Is Obesity a Disease?
Hi, I’m Dr. Craig Primack. Today, my job is to answer the question is obesity a disease?
When I first started treating weight, it wasn’t a common belief that obesity was a disease and the people who are not believers simply say, “Well, you should just eat less and move more to lose weight.” And my simple answer to that is number one, people who struggle with weight are trying to lose weight. The studies will say at least twice per year people are trying to, and they’re being ineffective. So if that recommendation worked, and that was the way to lose weight, I don’t believe in our city, in our country and our world would have the obesity problem we have today.
It all changed for me in 2011. Physicians like myself, we look to the new England Journal of Medicine as one of the places we get our information.In 2011, there was this study called the Sumithran study.
The Sumithran Study
The Sumithran study looked at weight loss or appetite hormones and what they did as we lost weight. So, number one, the two biggest hormones that we talk about are leptin and ghrelin. Leptin comes from the fat stores themselves and we want that to be high, that’s telling our body that we are full. We want ghrelin that comes from our stomach to be low. Leptin, high, = full, ghrelin low = not hungry. When we sit down in front of our food at the table, our ghrelin levels come up and about 20 minutes after a meal, our ghrelin levels come back down telling us that we’re not hungry any longer.
So what happened in this study? In this study people lost weight and their leptin levels came down, less full when they lost weight and their ghrelin levels went up for the whole time that their weight was below normal.This even lasted a year.
So pretend there’s a little person sitting on your shoulder. When our hunger goes up, he turns towards your ear and he says,
“Eat, eat, eat.”
And as you lose more weight and the hormones get stronger. It’s this little voice inside your head telling you to eat,..eat and we say, “Oh, I just can’t stick to the diet or that looks easier today to eat than it did in the beginning.” And that’s true, the hormones have changed our appetite.
We have tools though, fortunately, to help combat this. Some of them are dietary, some of them are medicines.
Keys to Weight Loss
So the easiest couple things to talk about, number one, we want to pick a diet that’s higher in protein and lower in carbohydrate. We want to keep adequate activity that makes us feel good, we want to get restorative sleep and we may want to use anti-obesity medications or weight loss medications.
You think of all of these, so the signals are still coming into our brain, but these help put, I call it the ear muffs on, so we can’t hear the signals that are saying eat all the time. Unfortunately, they’re still there, but we can’t hear them we don’t respond to them.
So next time someone says obesity is not a disease, tell them about the hunger hormones and that if the simple recommendation of eat less and move more really worked, we wouldn’t be where we are today.
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