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Obesity Myth: Obesity Is Caused By Simply Eating Too Much And Not Moving Enough



sharma-obesity-caloric-balance1In the latest issue of Canadian Family Physician, my colleagues JP Chaput, Zach Ferraro,Denis Prud’homme and I briefly address common myths about obesity.

Here is what we had to say about the commonly held notion that obesity is just about eating too much and/or not moving enough:

“Unhealthy diet and physical inactivity are the “big 2” on which almost all preventive and therapeutic programs for obesity are focused, thereby neglecting other possible contributors to excess body weight. Although intuitively appealing, clear evidence (eg, individual-level epidemiologic data and randomized experiments) beyond ecological correlations is lacking for the big 2.

Many other putative contributors to the increase in obesity (eg, insufficient sleep, psychological stress, endocrine disruptors, medications, intrauterine and intergenerational effects, etc) have supportive evidence that is as compelling as, if not more compelling than, the evidence for the big 2.

These nontraditional or new determinants of obesity influence energy input and output; overeating and reduced energy expenditure are perceived as “symptoms” and not as the root causes of the excess weight.

On the treatment side, an accumulating body of evidence shows that insufficient sleep can impede weight loss and addressing sleep for weight management has recently been endorsed by the Canadian Obesity Network.

Overall, accumulating evidence suggests that health practitioners and clinicians might need to consider a broader range of influential factors (eg, medications, lack of time, psychological stress, fatigue, chronic pain) to adequately identify and address the key factors responsible for the patient’s obesity, which is likely a clinical sign of chronic caloric “retention” (similar to edema being a clinical sign of fluid “retention”). This will enable health practitioners and clinicians to develop a personalized framework that addresses the root causes of patients’ weight gain.

Physicians must move beyond the simplistic and generally ineffective recommendation to “eat less and move more” by investigating and addressing the determinants of increased energy intake, decreased metabolic rate, and reduced activity.”

@DrSharma
Edmonton, AB

6 Comments

  1. Yes! This. Having obesity for 40 years- was obese at age 6, now normal weight 2.75, I can say that I walked half marathons, walked for 1 hour a day, but without the right metabolic balance ( for me low carb higher fat for weight maintenance, supervised low calorie low fat for weight loss).

    Until I got to the point where I could get my whole metabolism and hormone system humming along, I would be spinning my proverbial wheels. Very frustrating. Thank you for helping spread the word. I walk now to relieve stress and keep my head in the right space and maintain good body mechanics, not to earn or work off regular or junk food. Life would be pretty “fun” if that were the case!

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  2. I love the term “chronic caloric retention.” It is simple, descriptive, and non-stigmatizing. Please use this phrase more, and the highly stigmatizing word “obesity” less.

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  3. Stop. Please just stop. Sometimes (a lot of the time) obesity most certainly is caused by too much food, too much of the wrong foods, and too little activity. For a decade, I blamed my 200+ pounds (I am a 5’4″ woman and I’m talking about the years I was 27-37 years old) on my metabolic syndrome/PCOS. My body wants to be fat. It’s a vicious circle. I can’t lose weight, blah blah blah. Then I took my PCOS seriously, learned a little bit about insulin resistance, switched from a diet of processed/convenience foods high in added sugar, chemicals, simple carbs, and six diet sodas a day to a diet of clean whole foods (eggs, chicken, fish, tons of veggies, a little fruit, a little dairy, a little nuts…no baked goods, no junk) and started drinking a gallon of water a day and exercising 30 minutes a day, NO EXCUSES. I lost 80 pounds in 8 months, normalized all my labs, and have maintained that loss for over 8 years. I am pushing 50 now and in the best shape of my life at a strong 132 lbs. MOST PEOPLE are overweight because of poor food choices and lack of activity and excuses made all the easier by ENABLING. A TINY percentage of people are overweight due to thyroid issues (and even then it should be 15-20 lbs…NOT 100 extra) or really crazy things like Prader-Willi. PLEASE stop saying people have no control over their weight. EVERY adult has control over his/her food choices and activity level.

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  4. Yes it’s true that people have control over choices about diet and exercise. But, I think Dr. Sharma is saying that there are more factors that influence weight than just diet and exercise. We should explore and treat the issues that are influencing weight.

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  5. Plain Jane, I am glad changing your eating and exercise worked for you. I eat clean & healthy and always have. I actually cook from scratch, mostly whole grains and veggies, with small amounts of lowfat meat and dairy , and always have. Through most of my adult life I have walked 2-5 miles a day. I am about 80 pounds overweight. I was about 20 pounds heavier, then began taking exenatide for diabetes and lost 20 pounds without changing anything else. Clearly for me there is more than simply diet and exercise.

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