Expecting all obese people to lose weight solely by “eating less and moving more” misunderstands the nature of the condition and will never solve the obesity epidemic, leading doctors have said.
In a staunch rebuttal to commentators who argue obese people have brought the problem on themselves and should rely only on diet and exercise, experts from leading American universities said that, even after actively losing weight, biological mechanisms kick in that make it extremely difficult for previously obese people to stay a healthy weight.
Writing in The Lancet, they say recommendations just to cut back on high calorie foods might be “no more effective for the typical patient seeking weight reduction that would be a recommendation to avoid sharp objects for someone bleeding profusely”.
Many obese people can lose weight for a few months, but between 80 and 95 per cent regain their lost weight.
This is because cutting back on calorie intake triggers biological systems that evolved when humans needed to survive in times of scarcity.
In the modern environment, in which food is not just plentiful, but often highly calorific and aggressively advertised, these same systems, which act on the metabolism and the brain, make it hard for previously obese people to stay lean, the doctors write.
Dr Christopher Ochner, assistant professor of paediatrics and psychiatry at the Icahn School of Medicine in New York and lead author of the paper, said that in those with chronic obesity “bodyweight seems to become biologically stamped in and defended”.
“Few individuals ever truly recover from obesity; rather they suffer from ‘obesity in remission’,” he said. “They are biologically very different from individuals of the same age, sex, and bodyweight who never had obesity.”
Measures that can reverse obesity-induced changes to the body’s biology will be needed to treat many patients, according to the paper.
The healthy eating trends of 2015
The healthy eating trends of 2015
1/10 Acai bowls are the new green juice
Who ever thought we’d have been ok with adding spinach to our smoothies? Yet even virtuous green juices started to get something of a bad rep, as the ‘juice fast’ backlash grew and it turned out that some shop-bought juices contained as much sugar as a can of fizzy drink. Bring on Acai bowls, the new darlings of Instagram. Like a gloopier smoothie, these are made with antioxidant-rich acai berries (they are hard to come by - search for powdered or dried berries or frozen puree), which are said to aid weight loss. Blend with frozen bananas, berries and a little nut milk and top with whatever you like - seeds, nuts, cacao nibs, goji berries. A picture-perfect purple powerhouse for breakfast.
Ella Grace Denton, www.weneedtolivemore.com
2/10 Bone broth is the new Miso soup
Remember back in the day when the word ‘broth’ would conjure up visions of Dickensian orphanages? Then miso came along, Gwyneth embraced it, and we all followed suit, lauding how filling and protein rich with little wonder broth was. We’ve come full circle now, as bone broth is back on the radar. The glowing-with-health Hemsley sisters seem to use bone broth in most of their recipes, and rave about its nutritional benefits. “Bone broth is a nourishing all rounder packed with vitamins, minerals, collagen and keratin which makes it amazing for skin – including the dreaded cellulite! The healthy fats in the broth help you to assimilate important vitamins including Vit D.” There you go, something to stew over...
Food Loves Writing, Flickr
3/10 Bee pollen is the new Manuka honey
Every health hipster has a jar of manuka honey on their shelves - if they can afford it that is, a jar can cost about £15. But many claim it is worth its weight in gold, due to its unique antibacterial properties. Traditionally it was used on wounds, but many also claim that it performs miracles combatting cholesterol, diabetes, cancer and digestive problems (although the science is limited). Now bee pollen is the latest ‘superfood’ out there - thought to ward off colds, limit food cravings, improve skin tone, ward off allergies like hay fever (although some caution that it may exacerbate them) and, of course, fight cancer. Again, the science behind these claims is dubious - but it certainly adds a nice sweetness to your morning porridge.
4/10 Kelp is the new kale
Last year saw the emergence of an unassuming green leaf that was previously barely used beyond cattle feed. Now, we have kale chips in Pret, kale juices, ‘massaged’ kale salads - it’s even on the menu in fine dining restaurants. Yawn. Introducing kelp. This seaweed is high in iodine, which is said to improve thyroid function and control metabolism. It is also thought to have anti-aging properties for skin and hair. Try it in salads or add to asian-style soups.
5/10 Matcha is the new green tea
Yes, yes, yes, green tea, weightloss, yadda yadda yadda, boosts metabolism, etc etc. For 2015, though, it’s not about just any old green tea - this is matcha green tea. Made from finely milled high-grade matcha leaves, which are grown in the shade, matcha boasts 130 times more anti-oxidants than your bog standard green tea and is supposed to boost energy levels, lower stress, improve your mood and aid metabolism. It can be consumed as a regular tea, added to steamed milk for a matcha latte or even used to add a pleasant green shade and flavour to ice-cream.
6/10 Whole 30 is the new Paleo diet
Thought you were a culinary champ with your caveman-style eating plan? Well, think again, paleo is for wimps! Ok, not quite, but while people on the paleo plan cut out grains, legumes, sugar and processed foods, there is an increasing trend to paleo-fy your treats, with almond-flour pancakes, banana bread and a lot of brownies. The Whole 30 plan is a purer, stricter version of Paleo and really takes you back to basics when it comes to eating natural foods. The 30-day plan bans scales as well as sugar and alcohol, so that you can concentrate on nourishment rather than weight.
7/10 Fermenting is the new sprouting
Just when we thought we were ahead of the game by starting to sprout our own seeds and with sprouted flours creeping on to the market, the health set had to kick it up a notch. Now it’s all about making your own kombucha (fermented tea), sauerkraut or kimchi (both kinds of pickled cabbage). Fermented foods are said to aid digestion thanks to the creation of enzymes and probiotics in the process. Plus they tend to be high in B-vitamins and Omega-3 fatty acids. Think of it as the new jam-making, and break out those mason jars.
8/10 Banana flour is the new coconut flour
Coconut flour was one of the coolest baking ingredients of the year, beloved by Paleo fans. Its highly absorbent qualities mean you only need a tiny bit for baking, keeping your creations low carb but resulting in the odd dry-crumbly-mess baking fail. Banana flour is the next flour to experiment with. Made from green bananas (and no, not banana-flavoured), it is gluten free and light in texture, so ideal for baking. High in resistant starch, which is effective against colon cancer, obesity, and diabetes, it is already being lauded for its nutritional benefits in Africa and South America, and will surely start to become much more visible on health-food shop shelves in the near future.
9/10 Bulletproof coffee is the new soy latte
Nowadays it is possible to walk into almost any cafe and order a soy latte without being eyeballed as a lunatic by the person behind the counter. But would you have the guts to request a stick of butter in your morning brew? Well, some coffee shops are offering exactly that. Bulletproof coffee is a paleo-friendly invention which involves a black coffee with a dollop of coconut oil or butter. Bleurgh. But advocates say it gives you more slow-release energy, sharpens your brain and helps you to focus - and even that it is delicious. Now the theory has been expanded into a whole ‘Bulletproof’ diet plan, rich in fat. Who wants to bet on when Starbucks will give it a shot?
10/10 Tiger nuts are the new almonds
2014 was a good year for almonds. Gym-goers and raw foodists alike carried around a stash for healthy, protein-rich snacking, almond-milk lattes were quaffed, and almond flour featured in so many paleo and gluten-free treats. Now tiger nuts, or ‘earth almonds’ (yes, really), are about to vie for snacking superiority. Tiger nuts are not nuts, but the tubers of the sedge plant. Originally a key food source for Paleolithic Indians, they have until recently been used as animal feed or a side dish in South America, Africa and the Middle East, or in Hispanic companies made into a sweet, milky drink called horchata. But now the hipsters have got their hands on it, drying, roasting and flavouring with the likes of sweet chilli for an on-the-go snack. High in healthy fats, protein and natural sugar, it is rich in energy content, and thought to help prevent heart disease and improve circulation.
Weight loss surgery, which can have has this effect, has been shown to be effective in maintaining long-term weight loss. Drug treatments for obesity are not yet fully proven to work.
The Lancet paper, which is published today, coincides with the release of a new study that furthers our understanding of the genetic factors that predispose people to becoming overweight. The study, in the journal Nature, identified 97 regions in the genome that influence obesity, including genes that affect signals sent by the brain that control appetite and energy use.
Dr Rachel Batterham, head of University College London Hospital’s Centre for Weight Loss, said she saw hundreds of patients “nearly every one” of whom had successfully lost weight, only to put it back on again.
“That’s because their biology wants them to return to the maximum weight they had achieved,” she said. “Once people have become overweight, then biology changes. An understanding of how difficult it is to lose that weight and keep it off needs to be communicated.”
Professor John Wilding, of the University of Liverpool’s Institute of Ageing and Chronic Disease, who helped draw up recent NICE guidelines which will see weight loss surgery given to an estimated 15,000 people a year, said that while it was always best to begin weight loss interventions with diet and exercise, too many people, including doctors, did not understand that obese people who had lost weight would regain it if they took up their previous diet.
“It is in reality much, much harder for someone who has dropped from 15 stone down to 11 stone, to stay at 11 stone, than it is for someone who has always been at 11 stone, because they are fighting a whole set of complicated biological signals that are telling their body they should be at 15 stone,” he said.Reuse content