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Removing the Blame from Obesity

Guest blog by Aisling Mangan. Aisling is a  registered dietitian completing a research masters in obesity treatment.

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Currently, 1 in 4 Irish adults are obese1. It is, thus, an issue which affects many of us.  Despite this, the obesity “blame game” continues. Why does obesity come with an element of blame? What can we do to stop this?

 

Where did the Blame Game begin?

Traditionally obesity was viewed as an issue of mere will power. Obese people were blamed for their weight with a common belief that this may motivate individuals to lose weight. Indeed, a study estimated that weight discrimination has increased by 66% in the last decade2.

Meanwhile, advances in research have shown that obesity is much more complex than originally believed. Furthermore, organisations like the World Obesity Federation have defined obesity as a disease. These updates mean it’s no longer adequate, or helpful, to place blame on obese people.

 

The Science

There are many biological factors which can promote obesity. Recently, much research has focused on the hypothalamus. This is a region of the brain which controls our feeling of hunger. It is believed that alterations in the hypothalamus may cause some individuals to feel more hungry and less full3, 4. The result? Some people are programmed to need more food to feel satisfied. This excess food intake comes with excess weight.

Another potential factor is “hedonic hunger”. This refers to the drive for food without the physical feeling of hunger. It has been shown that people with obesity have greater activation of the brain regions which promote this feeling5, 6.

What does all this mean? Essentially, obese people have specific differences in their biology which promote weight gain.

 

Treating Obesity

Does this mean we should not treat obesity? Of course not! Obesity is associated with several negative health outcomes such as diabetes and heart disease. However, knowing the cause of someone’s obesity means we are closer to knowing how to treat it. For example, if we know someone has a stronger sense of hunger, dietary advice to increase fibre, a food that makes us feel full, would be useful.

All this evidence tells us that obesity is an extremely complex state.  It is now thought that individualised treatment strategies may pave the way towards more effective obesity management. We need to treat obesity at it’s root. And most importantly, we need to stop blaming people.

 

References

  1. Ireland H. Healthy Ireland Survey 2015: Summary of findings. Dublin The Stationary Office; 2015.
  2. Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006. Obesity (Silver Spring). 2008;16:1129-1134.
  3. Horvath TL, Stachenfeld NS, Diano S. A Temperature Hypothesis of Hypothalamus-Driven Obesity. The Yale Journal of Biology and Medicine. 2014;87:149-158.
  4. Yu YH, Vasselli JR, Zhang Y, Mechanick JI, Korner J, Peterli R. Metabolic vs. hedonic obesity: a conceptual distinction and its clinical implications. Obesity Reviews. 2015;16:234-247.
  5. Rothemund Y, Preuschhof C, Bohner G, et al. Differential activation of the dorsal striatum by high-calorie visual food stimuli in obese individuals. Neuroimage. 2007;37:410-421.
  6. Karhunen LJ, Lappalainen RI, Vanninen EJ, Kuikka JT, Uusitupa MI. Regional cerebral blood flow during food exposure in obese and normal-weight women. Brain. 1997;120 ( Pt 9):1675-1684.

 

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