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Obesity Cause Theories: Food Quantity vs. Quality

A bold new theory about the root cause of obesity has emerged in a ‘perspective’ article publishd in the latest issue of The American Journal of Clinical Nutrition. The authors propose that obesity is not caused by eating too much, but by eating the wrong stuff and warping your metabolism…

Fat American with Flag Shirt - © voanews.comWith more than 40 percent of Americans now overweight or obese, finding
a valid causal theory for the scourge is more important than ever…

The State of the Dinner Plate

According to the Centers for Disease Control and Prevention (CDC), more than 40 percent of Americans are dramatically overweight or outright obese, and that is putting them at significantly increased risk of heart disease, stroke, diabetes and some cancer4s, among other contemporary health scourges. These conditions take millions of lives around the work every year, and cost untold billions of dollars to treat.

So, it’s no surprise that scientific and medical thinkers are spending a lot of time and effort trying to nail down the root cause of obesity once and for all.

Critical thinking

The article’s authors point to a new study comparing what they call the carbohydrate-insulin model (CIM) of obesity to the conventional, century-old energy balance model (EBM).

“According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). […] An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body—resulting from the hormonal responses to a high-glycemic-load diet—drives positive energy balance.”

How the EBM model works

The traditional EBM theory of obesity contends that we get fat simple because we eat too much and tend to adopt a lifestyle in which we are less active than we should be. That notion is satisfyingly simple and logical, and tends to give folks a ‘comfort complex’ (my theory). People who are overweight and complacent about it, or want to lose weight but can’t, or can’t keep off what they do lose, point to the EBM, and sigh, and come up with all sorts of excuses why they can’t eat less or include more physical activity in their lives. End of story. Until the fat people suffer heart attacks or strokes, or develop type 2 diabetes or cancer, and wish they’d started eating better and exercising more when they had the chance.

It’s a classic case of, “I wish I’d listened to what my doctor said when I was young!”

“What did she say?”

“I don’t know! I wasn’t listening…”

Anyway… The EBM theory puts all the blame for obesity on the sufferers and offers little help for them to overcome the challenges they face. The result, the study authors say, is a massive societal failure to control obesity.

How the CIM model works

The CIM model, on the other hand, maintains that obesity – which is actually caused by metabolic imbalances – causes overeating.

“The carbohydrate-insulin model lays much of the blame for the current obesity epidemic on modern dietary patterns characterized by excessive consumption of foods with a high glycemic load: in particular, processed, rapidly digestible carbohydrates. These foods cause hormonal responses that fundamentally change our metabolism, driving fat storage, weight gain, and obesity.”

“When we eat highly processed carbohydrates, the body increases insulin secretion and suppresses glucagon secretion. This, in turn, signals fat cells to store more calories, leaving fewer calories available to fuel muscles and other metabolically active tissues. The brain perceives that the body isn’t getting enough energy, which, in turn, leads to feelings of hunger. In addition, metabolism may slow down in the body’s attempt to conserve fuel. Thus, we tend to remain hungry, even as we continue to gain excess fat.”

The takeaway

Rather than urge people to eat less, a strategy which usually doesn’t work in the long run, the carbohydrate-insulin model suggests another path that focuses more on what we eat. According to Dr. Ludwig, “Reducing consumption of the rapidly digestible carbohydrates that flooded the food supply during the low-fat diet era lessens the underlying drive to store body fat. As a result, people may lose weight with less hunger and struggle.”

My take

I like the logic behind the CIM theory, that ‘lays much of the blame’ for obesity on forces not directly within the control of the sufferers. That would explain why conscious attempts to lose weight and maintain weight loss often fail.

If the CIM model does prove valid, it could also lead to the development of drugs and treatments that could a significant weight loss for all who want it, and make maintenance of a healthy weight a reachable and reliable goal.

I also like the sound of Ludwig’s contention that that further research is needed to conclusively test both models and, perhaps, generate new models that better fit the evidence. he also calls for constructive discourse and, “collaborations among scientists with diverse viewpoints to test predictions in rigorous and unbiased research.”

~ Maggie J.