Abuse | Link to thisAlso, another article in the Feb magazine, on page 22, "Does this collar make me look fat?" is highly relevant. It says that lab animals "followed the same diet and exercise regimens since 1982...(yet)...the animals' percentage weight gain per decade, as well as their odds of being obese...showed a strong upward tendency...(including) 33.6 percent" weight gain per decade for chimps. Doesn't this corroborate Gary Taubes' thesis that "caloric balance" (calories in, calories out) is bunk? The conclusion must be that there is a fat regulation problem in these animals. I'm sure they were fed mostly carbs, and it was probably cheap grains and high glycemic bananas, instead of Ceasar salads and ribeyes. And the speculations of some of those scientists shows how hypnotized by the "calories in calories out" mantra we all are - "endocrine-disrupting toxins in the water supply or pathogens affecting mammalian metabolism", or even "crowded conditions". Really? Have they heard of Occam's razor? Or insulin?
Reply | Report Abuse | Link to thisSorry, but I missed the explanation your metaphor about building upward from the basement versus downward from the roof. Is it in there somewhere? How about rewriting for clarity? I'm really not trying to be snarky - it looks as if you have some good information to share. But it's sort of tangled up in verbosity.
Reply | Report Abuse | Link to thisSorry, but I missed the explanation your metaphor about building upward from the basement versus downward from the roof. Is it in there somewhere? How about rewriting for clarity? I'm really not trying to be snarky - it looks as if you have some good information to share. But it's sort of tangled up in verbosity.
Reply | Report Abuse | Link to thisObesity is an outcome of very active fork and lazy limbs. The work culture and the fast food industry have made us forget our ancient wisdom and our food habits. One must remember that a food habit developed over the years in a particular region and race are replaced by a fast food culture and sedentary life style. We are responsible for our obesity paradox which reminds us that beware of what you eat, how long you sit and how long you neglect your health. Dr.Diet, Dr.Quiet and Dr.Merryman have been replaced by Dr.Eat, Dr.stress and Dr.Depression. There is no magical wand to reduce our visceral obesity. We need to change our eating habits and life style for the solution for obesity lies within. Let us not look for remedy elsewhere. sheriff
Reply | Report Abuse | Link to this"The basic formula for weight loss is simple and widely known: consume fewer calories than you expend."
Reply | Report Abuse | Link to thisThis is so wrongheaded and has been thoroughly debunked by Gary Taubes.
Humans aren't simple mechanical machines: a combustion engine is a useless comparison and faulty model of the human animal. It's not about "calories in, calories out"--if it were, diets would work.
It's about the KIND of calories that induce insulin response.
Until that is more widely recognized, Americans will continue to get fatter.
Going over back issues this occured to me. What impact might widely distributing the Graphic Science from SA's Oct/2010, Dying to Eat: a Graphical View of U.S. Obesity. If that graph was displayed as a poster, not just a brochure, in doctors exam or waiting rooms, classrooms and school cafaterias (McD's would be objecting on 1st. amendment grounds, of course). Might being confronted by such stark information bear on behavior? Any behavioral scientists looking into the impact creative graphic information plays vs. verbal or text delivery? We are a highly visual species. There is a reason that yellow and red, not blue and purple are McD's 'signature' colors. Like dogs hearing the conditioning bell, we too begin to drool when viewing a food commercial. In fact, banning those, as we did cigarette commercials, might help the American waist line.
Reply | Report Abuse | Link to thisGoing over back issues this occured to me. What impact might widely distributing the Graphic Science from SA's Oct/2010, Dying to Eat: a Graphical View of U.S. Obesity. If that graph was displayed as a poster, not just a brochure, in doctors exam or waiting rooms, classrooms and school cafaterias (McD's would be objecting on 1st. amendment grounds, of course). Might being confronted by such stark information bear on behavior? Any behavioral scientists looking into the impact creative graphic information plays vs. verbal or text delivery? We are a highly visual species. There is a reason that yellow and red, not blue and purple are McD's 'signature' colors. Like dogs hearing the conditioning bell, we too begin to drool when viewing a food commercial. In fact, banning those, as we did cigarette commercials, might help the American waist line.
Reply | Report Abuse | Link to thisSugar is not the problem.
Reply | Report Abuse | Link to thisJust eat less of everything you like, include heathy foods, and walk or do some sort of exercise that you enjoy..
Also, weight yourself everyday, so that you never need to lose more than a few pounds if you overeat.
Form better habits, works for life.