What is Obesity?

The disease of obesity is very complex. We know it is not a simple case of calories consumes versus calories burnt. This is far too simple. If this was the case then we would be able to treat all patients with diet and exercise. However most of my patients have tried this often multiple times. One of the frustrating things that patients that tell me is that they go on diets but then when they stop the weight goes back on, often with extra weight.  All this means that there is more to obesity than just diet.

I am a firm believer in obesity being a disease that is driven by gut hormones.  Probably ones that are closely related to insulin or insulin related peptides. These hormones are produced in all of us and regulate appetite, fullness and weight gain. There are large amounts of these hormones produced by the gastro intestinal tract. These are produced to a number of stimuli including food hitting the stomach and food hitting various parts of the gut including the small bowel. When people produce higher quantities of these hormones the body responds by hunger, increased need for food and ultimately weight gain. To disrupt these hormonal signals surgery is sometimes the only way to help. Ultimately a drug that blocks some of these hormones may be developed but we must remember we don’t entirely understand what these hormones are or where they work so a drug will not be easy to develop and may be many years away.

It is these hormones that push people towards eating the wrong foods, primarily foods high in carbohydrates. Carbohydrates are a necessary part of our diet and include sugars and starches. These are important for energy production however if we eat too much the excess is converted to fat.  One of the things that most people I speak to snack on or binge on, is foods high in carbohydrates. These carbohydrates are then converted to fat and the cycle of obesity begins.  It is this addiction to carbohydrate that I believe is the primary cause of obesity in our society.

Although I believe that most people who are obese can’t entirely control their disease, there are ways to help with maintaining a healthy weight. I don’t believe that anybody should not have a regular exercise routine or a healthy diet, but it is soul destroying when you do all the right things and nothing much happens with your weight or health. It is even more soul destroying when your weight increases after a strict diet or exercise programme ends.

So knowing that obesity is a disease we can now understand why it is so hard for some people to lose weight and maintain a healthy weight. Surgery is not an easy thing to accept if you are obese but sometimes it is the only option for sustained weight loss and health benefits.