Obesity is a complex disease. It is influenced by physiological, environmental, genetic, economic, social and psychological factors. Many of these cannot be fully controlled by a person with obesity1,2,3
Although widely recognised as a chronic disease, obesity is influenced by multiple factors, many of which cannot be controlled. It is influenced by physiological, environmental, genetic, economic, social and psychological factors. Many of these cannot be fully controlled by a person with obesity.1,2,3
Misinformation, discrimination and stigma surround every aspect of obesity, what society thinks about it, and how it is treated.6
Obesity isn’t simply driven by an unhealthy food and activity environment which has political, commercial, economic, social and cultural aspects.1,2,3
When these lifestyle choices interact with a predisposed person’s unique biological, psychological, social and economic susceptibilities, obesity can result.5
So, the causes of obesity are usually different for everyone. Most of these causes can’t be controlled by the person with obesity.5
When you lose weight and are trying to keep it off, changes occur to the hormones in your body that manage your weight.6,7,8,9
These changes can result in you have to eat even less and exercise even more to just keep getting the same results.7,10 At the same time, your hormones increase your desire to eat, and in turn take longer to tell you that you are full when you’re eating.10,11
So as you lose weight your body resists further weight loss and tries to regain the lost weight. Your body is trying to push you back to your higher weight.7,8,12
You might expect that after you lose weight your body would eventually see it as a new normal, but it doesn’t.8,11 Even if you regain some or all of the weight you lost, your metabolism is slowed down for at least 6 years, so that you require fewer kilojoules (>2,000/day fewer) to function than would normally be expected.9
Studies in twins raised separately and in adopted children show that 50-80% of a person’s chance of having obesity is inherited.13
Genes also play a role in the extent of a person’s weight loss from different diets and in their desire to exercise.14
Can you think of other complex chronic diseases where you would expect to treat yourself without qualified medical help?11
Think of obesity like asthma; which also has genetic, physiological and environmental causes.16
Would you try to treat your asthma without help from your doctor? Would you feel ashamed or guilty just for having asthma or for asking your doctor for help?
Chronic diseases require medical care and treatment. Starting a conversation with your GP about effective treatment options suited to your obesity is a sensible course of action.15
1. Bray G, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation, Obesity Rev 2017; 18(7); 715–23.
2. Wolfenden L, et al. The challenge for global health systems in preventing and managing obesity. Obesity Reviews. 2019;(S2):185–193.
3. Caterson I, et al. Gaps to bridge: Misalignment between perception, reality and actions in obesity, Diabetes Obes Metab 2019; 21(8): 1914–24.
5. National Health and Medical Research Council (2013). Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Available at https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity, accessed September 2019
6. Action to prevent obesity and reduce its impact across the life course – Evidence Review. 2018. Available at https://www.racp.edu.au/docs/default-source/advocacy-library/racp-obesity-position-statement.pdf. Accessed December 2019
7. Das B, Khan O. The myths of obesity. Int J Surg 2019; 68: 114–16.
8. Sumithran P and Proietto J. The defense of body weight: a physiological basis for weight regain after weight loss. Clin Sci 2103; 124: 231–41.
9. Fothergill E, et al. Persistent Metabolic Adaptation 6 Years After “The Biggest Loser” Competition.Obesity 2016; 24(8): 1612–19.
10. Dhurandhar N. Stop the patient blame game: what actually causes obesity. Available at https://www.medscape.com/viewarticle/909500. Accessed September 2019.
11. Schwartz M, et al. Obesity Pathogenesis: An Endocrine Society Scientific StatementEndocrine Rev 2017; 38: 267–96.
12. Pilitsi E, et al. Pharmacotherapy of obesity: Available medications and drugs under investigation. Metab Clin Exp 2019; 92: 170–92
13. Brandkvist M, et al, Quantifying the impact of genes on body mass index during the obesity epidemic: longitudinal findings from the HUNT Study. BMJ 2019; 366:14067
14. Bray G, et al. The Science of Obesity Management: An Endocrine Society Scientific Statement. Obesity Rev 2018; 39; 79-132.
15. Obesity prevention and management position statement 2019. Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf. Accessed September 2019
16. WHO ASTHMA Factsheet https://www.who.int/news-room/fact-sheets/detail/asthma