Note: Please see the updates on healthism here. Flexibility, social connection, enjoyment of health, and not obsessing on perfection of diet is what makes health a means, not an end.
Why Are Americans So Obese?
On May 4, 2014, a nationwide movement was ignited, sparked by the movie, Fed Up. This was in order to bring awareness of how the junk food industry and massive sugar consumption were contributing to our nation’s current obesity epidemic.1-5 The movement consisted of participants who committed to 10 days of going sugar free with the support of famous and devoted health experts and celebrities.
With over 30% of adults being classified as obese, and the health comorbidities associated with this fact, this subject has become a “big” focus in health circles. Unfortunately, our children also continue to be effected by the implications of this issue. This is made evident by the resultant rise in “adult diseases” in childhood.
According to the CDC (Center for Disease Control & Prevention), more than one third of our youth is overweight or obese. Furthermore, in the past 30 years, “Childhood obesity has more than doubled in children and quadrupled in adolescents…” In addition, the CDC reports:
The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.5
Although there is some evidence of obesity rates leveling off in the youth, a 2014 study in JAMA reported, “Analyses of trends in obesity prevalence among middle and high school students have shown mixed results.”3 In this article, the authors discussed how time trends impact reporting:
Analysis of time trends depends on what is chosen as the initial point of examination. In this analysis, we selected 2003-2004 as the starting point because previous analyses had shown no change in sex- or race/Hispanic origin–specific trends in obesity prevalence between 2003-2004 and 2009-2010.8,9 The selection of the initial point can have an effect on findings. For example, analyses of childhood obesity trends between 1976-1980 and 2011-2012 show an increase in childhood obesity, whereas trends between 2003-2004 and 2011-2012 do not.3
Furthermore, they authors admitted that differences in measurements and age group divisions could present with issues of clearly delineating trends. The same study states,
In the current analysis, trend tests were conducted on different age groups. When multiple statistical tests are undertaken, by chance some tests will be statistically significant (eg, 5% of the time using ? of .05). In some cases, adjustments are made to account for these multiple comparisons, and a P value lower than .05 is used to determine statistical significance. In the current analysis, adjustments were not made for multiple comparisons, but the P value is presented.3
Regardless of the steady or increasing rates of childhood obesity, it’s still not a good picture. According to Dr. Katz in an article in Health Day, “The glass is half-full because stabilization is an improvement over obesity increases seen for decades,” he said. “The glass is half-empty, because stable rates are not falling rates, and obesity prevalence remains alarmingly high.”
Furthermore, as stated in a 2015 study in the Journal of Family Medicine and Primary Care, “Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low and middle income countries, particularly in urban settings. The prevalence has increased at an alarming rate. Globally in 2010, the number of overweight children under the age of five is estimated to be over 42 million. Close to 35 million of these are living in developing countries.”4
The study’s abstract reads:
Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Childhood obesity can profoundly affect children’s physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Many co-morbid conditions like metabolic, cardiovascular, orthopedic, neurological, hepatic, pulmonary, and renal disorders are also seen in association with childhood obesity.4
Clearly, simplifying this issue to a calories-in verses calories-out phenomenon is not only sorely missing the multitude of interacting factors, but is proving to be poor science. 7-9 For example, if calorie dense food was causing weight gain, why would studies with coconut oil show benefit for weight loss?10-12 Even in a controlled trial with caloric reduction comparing coconut oil to olive oil (given in muffins!), coconut oil consumption resulted in greater weight loss.12 Regardless of the updated scientific evidence, it seems many conventional recommendations are still to “decrease calories.”13
Another small study demonstrated how quality of food impacts weight. The researchers concluded that in just 9 days, children on an isocaloric diet who substituted starch for sugar not only experienced weight loss, but better metabolic results were also reported:14-15
“Isocaloric fructose restriction improved surrogate metabolic parameters in children with obesity and metabolic syndrome irrespective of weight change.”15 Various other studies have also demonstrated the metabolic derangement of fructose in the diet in regards to weight, liver health, and cardiovascular outcomes. 16-18
So, the good news is that changing our dietary patterns does have an effect on weight and health measures. However, there is more to the picture than that. If it were that easy, every diet would be successful. They aren’t. Furthermore, there’s a “bigger” issue with sub-quality diets, junk food can literally be addictive. One study from 2012states:
As of 2010 nearly 70% of adult Americans were overweight or obese. Specifically, 35.7% of adult Americans are obese, and this is the highest level of obesity in the recorded history of the United States. A number of environmental factors, most notably the number of fast food outlets, have contributed to the obesity epidemic as well as to the binge prone dynamic. There is evidence that bingeing on sugar-dense, palatable foods increases extracellular dopamine in the striatum and thereby possesses addictive potential. Moreover, elevated blood glucose levels catalyze the absorption of tryptophan through the large neutral amino acid (LNAA) complex and its subsequent conversion into the mood-elevating chemical serotonin. There appear to be several biological and psychological similarities between food addiction and drug dependence including craving and loss of control. Nonetheless there is at least one apparent difference: acute tryptophan depletion does not appear to induce a relapse in recovering drug-dependent individuals, although it may induce dysphoria. In some individuals, palatable foods have palliative properties and can be viewed as a form of self medication. This article will examine environmental factors that have contributed to the obesity epidemic, and will compare the clinical similarities and differences of food addiction and drug dependence.2
For the above reasons, I always like to assess my client’s digestion, assimilation, hormonal health, and neurotransmitters if changing dietary patterns is like a battlefield that seems hard for them to win.
What Else Could Be At Play?
In my blog, “The Dirty D Word,” published on Natural Path, I discussed all the different factors relating to healthy weight management. These include: maintaining a healthy microbiome, food quality, stress mediation, hormonal balance, digestive health, activity level, genetics, gender (you can’t change this, but there are dietary and exercise implications), environmental exposures, neurotransmitter balance, and sleep hygeine. I also give 5 quick tips for the confused dieter. You can read the blog here.
To continue on, I give some more updates on these connection in my Saratoga blog here.
What do consumers think, why are we so obese? Watch below:
- Mitchell N, Catenacci V, Wyatt HR, Hill JO. Obesity: An overview of an epidemic. The Psychiatric clinics of North America. 2011;34(4):717-732. doi:10.1016/j.psc.2011.08.005.
- Fortuna JL. The obesity epidemic and food addiction: clinical similarities to drug dependence. J Psychoactive Drugs. 2012 Jan-Mar;44(1):56-63.
- Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Childhood and Adult Obesity in the United States, 2011-2012 JAMA. 2014;311(8):806-814. doi:10.1001/jama.2014.732.
- Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care. 2015;4(2):187-192. doi:10.4103/2249-4863.154628.
- Childhood Obesity Facts. August 27, 2015. http://www.cdc.gov/healthyschools/obesity/facts.htm
- Reinberg S. Adult Obesity Still Growing in U.S., Youth Rates Hold Steady: CDC. HealthDay. November 12, 2015. http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/adult-obesity-still-growing-in-u-s-while-youth-rates-hold-steady-cdc-705186.html
- Harcombe Z. The Calorie Theory – prove it or lose it. June 8, 2014. http://www.zoeharcombe.com/2014/06/the-calorie-theory-prove-it-or-lose-it/
- Mercola J. What Really Caused the Obesity Epidemic, and How Can It Be Reversed? Mercola.com. September 20, 2015. http://articles.mercola.com/sites/articles/archive/2015/09/20/what-caused-obesity-epidemic.aspx
- Gunnars K.Debunking The Calorie Myth – Why “Calories in, Calories Out” is Wrong. Authority Nutrition. August 10, 2013. http://authoritynutrition.com/debunking-the-calorie-myth/
- Cardoso DA, Moreira AS, De Oliveira GM, Raggio Luiz R, Rosa G. A coconut extra virgin oil-rich diet increases HDL cholesterol and decreases waist circumference and body mass in coronary artery disease patients. Nutr Hosp. 2015 Nov 1;32(n05):2144-2152.
- Liau KM, Lee YY, Chen CK, Rasool AHG. An Open-Label Pilot Study to Assess the Efficacy and Safety of Virgin Coconut Oil in Reducing Visceral Adiposity. ISRN Pharmacology. 2011;2011:949686. doi:10.5402/2011/949686.
- St-Onge M-P, Bosarge A. Weight-loss diet that includes consumption of medium-chain triacylglycerol oil leads to a greater rate of weight and fat mass loss than does olive oil. The American journal of clinical nutrition. 2008;87(3):621-626.
- Zaratsky K. Can coconut oil help me lose weight? Mayo Clinic.
- Lusting R, Mulligan K, Noworolski SM, Tai VW, Wen MJ, Erkin-Cakmak A, Gugliucci A, Schwarz JM. Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. doi: 10.1002/oby.21371
- Cha AE. Cutting sugar from kids’ diets appears to have a beneficial effect in just 10 days. Washington Post. October 28, 2015. https://www.washingtonpost.com/news/to-your-health/wp/2015/10/27/cutting-sugar-from-kids-diets-appears-to-have-a-beneficial-effect-in-just-days/
- Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010 Sep;110(9):1307-21. doi: 10.1016/j.jada.2010.06.008.
- Lustig RH. Fructose: it’s “alcohol without the buzz“. Adv Nutr. 2013 Mar 1;4(2):226-35. doi: 10.3945/an.112.002998
- Thompson D. Sweetened Drinks Might Raise Men’s Risk for Heart Failure. Health Day. November 2, 2015. http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/lots-of-sweetened-drinks-raise-men-s-risk-for-heart-failure-704861.html