Okay, some of you know I'm passionate about this issue. Recently for uni I had to do a public health interventions essay, which I chose to do on obesity. Now that I've been graded on the essay I have uploaded it to my website 
and I can finally start talking about it! I refrained from doing so before because I did not want there to be any possibility that I would be done for plagiarising myself. I got a high distinction (92%) for the essay. This is what the unit convener said: "It was really impressive – one of the few that took a critical perspective on policymaking. It was very well written, clear, well referenced and persuasive." I have 27 references in the essay, and most are peer-review - so if you want more information I suggest you look to the references I provide there, I'm only going to mention a handful in this post. Also, the essay focused on policy (because that's what I had to do) and less on science, so I ended up leaving out a lot of science which I would have liked to have included if I was to do a 2500 word essay on the science behind obesity. I must have deleted 3 or 4 entire paragraphs that would have been science-focused.
What irks me is the blatant disregard of facts and science when it comes to this important issue.
1. Obesity as a disease: Yes and no. First proposed in the 1940's by the WHO as a disease in its own right, it is recognised by WHO and by the American Medical Association as a disease, but it is not recognised by such in Australia or for that matter most of the world.
2. 1lb of fat equals 3500 kcal. NO, No, no no no! It's true that if fat cells are roughly 87% lipid that in total they would yield 3555 kcal (approx) when catabolized. But the devil is in the detail. Adipose tissue is essentially a permanent structure that is not easily catabolized; thus if you loose weight you're only burning the lipids you are not burning the fat cells themselves at all.
3. Hunger is controlled by a homoeostatic process. As difficult as it might be to believe, the two hormones that control hunger - ghrelin and leptin - are responsible for biochemically controlling how much energy a person consumes from food. It is not possible to consciously choose to consume more or less than what is determined biochemically. If you don't believe me, then you have to explain to me the 20-year study done in the USA (Mozaffarian et al. 2011) that showed that long-term weight gain in 120,000 non-obese patients averaged to 0.38 kg per year. Per day that is 7 kcal or one single McDonald's French Fry. No one has that level of conscious precision over what they eat.
Now I want to put this in a way that perhaps is very easy to understand. Endurance athletes like marathon runners and cyclists sometimes drop dead, just like Bruce Lee. Right, a normal resting heart-rate for humans is between 60 to 100 beats per minute, and typically it's 80 or very close to 80 beats per minute. Endurance athletes actually change their physiology, in that they build up their RBC (red blood cell) count and consequently their resting heat rate can go all the way down to just 40 beats per minute. This is not what the body is designed to do, it is not healthy, and at 40 beats per minute your heart may "skip a beat" or simply stop beating and then you literally drop dead. So your food intake, just like your red blood cell count, you cannot consciously choose to increase or decrease, but you can choose to engage in activities that will influence it significantly. How many kcal you consume is well beyond your conscious control.
4. Diets and the diet industry cannot reverse obesity long-term. There is plenty of peer review literature on this, this is well known, and I will will quote one expert, Joe Proietto: "we now know body weight is very vigorously defended by the brain. In that following weight loss the hormones that control hunger (that circulate in our blood) change in a direction to make people more hungry. And hence making it very difficult to maintain weight loss." (see). Non-medical intervention does not work to reverse obesity long-term, end of story. The diet industry sells a product that doesn't work, and consumers of the product typically blame themselves instead of the product!
5. Policy has not worked. I guess I may as well mention this now since I had to research this! In Australia the various governments (state, territory and federal) have focused their efforts on mass-marketing campaigns costing tens of millions of dollars, starting with "Measure Up" in 2008 and continuing through to today. These campaigns have raised awareness of risk factors, but so far have not had any effect on changing behaviour. I was pretty scathing in my essay regarding them because they a. ignore the more detailed science and b. ignore the non-individual (environment and social) risk factors. So in short: the campaigns have had no benefit whatsoever beyond being an effective means of communicating the risk factors.
I hope that this discussion can help move us beyond seeing obesity as an individual problem or caused by gluttony or other such nonsense. Obesity is not caused by "overeating", it is caused by hormone imbalance and the two hormones most directly responsible are leptin and insulin.
and I can finally start talking about it! I refrained from doing so before because I did not want there to be any possibility that I would be done for plagiarising myself. I got a high distinction (92%) for the essay. This is what the unit convener said: "It was really impressive – one of the few that took a critical perspective on policymaking. It was very well written, clear, well referenced and persuasive." I have 27 references in the essay, and most are peer-review - so if you want more information I suggest you look to the references I provide there, I'm only going to mention a handful in this post. Also, the essay focused on policy (because that's what I had to do) and less on science, so I ended up leaving out a lot of science which I would have liked to have included if I was to do a 2500 word essay on the science behind obesity. I must have deleted 3 or 4 entire paragraphs that would have been science-focused.What irks me is the blatant disregard of facts and science when it comes to this important issue.
1. Obesity as a disease: Yes and no. First proposed in the 1940's by the WHO as a disease in its own right, it is recognised by WHO and by the American Medical Association as a disease, but it is not recognised by such in Australia or for that matter most of the world.
2. 1lb of fat equals 3500 kcal. NO, No, no no no! It's true that if fat cells are roughly 87% lipid that in total they would yield 3555 kcal (approx) when catabolized. But the devil is in the detail. Adipose tissue is essentially a permanent structure that is not easily catabolized; thus if you loose weight you're only burning the lipids you are not burning the fat cells themselves at all.
3. Hunger is controlled by a homoeostatic process. As difficult as it might be to believe, the two hormones that control hunger - ghrelin and leptin - are responsible for biochemically controlling how much energy a person consumes from food. It is not possible to consciously choose to consume more or less than what is determined biochemically. If you don't believe me, then you have to explain to me the 20-year study done in the USA (Mozaffarian et al. 2011) that showed that long-term weight gain in 120,000 non-obese patients averaged to 0.38 kg per year
. Per day that is 7 kcal or one single McDonald's French Fry. No one has that level of conscious precision over what they eat.Now I want to put this in a way that perhaps is very easy to understand. Endurance athletes like marathon runners and cyclists sometimes drop dead, just like Bruce Lee. Right, a normal resting heart-rate for humans is between 60 to 100 beats per minute, and typically it's 80 or very close to 80 beats per minute. Endurance athletes actually change their physiology, in that they build up their RBC (red blood cell) count and consequently their resting heat rate can go all the way down to just 40 beats per minute. This is not what the body is designed to do, it is not healthy, and at 40 beats per minute your heart may "skip a beat" or simply stop beating and then you literally drop dead. So your food intake, just like your red blood cell count, you cannot consciously choose to increase or decrease, but you can choose to engage in activities that will influence it significantly. How many kcal you consume is well beyond your conscious control.
4. Diets and the diet industry cannot reverse obesity long-term. There is plenty of peer review literature on this, this is well known, and I will will quote one expert, Joe Proietto: "we now know body weight is very vigorously defended by the brain. In that following weight loss the hormones that control hunger (that circulate in our blood) change in a direction to make people more hungry. And hence making it very difficult to maintain weight loss." (see
). Non-medical intervention does not work to reverse obesity long-term, end of story. The diet industry sells a product that doesn't work, and consumers of the product typically blame themselves instead of the product!5. Policy has not worked. I guess I may as well mention this now since I had to research this! In Australia the various governments (state, territory and federal) have focused their efforts on mass-marketing campaigns costing tens of millions of dollars, starting with "Measure Up" in 2008 and continuing through to today. These campaigns have raised awareness of risk factors, but so far have not had any effect on changing behaviour. I was pretty scathing in my essay regarding them because they a. ignore the more detailed science and b. ignore the non-individual (environment and social) risk factors. So in short: the campaigns have had no benefit whatsoever beyond being an effective means of communicating the risk factors.
I hope that this discussion can help move us beyond seeing obesity as an individual problem or caused by gluttony or other such nonsense. Obesity is not caused by "overeating", it is caused by hormone imbalance and the two hormones most directly responsible are leptin and insulin.
For Religion & Health see:[/b][/size] Williams & Sternthal. (2007). Spirituality, religion and health: Evidence and research directions. Med. J. Aust., 186(10), S47-S50. -LINK
The WIN/Gallup End of Year Survey 2013 found the US was perceived to be the greatest threat to world peace by a huge margin, with 24% of respondents fearful of the US followed by: 8% for Pakistan, and 6% for China. This was followed by 5% each for: Afghanistan, Iran, Israel, North Korea. -LINK
"That's disgusting. There were clean athletes out there that have had their whole careers ruined by people like Lance Armstrong who just bended thoughts to fit their circumstances. He didn't look up cheating because he wanted to stop, he wanted to justify what he was doing and to keep that continuing on." - Nicole Cooke
The WIN/Gallup End of Year Survey 2013 found the US was perceived to be the greatest threat to world peace by a huge margin, with 24% of respondents fearful of the US followed by: 8% for Pakistan, and 6% for China. This was followed by 5% each for: Afghanistan, Iran, Israel, North Korea. -LINK
"That's disgusting. There were clean athletes out there that have had their whole careers ruined by people like Lance Armstrong who just bended thoughts to fit their circumstances. He didn't look up cheating because he wanted to stop, he wanted to justify what he was doing and to keep that continuing on." - Nicole Cooke
