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About obesityBody weight regulation

Obesity -who is to blame? Part 1

By 28 August, 2021 No Comments

I have been meeting patients with obesity for many years and talked to several thousand patients with obesity or overweight. What strikes you consistently, both in the affected individual and in the reactions they tell you about from their environment or previous healthcare experiences -is the discussion of guilt.

Whose fault is it… and why is it so important?

Whose fault is it that you suffer from overweight/obesity? Whose fault is it that you don’t fix the problem yourself by “moving more and eating less”? Why do patients, their surroundings and healthcare (!) over and over again fixate on the issue of who is to “blame for the problem” of overweight/obesity? We never do it in other situations?

Someone who falls, has a fracture and has to be treated in the hospital – doesn’t get cross-examined about “risky behavior” by their loved ones or their treating orthopaedic surgeon before the fracture is even casted? Someone who is stressed at work, regularly drinks alcohol, doesn’t have time to exercise -and now develops angina; the environment does not point the finger at him/her for the “sloppy lifestyle”, delaying or even refusing(!) treatment for the person to first “get their act together”..? No, the heart disease patient immediately gets the proper examination and then the most modern medications. A conversation about the alcohol, stress and lifestyle choices during the care period, too, of course, but not with a “blame yourself” attitude linked to it. And why? Because both fractures and coronary artery disease are diseases. And we have the right to treatment for our diseases, right?

Now it is just that obesity is also a disease, classified as such by, among others, the United Nations. WHO and American AMA. It’s not a poor lifestyle choice by a less intelligent person who lacks character, it’s a disease.

Who is at risk of developing obesity, and how many people are affected?

Obesity in society develops in two stages: the first step is whether you are at risk of getting the disease obesity at all or not – this is determined by your genes. If you have genes that are sensitive to our obesogenic (obesity-inducing) environment, then you are at risk. Step two is how many of those with sensitive genes who then develop the disease. It is determined by our daily environment – that is, our community. More about this in part 2 of the blog series.

Time to wake up – the earth is round, not flat -obesity is disease, not laziness

Why do we continue to stigmatise, discriminate and bully people with obesity? A strong part-explanation is ignorance. Obesity is a complex, hormonally controlled disease – but very few know about this.

Within Sweden’s healthcare educations – including the medical program! Nothing is basically being taught about obesity. Zero. Nothing. Let that sink in.

And if you don’t know anything about a condition and then meet this particular condition every day, what are you going to do? Well, you have to make something up. Hence the most common prescription “you have to move a little more and eat a little less, so…“. The idea behind this phrase is that the body is like an unintelligent machine without built-in defense mechanisms – if you feed the body with less energy but burn more, it shrinks -as simple as that.

The problem is that science has known since at least the 1990s that it is not that simple – the body has its own idea of what weight it wants, a so-called “set point for body weight” in the brain. If you starve your body, it still remembers what the set point was before you lost weight and now your body is defending itself! (if you want to know more -read here,look here or here). It’s 100% biology. 0% morality, will or character.

The earth is round, not flat. But society or health care has not understood that. -yet.

Time for change!

If you’re suffering from obesity, hear this! It’s not your fault. You’re a perfectly normal person! You live in a large body because you have genes sensitive to obesity. Need support? Contact the National Association of HOBS – they will be happy to help you.

You who bully others for their obesity –stop immediately! Have a close look in the mirror instead: what makes you bully others? What right do you have to judge someone for a disease? Do you also judge other people for other diseases?

If you work in health care, you know what a ghrelin or leptin molecule is, or what they do? No? Then you need to do your homework -it is not acceptable to be ignorant of something as common and serious as obesity. Have you ever prescribed “move more and eat less”, or “you have to lose weight”? That is not evidence-based care. You must read up – feel free to contact us if you need help to move forward.

Next part of the blog series

… it is about who can actually be held responsible for us having an obesity epidemic on our hands. And it’s not individual people with obesity – it’s completely different factors. Follow us!

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