Earlier this month, a venerable news program 60 minutes dived into a raucous conversation about new weight-loss drugs like Wegovy in a segment on Recognizing and treating obesity as a disease.
The film is based on real people who have tried and failed to lose weight through diet alone, as well as Dr. Fatima Cody Stanford, a renowned obesity physician at Massachusetts General Hospital in Boston, and weight management at Brigham and Women’s Hospital in Boston. and wellness center. Dr. Cody Stanford tells host Leslie Stahl that willpower should be “thrown out the window” when discussing weight loss, and Dr. Apobian now has a safe and effective drug to offer his patients. He said he was grateful.
Sounds like a fair and balanced report. error, said the internet.As a reaction to the work, #easy about obesity trending on twitter. commenter pointed Dr. Cody Stanford Relationship with Novo Nordisk, the manufacturer of Wegovyreceived payment from 60 minutes did not disclose. (women’s health Cody Stanford, PhD, was reached for comment but did not hear back by press time.)
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A commenter’s biggest complaint seemed to lie in a single quote from Dr. Cody Stanford. “The number one cause of obesity is genetics,” she said. “This means that if you are born to obese parents, you have a 50-85% chance of becoming ill yourself, even with optimal diet, exercise, sleep management and stress management.” The implication that genetics is entirely responsible for obesity enraged commentators. Obesity is caused by lifestyle, The internet roared, sparking a two-pronged debate that is still bouncing across social media.
The problem is, according to interviewed obesity experts, women’s health, neither side is… not wrong, but neither is it right. Karl Nadolski, DO, clinical assistant professor at Michigan State University School of Medicine, explains: “If your parents have the disease, there’s a 50-85% chance that you’ll get the disease from him. But does that mean lifestyle factors don’t matter? It’s not true.”
genes, environment, lifestyle work together It causes obesity.
The truth is that obesity is complicated.This study suggests that both genetics and environment are responsible Soaring Obesity Rates the last few decades. Moreover, the extent to which any one factor contributes to obesity varies from person to person.
For example, there are different ways genetics contribute to obesity.a rare mutation known as MC4 mutation or POMC mutation It is known to be a direct cause of obesity. But more common is what scientists call “heteropolygenic” obesity. This refers to clusters of genetic attributes that may predispose to weight gain, especially if that person is in an environment that promotes weight gain. It’s a different aspect,” says Dr. Karl. “The father of obesity science, George Bray, once coined the analogy that ‘genes load the gun and the environment pulls the trigger.'”
This means that for most people, obesity is the result of a complex interplay of both genes and environment or habits. It used to be difficult to do, but these days Genome-wide association studiesSequencing technology was used to compare genetic differences along with age, sex, physical activity, and diet.
“These data show that understanding and accepting genetic predisposition is very important, but there is also evidence that genetic predisposition has increased. physical activity and/or improved nutrition [genetic predisposition] It reduces the risk of obesity by up to 40%,” says Dr. Karl. The bottom line: Genetics play a big role, but they don’t completely determine fate when it comes to weight.
Weight stigma leads people to believe that lifestyle is the biggest factor when it comes to obesity.
It’s easy to assume that lean people living in our “obesity” environment are simply genetically predisposed to be thin, but how genetics affect overweight people? It is difficult to understand.
When it comes to people with larger bodies, lifestyle is usually the factor they blame.This is a perfect example of weight bias.Spencer Nadolski, Dr. Karl’s brother and obesity and lipid specialist “There’s a very inherent prejudice in obese people that it’s a matter of willpower,” he says. “On Instagram, you’ll see comments like, ‘Stupid, I didn’t go to McDonald’s because of my genes.’ But that ignores the pathophysiology of obesity.”
Dr Cody Stanford said people with a genetic predisposition to obesity gain weight flat Optimal lifestyle and looks like the absolute.In reality, “it may be difficult to achieve optimal diet and exercise with genetic predisposition,” adds Dr. Karl. [have] Weight gain and obesity. “
As Dr. Cody Stanford pointed out, it’s true that obesity is related to the brain. 60 minutes (Although calling it a “brain disease” was definitely not the best way to put it). Part of what genetics can do, Dr. Spencer says, is to influence the appetite drivers in your brain that tell you when and how much to eat. They don’t have the same appetite signals. They think it’s willpower, but it’s not.”
(This is also why newer weight-loss drugs such as Wegovy and Ozempic are so powerful. They work by modulating appetite signals sent by the brain, making it easier for obese people to act out. Fundamentally, the concept of “willpower” is experienced differently by different people and has not been shown to be successful in long-term weight loss and management.
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Ultimately, this debate is an example of how the conversation around obesity needs to change dramatically, says Dr. Spencer. “We need to stop blaming the individual and start looking at the system.” he says. “We think we are in control, but at a population level the environment shapes us.”
Additionally, while some have the resources to change what they eat and follow strict lifestyle interventions, many live in food deserts with limited access to affordable, healthy food. their neighborhood may not be walkable and/or their work schedule may not allow for a workout routine. Health care and support may not be available. Even with all of the above, weight loss is difficult. For many, that is not possible and can have serious consequences such as: depression and eating disorders.
It’s important to put empathy and bodily autonomy at the center of this conversation.
Ultimately, we need a new way of looking at obesity. It’s the more nuanced one, says Dr. Karl. Not only do we need to understand the complexity of what causes obesity at population levels and in individuals, but we also need to recognize that weight is not the only important health factor. Overall health also includes mental health and a positive body image.
Dr. Spencer argues that the risk of being overweight should not be taken lightly, but ultimately everyone has the autonomy to decide how to manage their health without judgment, discrimination, or misinformation. New approaches, like powerful FDA-approved drugs to induce weight loss, should be widely available (and covered by insurance) for those who need them, he says. .
Similarly, people with larger bodies shouldn’t feel pressured to diet endlessly or take any steps to change themselves if it works best for them. How health is achieved varies from person to person, and for some it may be more important to focus on behavior rather than weight.