Obesity and weight gain: We're thinking about it all wrong

The problem of obesity is growing in western countries like never before [1]. Our three biggest killers: heart disease, cancer and strokes are strongly correlated with obesity. Today we will discuss a very difficult question: what drives the obesity epidemic?

The premise of this post is that the way we typically think of weight gain is fundamentally flawed.

The conventional wisdom says that every individual needs to consume a certain amount of energy (measured in calories) every day to maintain body weight [2]. The number of calories a person should eat for normal body function (called Basal Metabolic Rate – BMR) depends on the physical needs of that individual. Then the math is simple, take the total calories you eat a day, subtract from it the amount of calories you burn, if the difference is higher than your BMR then you will gain weight. If it is lower, you will lose weight. So to maintain your current weight, you must satisfy the equation:

(calories consumed) – (calories burned in exercise) = (calories recommend for basic body function)

According to this approach, obesity is just an energy balance disorder. So either obese people consume too many calories or their lifestyle doesn’t allow them to burn sufficient calories. We have already discussed studies that showed that excessive consumption of calories from certain foods don’t seem to lead to weight gain, in contrary to the common wisdom. In the future we will dive further into this question and show how problematic the caloric theory is.

A second hypothesis is that human beings should not eat certain foods. According to this hypothesis obesity is a growth disorder, which is triggered by certain foods in our diet that cause hormonal or enzymatic disorders. If this approach is correct, it wouldn’t matter how many calories you eat, as long as you eat the ‘right’ foods (whatever they are) you will not get overweight.

There are more approaches to this difficult question. A third hypothesis claims that the macronutrient content of our diet (protein, fat and carbs) influences fat accumulation. So according to this approach what matters is the macronutrients you eat, independently again of the total caloric intake. Other approaches claim that other environmental factors and not necessarily the food itself is what causing obesity [3-4].

There are dozens of studies trying to differentiate the hypothesis [5] and find the answer to this important question: what drives the obesity epidemic? Unfortunately, the evidence is still inconclusive. We still don’t have the answer to this question! This is a significant part of the problem of conflicting nutritional advice which we discussed last time.

But look what happened. The first approach produced a whole industry of nutrition apps that serve as calorie counters. All they do is make sure you don’t eat too many calories independently of the kind of food you eat. The second and third approaches created the diet industry. Today there are hundreds of different diets that recommend you should avoid certain foods (e.g. paleo diet, vegan diet) and/or nutrients (e.g. low fat diet, low carbs diet) typically without regarding your caloric intake [6].

I personally don’t believe either of these approaches as a standalone philosophy for health. The first approach fails in many cases like the one I discussed on nuts. The second and third approaches are also problematic, as they assume that all human-beings should eat the same things to maintain a healthy weight. Last year some preliminary studies started testing a more personalized approach to nutrition, which seems very promising [7].

So what should you do?

We are not going to have the answer in the next two years. For now, I recommend everybody to take responsibility for your own health and body. Instead of tediously counting calories, just don’t eat too much. Eat real food, mostly plants. Listen to your body, and most importantly download Nutrino! 😉