When the American Medical Association voted to recognize obesity as a disease in 2013, the largest professional group of doctors paved the way for the condition to finally be taken seriously.
At the time, and even now, much controversy surrounded the decision. But slowly the needle is moving, from the assumption that obesity is the fault of those who have it (they are lazy and have no willpower) to it being a chronic condition that puts health at risk and may need long-term medical management. Still, many people, including those in the fat acceptance movement, do not believe their bodies should be pathologized.
By now, the statistics are familiar: Around 42% of adult Americans are obese, according to the latest numbers from the U.S. Centers for Disease Control and Prevention, and another 31% are overweight. And the health conditions linked to obesity — high blood pressure, type 2 diabetes, high cholesterol, heart disease and stroke, to name a few — are well-documented.
But what exactly makes obesity a disease, and are all people who carry extra weight unhealthy?
“One of the important things we’ve learned is that obesity is a brain condition, for lack of a better term,” Giles Yeo, a world-renowned geneticist at the University of Cambridge and a pioneer in the field of obesity research, told CNN Chief Medical Correspondent Dr. Sanjay Gupta on the podcast Chasing Life recently.
“It is now clear — crystal clear, unequivocal — that (obesity) is a brain problem: It is a problem of our brain influencing the hunger,” Yeo said. “So, hunger is a brain scenario, even though the feeling of hunger comes from your stomach. And we now know that obesity is just your brain influencing what you eat and how you eat.”
While carrying extra pounds can lead to many inconveniences (such as arthritis and sleep apnea), Yeo said it alone won’t kill you. But it is dangerous to carry too much extra fat because once your fat cells fill up — Yeo calls them “professional fat-storing organs” — then the fat spills over into other parts of the body, such as internal organs and muscles, that are not designed to store fat. And that is when metabolic problems begin to take root, which can eventually lead to conditions such as cardiovascular disease.
However, not every person with extra weight is necessarily living with a disease, Yeo said.
“If you redefine the term obesity — I am maybe doing some verbal gymnastics here, but I think it is an important nuance — the moment we begin to understand that obesity is not high body weight, but (rather) obesity is a state where high body weight begins to influence your health, then it is a disease,” he said.
Genetics plays an important role regarding how much fat your fat cells can store, and it also affects how often and how strongly our brain sends out the hunger signal.
What can you do if nature has stacked the deck against you? Yeo has these five tips — which he calls “Yeo truths” in his first book, “Gene Eating: The Science of Obesity and the Truth about Dieting” — to help you eat sanely to lose weight.
Yeo truth No. 1: Losing weight ‘ain’t supposed to be easy’
Losing weight goes against our self-preservation mechanisms.
“Anyone that tells you that weight loss is easy is lying to you — trust me: lying to you,” Yeo said. “It ain’t easy because your brain makes it not easy. So, when you lose weight, your brain hates it and will try and get you to gain the weight back.”
Yeo said if you are having a hard time losing weight, “understand it’s not because you’re bad, it’s because ‘it ain’t supposed to be easy.’”
Yeo truth No. 2: Try moderation in eating
Cut back your food intake across the board — just a little.
“Eat a little bit less of everything,” Yeo said, adding that this kind of advice is not going to make him a rich man. “It’s otherwise called moderation, but it’s also true.”
He warns against trying to completely cut out often-vilified food groups, such as carbs or fat. “If you can drink dairy, then dairy is not poisonous for you,” he said. “Eat a little bit less of everything, if you … want to lose weight.”
Yeo truth No. 3: Slow-to-digest foods are your friend
Choose foods that stick to the ribs.
“Food that takes longer to digest makes you feel fuller,” Yeo said. “It’s true — you know it!”
One example is protein. “You don’t want to eat too much of it, but a higher protein diet does make you feel fuller,” he said. “Eating foods with fibre does tend to make you feel fuller as well.”
Yeo truth No. 4: Quality over calories
Consider the value of the entire food, not just one aspect of it.
“Don’t blindly count calories,” Yeo said. “Why? Because calories tell you about the amount of food; they do not tell you about the nutritional quality of the food. (The calorie count) doesn’t tell you how much protein, how much fibre, how much salt, how much micronutrients (are) in there.”
Yeo truth No. 5: Food is not the enemy
Whenever discussing diets, Yeo said, people talk needlessly about excluding so-called bad foods instead of understanding how they interact with food.
“Don’t fear food,” he said. “I think we do have to fix our food environment; I think some people need to eat less food. But if you fear food … you begin to think, ‘Oh, I need to cut this, I need to cut that out.’
“I think we need to eat a little bit less food. But I think we need to love our food.”
