Obesity is a chronic and often progressive metabolic disease. It is a serious threat to your health and results in increased mortality and morbidity. Obesity occurs when your body accumulates and stores excessive amounts of body fat. Can genetics explain why some people tend to gain weight more easily than others? Find out 3 myths about obesity here.
Many believe that obesity is a result of poor lifestyle choices that are under the voluntary control of affected individuals. This has led to a social stigma of obesity and a term known as “fat-shaming”. However, is obesity really up to an individual? In this article, we will explore 3 myths on obesity and debunk them step by step.
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Myth 1: I am obese only because I have poor lifestyle choices (unhealthy diet and lack of exercise).
Fact: There are many factors that contribute to the development of obesity. These include age, medications, hormonal issues and most interestingly, genetics.
Genetics contribute 40% to 70% of your BMI (body mass index) in most individuals. The World Health Organization (WHO) guidelines for Asian individuals define overweight as a BMI between 23 and 24.9kg/m2 and obesity as BMI more than 25kg/m2. Studies have also shown that if you have one biological parent with obesity, your risk of obesity is 3 to 4 times more than someone with parents who are not obese. This risk increases to 10-fold if you have two biological parents with obesity.
Since 2006, genome-wide association studies have found more than 50 genes associated with obesity. Genes that increase obesity risk generally cause increased hunger levels, increased caloric intake, reduced satiety, increased tendency to be sedentary and increased tendency to store body fat. Examples of genes that are associated with obesity include FTO (fat mass- and obesity-associated gene) and PPARG (peroxisome proliferator-activated receptor gamma). FTO promotes food intake while PPARG stimulates lipid uptake and development of fat tissue.
Myth 2: I have genes associated with obesity so I am destined to be obese.
Fact: Although genetics influence your risk to develop obesity, genes do not determine your destiny.
Many people who carry these so-called “obesity genes” do not become overweight, and healthy lifestyles can counteract these genetic effects. In 2008, Andreasen demonstrated that physical activity offsets the effects of one obesity-promoting gene, a common variant of FTO. The BMI of people with “obesity genes”, who were physically active, were no higher or lower than the BMI of people who did not have the genetic predisposition. In contrast, low physical activity accentuates the effect of the gene on body fat accumulation.
Moreover, in 2014, a study found that consumption of fried food could interact with genes associated with obesity. This underscores the importance of eating less fried food if you are already genetically predisposed to obesity. If you follow a consistent treatment plan that adopts an effective nutritional, physical activity and behavioural approach, this can help to prevent and treat obesity.
Myth 3: Diet and exercise alone can help me to get rid of obesity.
Fact: There is growing evidence that diet and exercise alone are usually ineffective in decreasing and maintaining a lower BMI.
This is especially true for people with severe obesity, defined as those with BMI of 40 and above. Weight loss causes hunger to increase and metabolism to slow down. Thus, people with initial weight loss can end up gaining a significant amount of weight back. So what else can you do to get rid of obesity? Medications can be used to complement diet and exercise for those with severe obesity. Weight loss medications work by reducing your appetite or by changing the way you digest food. Such medications are appropriate if you have:
- BMI of 30 or greater, or
- BMI between 27 and 29.9 and also have weight-related medical problems, such as diabetes, heart disease or high blood pressure
Another option would be weight loss surgery. Weight loss surgery works by making your stomach smaller or changing the path food takes through your gastrointestinal system so that fewer calories and nutrients get absorbed. Weight loss surgery can also be considered if you have:
- BMI greater than 40, or
- BMI of 35 to 29.9 and also have medical problems like diabetes, heart disease or high blood pressure, or
- BMI 30 or greater and have diabetes that cannot be controlled in other ways.
Genes may co-determine who becomes obese, but our environment determines how many becomes obese. It is important to remember genes contribute to your risk of obesity but it does not determine your destiny. Set clear behaviour goals and time frames for reaching your goal. If your BMI is 23 kg/m2 and above, losing 10% to 15% of your current body weight over 6 months at a rate of 0.5kg to 1 kg a week is a healthy target. Do not forget to reward small changes along the way to your final goal.
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