Outline:

  1. Obesity is linked to a multitude of chronic diseases, such as type 2 diabetes, heart disease, and others.
  2. Research shows that being overweight by 10 to 20 pounds increases the chance of type 2 diabetes by 90%. 
  3. Weight is not the only factor that contributes to chronic disease, but it is good to start by evaluating habits that contribute to obesity.
  4. Simple calorie restriction may not result in weight loss and/or chronic disease management, and may not be a sustainable solution for many individuals. 

The way we describe the world changes all the time. We invent new words to describe new phenomena. Have you ever heard of the term diabesity? It’s a new term that describes a recent trend in western society: the epidemic of people suffering from a combination of obesity and type 2 diabetes.

The close link between obesity and type 2 diabetes was conclusively demonstrated back in 1990 by Walter Willett, a nutritional expert at Harvard University. His research showed that post-puberty weight gain is the most significant factor in increasing the risk of type 2 diabetes. Putting on 44-77 pounds of weight, for example, means that we are an astounding 11,300 percent more likely to develop the disorder. Willett and his colleagues carried out follow-up studies in 1995. These showed that even small weight gains dramatically increased the chance of type 2 diabetes. An extra 10 to 20 pounds increases the chance of type 2 diabetes by 90 percent.

Unfortunately, it took a while before these breakthroughs became widely accepted in the general medical community. Today, however, there is no room for doubt: type 2 diabetes is intimately connected to weight gain and obesity. It also does not stop at diabetes - obesity also increases the risk of coronary heart disease, stroke, breast and colon cancer, sleep apnea, high blood pressure, fatty liver disease, and chronic kidney disease. While weight is not the only factor to consider, the habits which contribute to obesity are a great place to start making changes. 

Counterintuitively, curing obesity is not as simple as consuming fewer calories. When we reduce our caloric intake, our bodies adjust by reducing their metabolic rates, making us slower, colder, and hungrier. These changes in our subjective well-being make it difficult to stick to the lower-calorie diet for an extended period of time. The whole process becomes a test of willpower and self-denial which we are bound to lose. The solution, therefore, is not as simple as reducing the number of calories we eat. Instead, it is to control our meal timing, choose the foods which are satiating but not addictive, and avoid foods that have an outsized effect on our hormones. Timing, addiction, and hormones are the biggest drivers of hunger and obesity, and learning to control them is key to managing weight. We will talk about each of the three drivers of obesity at length in future articles but let's run through them quickly to understand what they mean. 

Timing refers to how often we eat, and how much time we let our bodies rest in between meals. Timing has a direct effect on hormones such as insulin, which will stay chronically elevated if we keep putting food into our bodies all day long. Adjusting our eating schedule will also teach our brains when it is appropriate to feel hungry. We all feel hungry at certain times of the day, but it is important to realize that we have some control over the scheduled release of our hunger hormones (ghrelin, etc) and that the way to adjust this schedule is similar to how we adjust our sleep schedule: by making small changes and sticking to them day after day, until they become second nature. Have you ever wondered how people can skip meals and still function well? It's mostly practice, more on this in future fasting section!

Addiction may not be something you think about when it comes to eating and nutrition, but we have all had an incident with a pint of ice cream that evaporated in front of our eyes (almost like we weren't in control of our own bodies). Why is this? Is it just a problem of self-control? The reason is that our biology is working against us. Ice cream is the epitome of an addictive food for humans. It is full of fat and sugar, making it extremely energy-dense and the perfect food to gorge on (if we were still living in a savannah)! From an evolutionary perspective, this type of food is rarely found in nature, and when it is found, it usually leads to gorging behavior (think honey, fruit, etc). These foods were so rare that our brains evolved to jump on the opportunity to consume them whenever possible in preparation for the inevitable famine ahead. Feast and famine is the natural way of life in the wild. Unfortunately for our stone-age brains, the grocery store never runs out of ice cream, and our inability to control ourselves around calorie-rich foods is one of the main drivers of obesity.

Finally, hormones play an important role in our energy partitioning (deciding how calories are used by our bodies). You can see just how powerful these signals are by looking at the weight differences between boys and girls at puberty or during other transition periods in our life histories such as pregnancy, and menopause. The natural hormonal changes during these periods lead to drastic differences in hunger, sleep, weight, and other behaviors! Foods that alter these powerful hormonal pathways can also lead to unwanted changes such as increased appetite, more fat accumulation, and less physical exertion. 

More on hormones and the role they play in the complexities of health, weight, and disease next time! 

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