In each instance, the proximate cause of the issue was not permanently or meaningfully resolved. Treatment of the root problem, however, is significantly more effective.
In the case of obesity, what factors contribute to weight gain?
Consuming more calories than you burn off as a primary cause.
The underlying response to that last query is that "personal choice"—choosing to eat chips instead of broccoli—is the ultimate reason if "more calories in than out" is the proximate cause. We decide against working out and instead watch TV.
By applying this logic, obesity is changed from a condition that requires research and understanding into a character flaw, a personal failing. Instead than attempting to identify the root of obesity, we change the issue into
excessive eating (gluttony) and/or insufficient exercise (sloth).
Two of the seven deadly sins are gluttony and sloth. As a result, we describe obese people as having "brought it on themselves" or as having "let themselves go," which gives us the reassuring impression that we know the true root of the issue. A 2012 online survey1 found that 61
percent of American respondents said that the obesity problem was caused by "personal choices regarding eating and activity." Therefore, we are prejudiced against those who are obese. We both feel sorry for and detest them.
On closer inspection, this notion, however, cannot possibly be accurate. Boys and girls often have the same body-fat proportion before puberty. Women often have close to 50% more body fat than men do after puberty. Despite the fact that men often consume more calories than women, this transformation nevertheless takes place. Why then is this the case?
What is the underlying reason? It is unrelated to personal preferences. It is not a flaw in character. ladies are not
more sluggish or gluttonous than males. Women must be more inclined to store extra calories as fat rather than burning them off due to the hormonal mix that makes men and women distinct.
Additionally, weight increase during pregnancy is important. What is the underlying reason? Once more, pregnancy-related hormonal changes are to blame.
—not self-decision—that promotes weight gain.
We assume the answer to obesity is to eat less calories because we misunderstood the primary and secondary reasons.
All of the "authorities" concur. The most recent revision to the Dietary Guidelines for Americans was made in
The Centers for Disease Control2 urge patients to balance their calories in 2010, which loudly declares its major recommendation: "Control total calorie intake to manage body weight." The National Institutes of Health's booklet "Aim for a Healthy Weight" offers the following advice: "to reduce the number of calories... they obtain from food and drink, and they engage in more physical activity."3
All of this advice comes together to make the well-known "Eat Less, Move More" plan that obesity "experts" adore. However, here's an odd idea: If we already understand what causes obesity, how to treat it, and we've spent millions on education and obesity, why do we still need more advise?
Programs, what's up with the weight gain?
An epidemic's anatomy
WE DIDN'T ALWAYS have such a fixation on calories. Obesity has not been common over the majority of human history. Even in periods of plentiful food, those who followed traditional diets rarely became obesity. Obesity increased along with modernity. Many hypothesized that processed carbohydrates like sugar and grains were to blame. The seminal book The Physiology of Taste was written in 1825 by Jean Anthelme Brillat-Savarin (1755–1826), who is regarded as the father of the low-carbohydrate diet. "The second of the major causes of obesity is the floury and starchy items which," he wrote there
Man creates the main components of his daily nutrition. As we've previously stated, "all creatures that live on farinaceous food gain fat at random, and man is no exception to the universal law.
Fat, protein, and carbs are the three main macronutrient classes into which all foods can be categorized. The "macro" in "macronutrients" alludes to the fact that these three groups make up the majority of the food we eat. Micronutrients are vitamins and minerals such vitamins A, B, C, D, E, and K as well as minerals like calcium and iron, which make up a very small fraction of the food. Carbohydrates include sugars and starchy meals.
A few decades later, an English undertaker named William Banting (1796-1878) rediscovered the refined carbohydrate's capacity to make people fat. He released the pamphlet Letter on Corpulence, Addressed to the Public in 1863, which is frequently referred to as the first diet book ever written. His tale is not particularly noteworthy. He did not have a history of obesity in his family or as a child. But about the middle of his forties, he began to put on weight. Not much; maybe a pound or two annually. He was 52 years old, 5 feet 5 inches tall, and 202 pounds (92 kilograms). He may not have been exceptional by today's standards, but he was at the time rather large. In distress, he looked for
guidance from his doctors about losing weight.
He first made an effort to eat less, but this simply made him more hungry. Even worse, he was unable to reduce his weight. Then, close to his London residence, he intensified his workout by rowing down the River Thames. He became more physically active, but he also gained a "prodigious appetite, which I was obliged to indulge"5. Despite this, he was unable to shed weight.
Finally, Banting adopted a fresh strategy after consulting his surgeon. He vehemently shunned all breads, milk, beer, sweets, and potatoes that had previously made up a big component of his diet because he believed that sugary and starchy foods were fattening. (Today, we'd
If you want to lose weight and keep it off, call this diet low in refined carbs.) William Banting likewise felt so good that he was inspired to write his well-known booklet. He thought eating an excessive amount of "fattening carbs" was the cause of weight gain.
Diets reduced in refined carbs were regarded as the gold standard for treating obesity throughout the most of the following century. It was regarded as pretty common advice by the 1950s. Your grandparents wouldn't mention calories if you asked them what led to obesity. They would advise you to cease consuming sugary and starchy foods instead. The truth was supported by common sense and empirical observation.
Governmental advice and nutritional "experts" were not required.
As a "scientific system of weight control," Dr. Robert Hugh Rose's book Eat Your Way to Health, published in the early 1900s, was the first to introduce calorie counting. In 1918, Dr. Lulu Hunt Peters, an American doctor and newspaper columnist, followed it with the best-selling Diet and Health with Key to the Calories. the U.S. president at the time, Herbert Hoover switched the Food Administration to calorie counting. Dr. Peters encouraged patients to begin by fasting for one to two days without eating, and then closely adhere to 1200 calories per day. While the recommendation to fast
Modern calorie-counting routines are not much different and are soon forgotten.
A purported "great epidemic" of heart disease had begun to raise public anxiety by the 1950s. Americans who appeared to be in good health were having heart attacks more frequently. In retrospect, it ought to have been clear that there was no such outbreak.
The medical environment had changed as a result of the development of vaccinations and antibiotics as well as improved public cleanliness. Infections that were once fatal, such pneumonia, TB, and gastrointestinal infections, can now be treated. Heart
Since sickness and cancer suddenly accounted for a disproportionately higher number of fatalities, the public has begun to believe there is an epidemic. As seen in Figure 1.1.6
Picture 1.1 death factors in the
1900 and 1960 U.S. data.
The view was strengthened by the rise in life expectancy from 1900 to 1950.
of an outbreak of coronary disease. In 1900, a white male's life expectancy was 50 years.7 By 1950, it had increased to 66 years, and by 1970, it had nearly reached 68 years. People would live long enough to experience heart attacks if tuberculosis was not killing them. The average age of the first heart attack is currently 66 years.8 A man's chance of having a heart attack is significantly lower at 50 than it is at 68. Therefore, a higher incidence of coronary disease is a natural result of a longer life expectancy.
But every great tale requires a villain, and dietary fat was given that assignment. It was believed that dietary fat would lead to an increase in the fatty substance cholesterol.
It is believed to be present in the blood and causes heart disease. Soon, doctors started recommending lower-fat diets. The demonization of dietary fat started in earnest with a lot of fervor but questionable science.
Even though we weren't aware of it at the time, there was a problem. Fat, protein, and carbs are the three macronutrients; reducing dietary fat required substituting either protein or carbohydrates. It is challenging to reduce fat in the diet without also reducing protein because many high-protein items, such as meat and dairy, are also rich in fat.
Therefore, increasing dietary carbohydrates would be necessary if dietary fats were restricted, and vice versa. In the
These carbohydrates are typically all highly refined in the developed world.
The paradox Low Fat = High Carbohydrate led to substantial
cognitive conflict. Since refined carbs have little fat, they cannot be both good and bad at the same time (because they are fattening). Most nutrition specialists suggested that carbs were no longer fattening as a remedy. Instead, calories made them obese. It was unilaterally decided that additional calories, not specific foods, caused weight gain, without any supporting data or historical precedence. A previously unheard-of notion, fat was now regarded as the dietary devil and as being fattening. The Calories:
The prevalent "fattening carbs" approach started to be replaced by the In/Calories-Out model.
However, not everyone agreed. John Yudkin, a well-known British nutritionist, was one of the most well-known rebels (1910–1995). He researched food and heart disease and discovered no link between dietary fat and the disease. His 1972 book, Pure, White and Deadly: How Sugar Is Killing Us, is startlingly accurate. He claimed that sugar was the primary cause of both obesity and heart disease.9, 10. (and should certainly win the award for Best Book Title Ever). Whether dietary fat or sugar was to blame for the problem was the subject of intense scientific dispute.