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The stupid explodes: obesity now a disability

Maybe, in this case, her C. diff problem screwed her digestion, causing her to need to eat more. Then when she was cured she went on eating in the same way and put on weight?

Digestion can only ever approach 100% efficiency, so for certain gut flora to cause obesity doesn't sound right.

The process has been tested experimentally in mice :

http://www.sciencemag.org/content/341/6150/1241214.short

One of the mechanisms identified is increased metabolism of metabolism of branched-chain amino acids in obese mice. Metabolism of branch chain amino acids is already known to be linked with weight regulation and has recently been found to be associated with insulin resistance :

http://link.springer.com/article/10.1007/s00726-011-1088-7

Transplant of gut bacteria from lean donors into obese recipients with metabolic syndrome decreased insulin resistance in humans :

http://www.ncbi.nlm.nih.gov/pubmed/22728514

There is possibly a mechanism involving amino acid metabolism that links gut bacteria to both increased body fat and insulin resistance, but so far limited research in humans.
 
Interesting replies from all involved, thanks.

Another tidbit I've stumbled across, this rime on taste

http://www.theage.com.au/national/fat-the-next-taste-sensation-20150208-138u16.html

In the paper titled Is Fat the Sixth Taste Primary? Evidence and Implications, Professor Keast outlines ways our ability to taste fat could help treatment of obesity.

The paper suggests that people who detect fatty acids also associate the taste sensation with the feeling of being full and that people who have difficulty in detecting fatty acids are often obese.

Sensitivity to fatty acids can be increased by putting them on a low fat diet after which their ability to detect fatty acids increases and, by association, their ability to feel full.

The paper also outlines how tasting fat triggers many metabolic processes to aid digestion such as the release of fat digesting enzymes in the digestive system.

"These findings could lead to the food industry responding with new products that reintegrate naturally occurring fatty acids to help people feel full," says Professor Keast. "Whether the scientific world accepts fat as a 'taste' like sugar, which gives us a pleasant sensation," he said, "will become a matter of academic debate. But I am positive that we will now see a change in the way we view and perceive fat."
 
New study released that shows 140 genomic indicators for adipose deposits.

Link (requires free registration)

"Our work clearly shows that predisposition to obesity and increased BMI is not due to a single gene or genetic change," said Elizabeth Speliotes, an assistant professor at the University of Michigan Health System and co-senior author of the BMI paper, in a statement. "The large number of genes makes it less likely that one solution to beat obesity will work for everyone and opens the door to possible ways we could use genetic clues to help defeat obesity."

On that basis, the genetic markers have obviously been around for some time, yet this is the first generation where obesity is anything like prevalent, begging the question of why that should be.

Answer: people nowadays eat more.

Solution: eat less.

Problem solved; next...
 
Athiest, you are swatting flies with a sledge hammer. Not ALL of us have all 140. Say I have three. If two of them have work arounds by nutrition, or maybe pharmaceuticals, appetite might be controlled more easily.

Genes control enzymes. Period. Enzymes turn one substrate into something else. Oftentimes the enzyme is not completely blocked genetically, the patient has less of it. So taking in extra substrate helps. Other times the product is known and available for direct supplement.

I think the knowledge base is nearly a million subjects who have had full or partial genomes. I think we know which genes are linked to many diseases. More so than we know the mechanism of the gene/disease link. And that knowledge will be the upcoming breakthrough.

Examples might be hypertension caused by the lack of a NOX enzyme, a nitro glycerine treats it much more directly than a low salt diet. Or maybe it's a neurological problem, patient needs more Folate than the norm. Or his diet has been deficient in Folate for so long, taking the supplement for a few months will cure him.
 
I have a general question, hopefully someone more informed on these matters can answer. What if a person is not overeating (meaning, eats 2000 or fewer calories a day), but still wants to lose weight? Is an exercise regimen the best option in that situation? I was under the impression eating significantly less than 1500-2000 calories a day wasn't recommended. But it would it be okay for weight loss?
 
Athiest, you are swatting flies with a sledge hammer. Not ALL of us have all 140. Say I have three. If two of them have work arounds by nutrition, or maybe pharmaceuticals, appetite might be controlled more easily.

Genes control enzymes. Period. Enzymes turn one substrate into something else. Oftentimes the enzyme is not completely blocked genetically, the patient has less of it. So taking in extra substrate helps. Other times the product is known and available for direct supplement.

I think the knowledge base is nearly a million subjects who have had full or partial genomes. I think we know which genes are linked to many diseases. More so than we know the mechanism of the gene/disease link. And that knowledge will be the upcoming breakthrough.

Examples might be hypertension caused by the lack of a NOX enzyme, a nitro glycerine treats it much more directly than a low salt diet. Or maybe it's a neurological problem, patient needs more Folate than the norm. Or his diet has been deficient in Folate for so long, taking the supplement for a few months will cure him.

I think what Atheist was getting at was that even if there's a genetic predisposition, it's probably not new alleles from what previous (thinner) generations had, so genetics is not an explanation for the increase in population percentage that is obese.

I agree, but point out that peoples' willpower has not declined either, so it's can't be a lack of willpower. We are probably exhibiting greater willpower than our ancestors, but we are not increasing our willpower in proportion to 'something that has changed' in the last few generations.

What has changed is that we live in a world with massive commercial interests that intentionally immerse us in ubiquitous eating triggers that didn't exist 100 years ago. It's called 'our Obesogenic Environment'. There is disagreement about how to address this.
 
I have a general question, hopefully someone more informed on these matters can answer. What if a person is not overeating (meaning, eats 2000 or fewer calories a day), but still wants to lose weight? Is an exercise regimen the best option in that situation? I was under the impression eating significantly less than 1500-2000 calories a day wasn't recommended. But it would it be okay for weight loss?

There is no universal threshold for minimum calorie intake - that is specific for the individual, and depends largely on size, and secondarily on gender, age, and activity level.

A small woman who does not exercise may be overeating at 1500 calories/day.

I just did a calculation for my mom, who is 70 and 5' zero in height, and 120lbs, her BMR is just over 1100 calories/day, so 1500 calories/day she would gain weight walking a brisk 5 miles a day.
 
Athiest, you are swatting flies with a sledge hammer. Not ALL of us have all 140.

I have to confess with finding answers to my posts that bear no relation to what I said quite tedious.

Where did I mention everyone having 140 markers?
 
I think what Atheist was getting at was that even if there's a genetic predisposition, it's probably not new alleles from what previous (thinner) generations had, so genetics is not an explanation for the increase in population percentage that is obese.

I agree, but point out that peoples' willpower has not declined either, so it's can't be a lack of willpower. We are probably exhibiting greater willpower than our ancestors, but we are not increasing our willpower in proportion to 'something that has changed' in the last few generations.

What has changed is that we live in a world with massive commercial interests that intentionally immerse us in ubiquitous eating triggers that didn't exist 100 years ago. It's called 'our Obesogenic Environment'. There is disagreement about how to address this.

I would agree.

A generation or two isn't enough time for genetics to change much.

I'm unsure what to think about the whole gut bacteria thing. It seems odd to me that it could have that much of an effect, that the effects only started recently, and mostly in industrialized countries.

We, as a society, tend to have a more sedentary lifestyle than in the past.

I fully agree about the commercial interests. We have essentially unlimited access to a wide variety of inexpensive, delicious food, much of which is designed to limit the satiety response and keep us eating. Plus there's all the marketing that goes into food.
 
I would agree.

A generation or two isn't enough time for genetics to change much.

I'm unsure what to think about the whole gut bacteria thing. It seems odd to me that it could have that much of an effect, that the effects only started recently, and mostly in industrialized countries.

We, as a society, tend to have a more sedentary lifestyle than in the past.

I fully agree about the commercial interests. We have essentially unlimited access to a wide variety of inexpensive, delicious food, much of which is designed to limit the satiety response and keep us eating. Plus there's all the marketing that goes into food.

Epigenetics could do it.
 
I would agree.

A generation or two isn't enough time for genetics to change much.

I'm unsure what to think about the whole gut bacteria thing. It seems odd to me that it could have that much of an effect, that the effects only started recently, and mostly in industrialized countries.

I put a pin in 'the whole gut bacteria thing' at this point - it's basically at what i'd call the 'plausible hypothesis' stage. Like so much mouse research it will probably have no bearing on humans (*cough* calorie restriction *cough*), but who knows.



We, as a society, tend to have a more sedentary lifestyle than in the past.

It depends on how far in the past we compare, and how we define sedentary lifestyle. Studies have been done to measure activity levels that contribute to calorie burn going back a few generations, and while there's imperfect methodology (no pedometers 100 years ago), we seem to be almost as active as before. Kids today are probably even more active than ever before. In any case, there's no evidence that the quantity of decline in activity is equal to the calories accumulated in people's obesity. It doesn't add up. But the food intake increase can account for probably 80% of it. So it's the best explanation.

However, this is because people have more sport activities - obviously, our everyday jobs are less active.

Current estimates are that the increase in population %age with obesity is about 20% from decline in activity, 80% from increase in caloric intake. Addressing eating is the biggest bang for the buck.



I fully agree about the commercial interests. We have essentially unlimited access to a wide variety of inexpensive, delicious food, much of which is designed to limit the satiety response and keep us eating. Plus there's all the marketing that goes into food.

Unfortunately, I think marketing is the big one.
Like the Cylons: they have a plan.
Obesity is not a side effect of marketing: getting people to eat more food is the entire purpose of their marketing. They spend literally billions of dollars a year making it happen, and they're not above lobbying the government and funding expensive campaigns based on deception and half-truths. Facts and willpower don't stand a chance.

Here's why it's complicated: I just read a medium quality 2012 study of the impact of 'after school sports programs' - ([Do youth sports prevent pediatric obesity? A systematic review and commentary.]) the results were what I predicted: participation in after school programs (including sports) is positively correlated with obesity and junk food consumption and total calorie consumption. This is because the junk food marketers have been concentrating there for quite some time (eg: [Amateur Hockey Canada]) - it's a 'target rich environment' (kids don't have willpower to resist advertising - why should they?). So, the hockey kid is more likely to be a junkfood junkie with obesity than the kid who opts out and plays Nintendo in his basement.

This study is not a one-off - it is entirely consistent with probably another hundred examining the situation: physical activity levels are not very strongly related to whether a person has obesity (see below), and secondly, children's sports is a critically important advertising environment for junk food sellers, establishing hard-to-break habits and beliefs for life.

Regarding exercise and obesity: Here's an example of a higher quality study about this: [Maintaining a High Physical Activity Level Over 20 Years and Weight Gain]. Exercising intensely an hour a day six days a week for 20 years appears to result in 4.5 fewer ounces of weight gain. Not weight loss, but just slightly less weight gain.
 
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Regarding exercise and obesity: Here's an example of a higher quality study about this: [Maintaining a High Physical Activity Level Over 20 Years and Weight Gain]. Exercising intensely an hour a day six days a week for 20 years appears to result in 4.5 fewer ounces of weight gain. Not weight loss, but just slightly less weight gain.

Here's a 10 year study showing even less weight management benefit from regular exercise: [Effect of change in physical activity on body fatness over a 10-y period in the Doetinchem Cohort Study]. The difference between decade-long daily exercisers and non-exercisers was 280 g. Both cohorts gained weight.
 
Regarding exercise and obesity: Here's an example of a higher quality study about this: [Maintaining a High Physical Activity Level Over 20 Years and Weight Gain]. Exercising intensely an hour a day six days a week for 20 years appears to result in 4.5 fewer ounces of weight gain. Not weight loss, but just slightly less weight gain.

Another, but this is a shorter timeframe, and it's comparing 3 programs rather than binary exercise vs non-exercise. The attempt is to see if more exercise leads to more weight loss.

[The Effect of Physical Activity on 18-Month Weight Change in Overweight Adults]

The result is that the majority of the people who increased their exercise also increased their adiposity. So, not just increased weight, but increased body fat percentage. The amount of exercise was slightly correlated to the fat gain. They share the same mechanism theories I described above: increased food and beverage cravings and reward beliefs.
 
Regarding exercise and obesity: Here's an example of a higher quality study about this: [Maintaining a High Physical Activity Level Over 20 Years and Weight Gain]. Exercising intensely an hour a day six days a week for 20 years appears to result in 4.5 fewer ounces of weight gain. Not weight loss, but just slightly less weight gain.

I'm starting to get better access to my old site's sql database. Here are more on the same topic:
  • Church, T., Thomas, D., Tudor-Locke, C., Katzmarzyk, P., Earnest, C., Rodarte, R., Martin, C., Blair, S., & Bouchard, C. (2011). [Trends over 5 Decades in U.S. Occupation-Related Physical Activity and Their Associations with Obesity] PLoS ONE, 6 (5) DOI: 10.1371/journal.pone.0019657

    blutoskitorial: the above study is well done; just ignore their fallacious conclusion. 100 calories per day cannot explain 'the majority' of weight gain. maybe 17%, though.



  • Wilkin, T., Mallam, K., Metcalf, B., Jeffery, A., & Voss, L. (2006). [Variation in physical activity lies with the child, not his environment: evidence for an ‘activitystat’ in young children (EarlyBird 16)] International Journal of Obesity, 30 (7), 1050-1055 DOI: 10.1038/sj.ijo.0803331

    blutoskitorial: the phenomenon called 'activitystat' is not completely proven, but very well supported by evidence - it is why registered dieticians are not concerned about the impacts of eliminating physed from K-12 public education... kids seem to just have a fixed amount of daily exercise they can perform, and they will accommodate



  • Luke, A., Dugas, L., Ebersole, K., Durazo-Arvizu, R., Cao, G., Schoeller, D., Adeyemo, A., Brieger, W., & Cooper, R. (2008). [Energy expenditure does not predict weight change in either Nigerian or African American women American] Journal of Clinical Nutrition, 89 (1), 169-176 DOI: 10.3945/ajcn.2008.26630

    blutoskitorial: the goal with this one was to control for both genetics and exercise - the dominant difference between these cohorts was clear... nether genetics nor exercise are as important as the 'environment' as a contributor to obesity levels; the best explanation is that we have absorbed marketing messages to eat more into our cultural values



  • Lara R Dugas, Regina Harders, Sarah Merrill, Kara Ebersole, David A Shoham, Elaine C Rush, Felix K Assah, Terrence Forrester, Ramon A Durazo-Arvizu, & Amy Luke (2011). [Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies The American Journal of Clinical Nutrition], 93 (2), 427-441 : 10.3945/​ajcn.110.007278

    blutoskitorial: conclusion does follow from the data analysis... this is consistent with other findings that we are about as 'active' as previous generations, just different activities (ie: less on-the-job activity, but considerably more sports)



  • Westerterp, K., & Speakman, J. (2008). [Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals] International Journal of Obesity, 32 (8), 1256-1263 DOI: 10.1038/ijo.2008.74

    blutoskitorial: there's more than one thing going on here... two key conclusions, both independently replicated over and over... firstly, the more overweight a person is, the worse they are at estimating their caloric intake, and the direction of causality seems to flow that way (first obesity, followed by poor estimation of caloric intake); secondly, that there may have been a slight increase in average energy expenditure since 1982 (this is consistent with Church et al above, in that Church was only examining occupational energy expenditure, not taking any account for non-occupational exercise), but our caloric intake has increased much faster;



  • Swinburn, B., Sacks, G., & Ravussin, E. (2009). [Increased food energy supply is more than sufficient to explain the US epidemic of obesity] American Journal of Clinical Nutrition, 90 (6), 1453-1456 DOI: 10.3945/ajcn.2009.28595

    blutoskitorial: this is calories in calories out, and attempting to see if independent approaches to estimates match up... they do. in this study, they worked backwards by calculating the food produced, destroyed, imported, exported, and therefore how much Americans must have eaten, year over year, subtracted the total energy in BMR and exercise, and the increase each year it is almost exactly the amount of energy in Americans' adipose tissue that has accumulated in that period.
 
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Like the Cylons: they have a plan.

And they know to stay on message... here's Indra Nooyi's take on PepsiCo's culpability, since Americans' annual intake of 'sugar sweetened beverages' (SSBs) has tripled in the last 25 years:

"If all consumers exercised, did what they had to do, the problem of obesity wouldn't exist."

This is not a fact; it is marketing.
 
Nice to see UK's Conservatives treating the subject appropriately:

If you're on a sickness benefit because if obesity or addiction - go on a treatment program or lose the benefit.
http://www.independent.co.uk/news/u...servatives-win-general-election-10046025.html

Very rare I agree with the Tories, and this is one of those occasions.

I don't think I see a problem with that. It sounds reasonable, as long as the obesity was indeed due to addictive overeating and not to some one of the other (apparently much rarer) physical conditions that have come up in the thread. :)

Also blutoski, thanks for answering my question. I've been trying to look up what my personal recommended daily calorie intake should be, but all the numbers I'm finding on the web seem pretty high. (I'm trying to lose just 5 stubborn pounds, so I might just cut myself down to 1500 or so a day, with the exercise routine I've been doing, until it's done. I'm getting pretty impatient.)

Some kind of treatment program for the addictive tendencies and/or underlying negative habits causing a person's obesity sounds like a reasonable criterion for them receiving continued benefits. I would not, however, personally be comfortable with including surgery in those requirements.
 
Nice to see UK's Conservatives treating the subject appropriately:

If you're on a sickness benefit because if obesity or addiction - go on a treatment program or lose the benefit.

http://www.independent.co.uk/news/u...servatives-win-general-election-10046025.html

Very rare I agree with the Tories, and this is one of those occasions.

It carries all the hallmarks of a Conservative party policy, aimed at attacking stereotypes maligned in the tabloid press without providing funding to actually deliver effective treatment.

Alcohol, drug and obesity management services are already critically underfunded and stretched, this will only make it worse. A similar proposal by Westminster council a couple of years ago was criticised by the BMA as unworkable. Once again it's typical of this government to fail to get onside those people who are actually supposed to deliver their crackpot ideas.
 

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