Myth # 1 Obesity results from lifestyle choices. Nearly half of Americans believe obesity, defined as a body mass index (BMI) of at least 30, is a reflection of poor exercise and diet choices, according to a 2018 survey by the ‘University of Chicago. In 2020, an international group of obesity medicine experts reported that many healthcare providers also view weight gain as a failure of personal responsibility, coupled with an inability to stick to a treatment plan. But the most recent research indicates that the causes of obesity are complex and cannot be explained by just the calories in and out based on diet and exercise. Calorie absorption, or energy derived from the food consumed, varies among individuals and is determined not only by portion size at mealtime, but also by factors such as gut microbes, hormones, enzymes digestive and nerve signals. When it comes to burning calories, the metabolism is a major player. And there’s growing evidence that genetics, sleep deprivation, medications, stress, and even the environment a person has been exposed to in utero can contribute to unhealthy weight gain. Myth # 2 Obesity is not a disease. The American Medical Association’s decision to classify obesity as a disease in 2013 went against the recommendations of its own Council on Science and Public Health. Board members did not believe obesity met the definition of a disease, believed this classification would have little impact on treatment, and feared that it would lead to decreased personal responsibility. The 2015 ACTION study, which examined barriers to obesity care, noted that health care providers do not routinely make formal diagnoses of obesity, suggesting that many do not view it as a problem. disease.
But obesity is a disease, according to the definition of the AMA, because it causes “an impairment of the normal functioning of certain aspects of the body”. Obese people have adiposopathy, or “diseased fat”, which contributes to abnormal responses of the glands and the immune system, leading to an increased risk of diabetes, high blood pressure, high cholesterol and fatty liver disease. This abnormal immune response is evident as covid-19 wreaks excessive havoc in obese people. Since obesity was recognized as a disease, treatment options have increased dramatically thanks to new drugs and improved guidelines. These treatments increase, but do not eliminate the need for changes in diet and physical activity. Additionally, insurance companies are slowly revising their policies to provide coverage for the management of obesity. Myth # 3 Diet and exercise will reverse severe obesity.
The 2019 Attitudes, Stigma and Knowledge Study, a survey of the general population in the United States, Britain, Australia and New Zealand, found that 80% of the population believed that A lifestyle intervention, including diet and exercise, was the cure for severe obesity. It also found that 52 percent of healthcare providers surveyed in 77 countries thought the same. The reality show “The Biggest Loser” is also based on this premise. But there is growing evidence that diet and exercise alone are generally ineffective in reducing and maintaining a lower BMI, especially for people with severe obesity, defined as a BMI of 40 or more. In fact, weight loss leads to increased hunger and slower metabolism, which can lead to weight gain. Most of the competitors on “The Biggest Loser” ended up regaining considerable weight. Medicines can supplement diet and exercise to help people with severe obesity improve their health. Another effective treatment is weight loss surgery, which also leads to metabolic changes in the body that significantly lower the risk of heart disease and diabetes. Myth # 4 It is simply “baby fat”.
As early childhood is a time of rapid growth and development, it is often assumed that young children who are obese do not remain so. As pediatricians, we often hear parents say that “it’s just baby fat” and their children will get too big to be overweight. Although childhood obesity does not always lead to obesity in adulthood, most children do not overcome their weight problem. According to a 2015 clinical pediatrics study, only about 17% of overweight or obese preschoolers return to normal weight by the time they enter college. Other studies show that childhood obesity is a major predictor of whether a person will become an obese adult. Compared to obesity in adulthood, the consequences of obesity that begins in childhood can be more serious because the child has had the disease for more years, resulting in more consequences. harmful to health. Myth # 5 I can be both fit and fat.
The cover of Cosmopolitan UK magazine recently featured women of varying sizes and a headline stating “It’s healthy!” A March article in Good Housekeeping quoted a writer as saying, “Your body is the size it’s supposed to be.” These messages aim to reduce shame in overweight people – a laudable goal. Some previous studies seemed to show that cardiovascular health lowers the risk of heart disease, even in obese people. But more recent research may reverse these findings. A study published in January in the European Journal of Preventive Cardiology found that while the risks of diabetes and hypertension decreased as physical activity increased, overweight and obese adults were at greater risk of heart disease than their peers. of normal weight, regardless of their activity level. Other recent studies have shown that although being fat and unfit was a risk factor for death, being in good shape did not reverse the increased risk of obesity. BMI was more important than physical activity in predicting negative health effects.