Obesity – Why we are fat and what can we do about it!

Obesity is a modern disease. No ‘hunter-gatherer’ was obese, they wouldn’t be able to function in that society.  Now more than sixty per cent of the population are obese and the number is rising. Many chronic, metabolic conditions are becoming increasingly common and they are all associated with obesity. These include, but are not limited to, high blood pressure, diabetes, various cancers, heart disease as well as liver, gallbladder and kidney diseases.

We used to think, and it is still commonly touted that if someone is obese, they simply eat too much, that it is merely calories in and calories out. One might think that if calories in, equal calories expended, balance is achieved.  However the human body is dynamic and it is constantly adjusting. For example it adjusts the metabolism up, to burn more or down to burn less. So same calories, different response, some people will gain weight and others wont.

It seems the body has what is referred to as a ‘set weight’ or ‘set point’ and will do it’s best to maintain this weight.  Studies have been done with obese and non-obese people to try and get some to gain weight and others to loose weight.In the short term it proved challenging to change their weight as the body tries to maintain it’s ‘set weight’.  The hormone leptin plays an important role in appetite control and metabolism. It’s produced by the fat cells and it is produced in proportion to body’s fat mass.  Therefor the more the body fat the more leptin produced. Through the hypothalamus it regulates appetite and the rate at which the body will burn energy. Leptin regulates metabolism.   If the body is constantly ‘bathed’ in this hormone because there is too much fat, there is the danger the body becomes less sensitive to it and leptin resistance occurs. Now there is no turn off to appetite.  I like the analogy of playing music. Too much, too loud impairs hearing, so we turn the music up to hear better which causes more damage. Too much leptin means more produced, which means more food, more fat and more leptin. Leptin resistance occurs. 

A deficiency in leptin hormone can also lead to obesity. The signalling pathways can become disrupted to the hypothalamus and without leptin signally ‘enough food’ calorie intake is not regulated. There is a hypothesis that inflammation of the hypothalamus might cause dysfunctional signalling, and cause over eating resulting in a higher ‘set point’.

Similarly insulin when it is always in the bloodstream the body becomes less sensitive to it. Insulin is produced in the pancreas in response to how much glucose there is in the bloodstream. It has two main jobs, firstly to ‘escort’ the glucose to our cells and secondly to promote any excess to form fat. When insulin resistance occurs or the body doesn’t use insulin efficiently, the body is forced to make yet more insulin to compensate. With too much insulin in the bloodstream, there isn’t the control of leptin, which creates a range of problems.

It is not just inflammation of the hypothalamus that may lead to a higher set point or set weight. Another cause may have started a lot earlier. Obesity is occurring in young children at an alarming rate and it’s not just from inactivity and junk food, but from their obese mothers. The glucose molecule is small and can easily cross the placenta and into the foetus, so the unborn child has to deal with large amounts of mother’s circulating glucose. Her insulin can’t help as the insulin molecule is too large to cross the placenta. The unborn child’s own pancreas has to compensate producing high levels of insulin in response to mums high levels of glucose and this puts the child at risk of developing Insulin Resistance Syndrome. At the very least the child is likely to develop insulin and leptin resistance at a later stage. 

When the body’s two choices to either burn or store calories go awry, obesity and disease results.  What do we do to avoid, type 2 diabetes and the variety of other metabolic disorders developing? How do we loose weight easily?

There is a plethora of diets, ideas and protocols that have been developed over the years. People have made a lot of money selling all manner of supplements and plans and with so many ideas, many conflicting, it is almost impossible to decide what to do. Lots people try and give up, resigning themselves to being obese.

We need to turn the volume down, not up. We need to increase sensitivity to leptin. Likewise by not spiking blood glucose to dizzying heights with refined carbohydrates we can reduce the amount of insulin required and again, increase sensitivity to it.

We need to reduce the body’s ‘set point’ or ‘set weight’,and yes, this does require less calories in, but it is also important to keep in mind the body’s metabolic rate and how the body might not only deal with those calories, burn or store, but how the body will respond to those calories.What signals are triggered? This is important, different foods may have a similar calorific value, but the effect on the ‘reward’ centre of the brain, which releases dopamine, the effect on the pancreas which releases insulin and the effect on satiety, can be completely different.

It is actually not that difficult to follow a plan that reduces the reliance on reward or dopamine, reduces insulin production and increases the feeling of satiety. We can avoid feeling hungry, eat many of the foods we like and still loose weight, and it is not what popular press, nor the medical world will tell you. 

This way of eating and change in lifestyle, will slowly reduce the body’s ‘set weight, increase metabolic rate and decrease overall weight.It promotes high protein foods, like meats, because proteins will signal appetite satiety, it promotes eating complex only carbohydrates as they do the same and don’t spike insulin production and what’s more, they also reduce the stimulation of the reward centre.  These high fibre foods like leafy greens and roots vegetables are high in nutrients.Nutrient dense foods are what we should be aiming for, not the ‘empty’ calories of processed foods.

In summary, the changes in nutrition and lifestyle I would be recommending would be to eat high fibre foods, low glycemic fruits like strawberries, blueberries, apples and kiwi fruit, nutritiously dense dark leafy greens and high protein foods. This translates to eating meat and eggs regularly, so an average day might look like bacon and eggs on wilted greens for breakfast, sardines and salad for lunch and steak, onions, broccoli and cauliflower for diner.

I would recommend good sleep and moderate exercise, walking daily is good, as this would improve metabolism. Whilst I don’t advocate high fat foods in isolation, I do suggest that there is nothing wrong with a healthy amount of various fats on meat, in cooking or as a salad dressing.  However to loose weight, I do strongly suggest following a very low carbohydrate diet, which includes avoiding all processed flours, especially wheat.

Another important suggestion would be to follow a fasting regime. This can mean a combination of eating within a small window during the day, i.e. 11 am to 5 pm and, or having one or two days per week where a very small amount of food is eaten, if any.

If you would like to talk further, have meal plans and shopping lists prepared, please make an appointment.

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