SUMMARY: Obesity has many causes, and while we would like to think the answer is as easy as people exercising more and eating less, it isn’t that simple. There is disagreement whether obesity is really considered a disease or a behavioral risk factor, similar to smoking, alcohol, and substance abuse that may lead to disease. Obesity is a multifactorial disease in which environmental conditions and several genes play an important role in developing this disease. Obesity is associated with neurodegenerative diseases (Alzheimer’s, Parkinson’s, and Huntington diseases) and neurodevelopmental diseases (autism disorder, schizophrenia, and fragile X syndrome). Some of the environmental conditions that lead to obesity are physical activity, alcohol consumption, socioeconomic status, parent feeding behavior, and diet.

The U.S. Department of Agriculture (USDA) reports that the average American ate almost 20% more calories in the year 2000 than they did in 1983, thanks, in part, to a boom in meat consumption. Today, each American puts away an average of 195lbs of meat every year, compared to just 138lbs in the 1950’s. Consumption of added fats also shot up by around two thirds over the same period, and grain consumption rose 45% since 1970.

Research published by the World Health Organization found that a rise in fast food sales correlated to a rise in body mass index, and Americans are notorious for their fast-food consumption ― such food makes up about 11% of the average American diet. Another study demonstrates the full effect added sugars from soda and energy drinks are wreaking havoc on American waistlines. So it is not just how much we eat, but what we eat.

Lack of exercise is also a major culprit in the obesity epidemic. It’s been decades since most Americans worked in fields and on factory floors, a far greater majority of us are sitting throughout our workday. This means less exercise each day. According to one study, only 20% of today’s jobs require at least moderate physical activity, as opposed to 50% of jobs in 1960. Other research suggests Americans burn 120 to 140 fewer calories a day than they did 50 years ago. Add this to the higher amount of calories we are packing in, and we get a perfect recipe for weight gain.

Obesity and Cancer

Being overweight or having obesity are linked with a higher risk of getting 13 types of cancer. These cancers make up 40% of all cancers diagnosed in the United States each year.

Being overweight and having obesity are linked with a higher risk of getting 13 kinds of cancer. These cancers include—

• Adenocarcinoma of the esophagus.
• Breast (in women who have gone through menopause).
• Colon and rectum.
• Uterus.
• Gallbladder.
• Upper stomach.
• Kidneys.
• Liver.
• Ovaries.
• Pancreas.
• Thyroid.
• Meningioma (a type of brain cancer).
• Multiple myeloma.

From 2005 to 2014, most cancers associated with overweight and obesity increased in the United States, while cancers associated with other factors decreased. During this time, the rate of new cancers associated with overweight and obesity (except colorectal cancer) increased 7%, while the rate of new cancers not associated with overweight and obesity dropped 13%. (The rate of new cases of colorectal cancer dropped 23% during this time. 

Obesity and genetics

According to the National Library of Health, “genetics is now known to play a substantial role in the predisposition to obesity and may contribute up to 70% risk for the disease. Over a hundred genes and gene variants related to excess weight have been discovered. Yet, genetic obesity risk does not always translate into actual obesity development, suggesting complex interactions between genetic, behavioral, and environmental influences and resulting epigenetic change”.

German researchers have uncovered some hopeful news while investigating the impact of genes.

Though some “obesity genes” do play a minor role in the success of weight-loss interventions, environmental, social, and behavioral factors make the biggest difference, according to a new study from the Technical University of Munich. Even individuals who carry risk variants of obesity-related genes will benefit from a healthy lifestyle, including a calorie-balanced diet and regular physical activity, the study said.

Fighting Obesity

An article entitled “The Obesity Pandemic—Whose Responsibility? No Blame, No Shame, Not More of the Same” listed a nine-point plan for tackling obesity (see below).

What’s important to remember is that these suggestions are by no means perfect. Only by testing each one like a dug trial can we achieve some success. Doing nothing is not an option is especially true since research has said that people may have gained as much as 20-40 pounds because of the pandemic lockdowns.

Apple’s attempt to get us up and moving is apparent on their iWatch which reminds wearers that it’s time to move and apps that tell people how long they have been online.

Employers are getting the message that wellness programs can also reduce obesity-related health issues. Research, however, has indicated that obesity prevalence remains a significant challenge for organizations. Despite the best intentions, traditional wellness programs have not been shown to be effective in helping care for individuals with obesity, and employees hold the widespread perception that they are ineffective. This ineffectiveness is in part because a majority of wellness programs have focused on addressing obesity only through weight management programs, instead of taking a more holistic approach. Some employers do cover or partially subsidize the cost of onsite weight management programs, while others offer incentives for participation in their company’s weight management program. However, this will only go so far as to continuously engage employees and help them maintain their health status.

Emerging science demonstrates that a more comprehensive—and fresh—approach to addressing obesity is needed to more effectively support individuals with obesity. This includes looking at obesity as a disease, viewing it in a similar manner to how employers see chronic diseases, such as diabetes or heart disease.