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The Global Obesity Epidemic

2023 study/review by Masood that lists and provides references for the many causes of obesity.

Causes of obesity: a review - PMC

Obesity research is advancing swiftly, but the increase in obesity prevalence is faster. Over the past three decades, researchers have found that biopsychosocial factors determine weight gain much more than personal choices and responsibility. ...
pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov
 
Interesting!
Skeptical Greg will appreciate the highlighted parts. :)
Causes of obesity: a review
Alongside the intrinsic mechanism of obesity, we must recognise external influences, such as the rapid emergence of fast-food chains, meal deals, upsized drinks and the easy availability of inexpensive ultraprocessed food as part of the problem; we also ought to take a step back and analyse why such a significant part of the world's population suddenly has an energy balance disorder. According to the Foresight report on Tackling obesities,1 although genes, energy intake, early growth pattern and diet have an important role in the development of obesity, it is the obesogenic environment that has modified human behaviour and interacted with human physiology to cause the increase in obesity rates. Today, there are numerous opportunities to eat high-calorie food. Other aspects include: the lower cost of food and drinks; increased marketing of food products; technological advances (such as the improved quality of television and computer screens, increased variety of video games and virtual reality simulators that encourage sedentary behaviour); increased rates of sedentary employment; longer working hours; and improved accessibility of food (convenience stores and vending machines), which result in decreased overall movement.
(...)
Conclusion
The causes of obesity are a nexus of communal and individual factors. Although most of these are modifiable, controlling all contributing factors is a real challenge. The Foresight report 1 describes these risk factors as ‘interconnected’ and grouped them into different clusters on an ‘obesity map’ to enable easier understanding and management of obesity. These groups include the physical activity environment, food consumption, food production, individual psychology and social psychology. Understanding these risk factors individually and appreciating their interconnection is key to understanding the causes of obesity and working toward a plausible solution to curb this worldwide pandemic.
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I appreciate that they mention "the physical activity environment."
It is also fascinating, "that a longer duration of breastfeeding was associated with a lower risk of weight gain in the baby, with each month of breastfeeding reducing the risk by 4% 60; and rate of weight gain in infant: the speed at which a baby gains weight has also been associated with obesity in later life."
4% per month! That's a lot! It would amount to 48% per year. However, I wonder if it is causation or just correlation, e.g. prolonged prolonged breastfeeding being connected to less stressfull lives.
 
Skeptical Greg does tend to focus just on that one aspect. :)

In reality, the article lists multiple other factors that also contribute to obesity and the obesogenic environment.
 
Yes, it does. From my quotation:
"The causes of obesity are a nexus of communal and individual factors. ... These groups include the physical activity environment, food consumption, food production, individual psychology and social psychology."
I have mentioned the importance of infrastructure several times, e.g. in the context of transport (see post 466).
I was reminded of this when I stumbled upon this article by Michael Moore:
I Like America. Well, I like 13 things about it. (Michael Moore, Oct 17, 2021)
13. We Are a Hot Mess!
Yes, there’s a lot wrong in America. But that gives us each a chance to fix it. There’s literally something we can do to fix something here every single night and day. Never boring! Never a dull moment! What would we do if we all lived in Denmark?! Ride bikes?
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Yes, Mike, you would! And it would be good for you!
 
www.theguardian.com

Weight-loss jabs may be good for mental health, research shows

Swiss study finds wellbeing and life quality can be improved more than with insulin and other antidiabetic drugs
www.theguardian.com www.theguardian.com

More evidence of general health benefits beyond just losing weight or controlling diabetes.

A study by scientists from the University of Bern in Switzerland has found that appetite-suppressing injections also improve mood, wellbeing and quality of life more than insulin and other antidiabetic drugs.

Originally developed for diabetes patients, the medicines have transformed how obesity is treated and there is growing evidence of wider health benefits.
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That is impressive!
Five studies found that they actually improved mental wellbeing and quality of life in people with schizophrenia spectrum disorders, major depressive disorder and bipolar effective disorder. For adults without mental illness, the weight loss injections had a greater beneficial effect on mental health than insulin and other antidiabetic drugs.
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I didn't know that diabetes is one of the things that tend to cause people with mental illness to die much sooner than others:
Rachel Hastings-Caplan, the clinical research policy manager at Rethink Mental Illness, said: “The physical health of people severely affected by mental illness is often overlooked, and they tragically die on average 20 years earlier than the rest of the population, often due to preventable conditions such as diabetes.
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If that's replicable, I'm somewhat inclined to think the weight loss (and clinical markers improvement) improved their mental health, rather than any happy hormones in the drug, but either way (or another) is a win.
 
I don't think it's "happy hormones in the drug," but this is another thing I wasn't aware of (I googled it just now):
Diabetes and Mental Health (CDC, May 15, 2024)
People with diabetes are 2 to 3 times more likely to have depression than people without diabetes.
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I came across this YouTube short (1:00 min.) mentioning "muscle wasting" as a side effect of Ozempic that I hadn't heard about before:
Beware of this new problem with Ozempic

When I tried to find out more, I found this article:
Does Ozempic cause muscle loss and how to prevent it? (Drugs.com, Feb 2, 2025)

This makes it seem less serious than it sounds at first:
  • Even though lean mass was reduced in these studies, the amount of lean mass lost when compared to total body mass increased, suggesting a positive overall effect.
  • The authors conclude that semaglutide affects weight loss primarily through fat mass reduction, but loss in lean mass leads to concerns, especially from larger clinical studies.
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And it is also preventable:
The good news is that there are proven way to help maintain muscle strength if you are at risk of muscle loss.
  • Engaging in strength (resistance) training and maintaining optimal levels of protein in your diet may help with muscle loss during Ozempic treatment.
  • Studies have shown that resistance training can be effective to maintain muscle mass during weight loss in people with obesity or overweight.
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But it made me wonder: Is it possible that muscle wasting is not due the medication as such but due to the weight loss that it causes?
I.e. if you don't combine the use of Ozempic or other semaglutide products with increased exercise, you now carry around less weight than you used to, so your muscles will be exercised less and shrink.
I don't know if that's the case or if there is a way to measure if is, but it would be interesting to know.
 
There's an interesting article in today's Guardian about weight loss drugs:

www.theguardian.com

How weight-loss wonder drugs are redefining the way our bodies work

Medications such as Ozempic have transformed obesity treatment and are now leading a healthcare revolution
www.theguardian.com www.theguardian.com

This is what it says about the muscle loss issue:

With the medications known to reduce muscle mass, Whyte said an important question was whether this went beyond what would be expected from weight loss alone.

Yet with GLP-1 drugs having been used for diabetes for almost 20 years, Whyte said the data suggested overall the medications were safe.

“There was an initial concern [about], maybe it could lead to higher risk of pancreatitis or even pancreatic cancer or thyroid [cancer]. That has not been borne out in any of the follow-up data,” he said.
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The YouTube short also mentioned pancreatitis and thyroid cancer, but it appears to be a bit alarmist or at least not up to date:
"It's got a host of problems from pancreatitis to causing thyroid carcinoma to causing gastric issues. There's another thing that's being found out: muscle wasting."

The article in The Guardian is interesting. Contrary to the YouTube short, it makes Ozempic and Wegovy sound like miracle drugs, but unfortunately drugs that you can't stop taking without gaining back weight. Novo Nordisk shareholders will be pleased to hear that.
 
dann said:
But it made me wonder: Is it possible that muscle wasting is not due the medication as such but due to the weight loss that it causes?
I.e. if you don't combine the use of Ozempic or other semaglutide products with increased exercise, you now carry around less weight than you used to, so your muscles will be exercised less and shrink.
I don't know if that's the case or if there is a way to measure if is, but it would be interesting to know.
Click to expand...
Any time you lose weight, you will tend to lose both fat and muscle weight, roughly in proportion to the percentage of your total body weight that was fat and muscle to begin with. This is especially true for diets that aren't accompanied by increased exercise. Semaglutide helps control your appetite so you eat less and lose weight. Calling this "muscle wasting" is alarmist nonsense.

The way to maintain muscle is of course to add exercise to the diet, especially resistance training like weight training or calisthenics.
 
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