It's more complex than too many calories and not enough physical activity.
The American Medical Association officially recognized obesity as a disease in 2013. But in the past 13 years, there's not been much of a shift in the understanding of what causes obesity — not in the general public, in people who contend with the condition or in the practice of medicine. Most people still think of obesity as a character flaw caused by too many calories and not enough physical activity. But it's much more complex than that.
A study analyzing National Health and Nutrition Examination Survey (NHANES) data found that even though US adults' BMI increased between 1988 and 2006, the amount of calories adults consumed and the energy they expended were unchanged. It also appears that the quality of calories consumed (low versus high glycemic index) is as important a consideration as the total quantity. And genetics only explains about 2.7% variation in people's weight, according to a study in Nature. That all adds up to this: The two most common explanations for obesity — calories in, calories out and family history — cannot, by themselves, explain the current epidemic.
So what are the other factors contributing to the obesity epidemic and how can you use this information to help you remain or achieve a healthy weight?
Harvard's T.H. Chan School of Public Health says "prenatal and early life influences; too much television watching; too little physical activity and sleep; and our food and physical activity environment are major influencers."
That means that what your mom ate before your were conceived, what Mom ate while pregnant, your first food experiences as an infant — if they were unhealthy, they all prime your body for obesity in childhood and as an adult.
In addition, living in an environment that is hostile to outdoor physical activity contributes to obesity. And a toxic food environment where there's a high-density of fast food outlets and a lack of stores selling fresh foods fuels it too. Then if you add the mistaken idea that healthy food is too expensive and that's coupled with not knowing how to cook, well, you're on the road to weight issues.
There's also what's called the obesogen hypothesis. It suggests that chemicals in our environment (called obesogens) promote obesity. The culprits? Hormone disruptors in receipts, plastics, personal care products and foods; antibacterials in cleaning products that alter your skin and gut biome; pesticides that leave residue on foods and in the air; and a variety of contaminants in water and air.
Clearly obesity is a disease caused by many factors — biological, genetic, social, environmental and behavioral. So where does that leave you? Ready to defeat obesity! Just like you would work to prevent or treat heart disease with lifestyle changes and perhaps medications, you can do the same for obesity.
So here's a five-step plan from Dr. Oz and Dr. Michael Roizen's book, YOU On a Diet: The Owner's Manual for Waist Management.
1. Clear your fridge of foods with added sugar, syrups, and simple carbs, plus red and processed red meat and egg yolks. Swear off fast and fried foods. Stick with whole grains and complex carbs in vegetables and fruits. Experiment with cooking — here are some great ideas.
3 Aim to walk 10,000 steps a day. Limit sitting-down time — and get up every 30 minutes for a stretch and jumping jacks.
4. Adopt a healthy sleep routine — seven to eight hours nightly, in a quiet, dark, cool room.
5. Avoid endocrine-disrupting chemicals. Refuse register and ATM receipts; say no to perfumed products and unnecessary use of antibacterials. Ditch plastic used for food storage for glass, parchment and wax paper. Limit your use of canned foods—even those that say BPA-free; the substitute isn't any better. Opt for furniture that isn't treated with a flame retardant.
6. Talk with your doctor about your weight — you'll have to bring it up. Ask about good-for-you forms of resistance training and what medications might help you or be hindering you in achieving and maintaining a healthy weight.