Fat people don't lack willpower and your mother didn't make

[beskeptical]

you autistic.

This is a thread intended to counter the judgmental nature of some people who readily lay blame on others for various things. I intend to focus on weight but first some background.

Over the years a number of human disorders have been blamed on either the person themself or in some cases a parent's actions only to find out through research, the blame was misplaced. One very good example was the not too distant past when mothers were told outright, their child was autistic because the mother had failed to bond or essentially love the child correctly. Homosexuals were supposedly that way because they had a dominant mother.

After making these horrible and very painful claims to mothers of these children, it turns out the claims were completely wrong. Ooops. Oh well.

So now let me bring up the issue which has a more current basis. After years of blaming excessive weight on the person because it's pretty obvious the issue is calories in vs. calories burned, researchers have been trying to find ways to change the equation. Almost all of the research has been based on behavior modification in the past. And in the majority of cases, behavior modification is not successful. Are that many people really just lacking self control?

Well, finally researchers are taking a serious look at the fallacy of the underlying premise that it is just a matter of self control and behavior modification. This idea has been bantered about over the years. Genetic predisposition to obesity is well established. And drugs to suppress appetite have been researched because of the great market potential.

Now, however, there is much more focused research on the exact mechanisms of weight control. What is being discovered is that the drive to consume weight conserving calories is extremely strong and not something easily overridden. Just as you cannot hold your breath beyond a few minutes, and just as you will have a very hard time refusing water after a few days without it, your body has a physiological drive to maintain a certain calorie intake that is just as strong as the drive of thirst and even as strong as the drive to breathe. Just willing that drive away or trying to change it by behavior modification cannot always be done.

Reactions to the concept that weight loss is not a matter of will power lead many people to react with comments like, "It just gives the person an excuse to continue their over eating," and, "You have a choice to put the food in your mouth or not." These are very shortsighted statements just as was telling mothers their child's autism was the result of the mother's actions.

See if you can hold your breath. Now blame your failure on your lack of willpower. Despite this analogy, many people will conclude the drive to breathe is completely different than the drive to eat. Yes, it is. But the demonstration is intended to highlight just how strong our physiological drives are. Understanding the physiological drive to eat is critical to successful weight loss for millions of people. This doesn't mean one throws away the tools of behavior modification in treating obesity. But it does mean throwing away the blame if behavior mod is not successful.

NEUROENDOCRINE INTEGRATION OF BODY WEIGHT REGULATION

For more than 70 years, increasingly sophisticated methods have been brought to bear on the problem of the brain involvement in the physiology of energy homeostasis and the pathogenesis of obesity. A vast number of experimental observations have been produced and, particularly within the last decade, the combination of novel genetic and sophisticated physiology techniques has allowed for great progress. These methods have helped identify metabolic hormones and their relationship to key peptidergic systems in the hypothalamus. Although the central integration of afferent signals reflecting acute and chronic energy requirements has started to become clearer, the neuronal pathways that actually initiate changes in ingestive behavior or energy expenditure are still largely unknown. Furthermore, researchers are far from understanding the overall picture of central body weight regulation that involves multiple brain areas outside the hypothalamus. This chapter summarizes the current knowledge [May 28, 2003] and understanding of central nervous system anatomy and physiology in relation to mechanisms controlling energy balance.

I found the following particularly enlightening, the fact there is strong resistance to losing weight and little resistance to gaining it.

Control of Food Intake in the Obese

In general, humans display a system of weight regulation that is asymmetrical—a reduction in body weight is strongly defended but weight gain is not. The body seems to tolerate a positive energy balance. There is no mechanism that can detect a positive energy balance per se or that can implement a sufficiently strong correction to behavior to maintain body weight in an environment that promotes consumption. The evolutionary process has favored biological traits associated with preferences for high energy density (sweet and/or fatty) energy-yielding foods. The control of food intake in obese or weight-gaining individuals may display various risk factors that favor an increase in energy.

And these papers had some additional points like the failure of Leptin to be the key to the castle doesn't mean we have nothing else left to try.

Pro-opiomelanocortin and weight regulation: from mice to men

Significant progress in our understanding of the mechanisms of weight homeostasis has been made by studying the many genetic mouse models of obesity. Positional cloning in the obese mouse led to the discovery of leptin as a feedback messenger indicating the adequacy of peripheral energy stores. This was the first in a series of important advances in this field. Shortly after this discovery, two research laboratories presented evidence for the role of hypothalamic pro-opiomelanocortinergic (POMC) neurons as important mediators in the regulation of feeding behavior, insulin levels and, ultimately, body weight.

Ghrelin, Appetite & Weight Control

Scientists say they may have found out why people get hungry at mealtime, why dieters who lose weight often gain it back and why a certain type of stomach surgery helps very obese people lose a great deal of weight.

The reason may be a hormone called ghrelin, which makes people hungry, slows metabolism and decreases the body's ability to burn fat.

Leptin Appetite Suppressant

Another promising discovery, leptin, an appetite suppressant made by fat cells and thought to have great promise as a treatment for obesity, has turned out to be a disappointment because most overweight people are resistant to its effects.

Central nervous appetite regulation: mechanisms and significance for the development of obesity

Diet, monoamine neurotransmitters and appetite control.

[gethen]

Interesting post. But do you think that the role of hormones and other chemicals in the body accounts for the majority of overweight or obese people out there? Or are we talking about a few people with a genetic dispostion toward over consumption? I'm wondering why we're all not "fat".
Not in any way arguing with your point, beskep. Just curious as to how widely this is thought to affect the population.

[mickal555]

You could say your mother made you autistic because it is genetic. I agree with you though.

[teddyv]

Interesting post. But do you think that the role of hormones and other chemicals in the body accounts for the majority of overweight or obese people out there? Or are we talking about a few people with a genetic dispostion toward over consumption? I'm wondering why we're all not "fat".
Not in any way arguing with your point, beskep. Just curious as to how widely this is thought to affect the population.

Also, why is that North Americans are principally the ones who are overweight in the world at large. There are few obese people in West Africa and believe me, they can and will eat a lot (especially high starch meals). I'm pretty sure the same can be said for a lot of the world.

I think our food processing techniques may have a few answers as well.

[gethen]

Unfortunately, the "obesity epidemic" seems to be spreading worldwide. In the August issue of National Geographic there is a map of the world showing the percentage of obese people all over the world, and very few places seem to be immune. Parts of Africa, China, parts of South America and a few other isolated spots show a very low percentage of obesity, but North America, Australia, much of Europe, Russia, and lots of the Middle East are at 15% to over 24% obese. It looks like prosperity breeds obesity. I would post a link to this map, but it appears you must subscribe to the online magazine to see it.

[Ut]

Now match that obesity map with a map of McDonalds corporate expansion...

[Candy]

Now match that obesity map with a map of McDonalds corporate expansion...

I was thinking the same thing. 8)

[beskeptical]

There are very strong influences which are both environmental and genetic which result in obesity in the first place.

Genetic obesity is pretty straight forward in some cases. Some of the persons who responded to Leptin in the original trials were found to be Leptin deficient. Others have a clear family line of obese ancestors. Some Pacific Islanders and high latitude Northern American natives are such examples.

By the same token, I presume, though have not seen a lot of research, there are some equally predisposed to keeping very little body fat.

But for the rest of the population you get a mix of genetic and environmental influences. That's where the research showing we have a drive to maintain weight but no drive 'not to gain' it is revealing some of the reasons everyone is not fat in those countries McDs hasn't yet reached.

Some environments stimulate eating. TV commercials and other advertisements as well as cultural influences like parents overfeeding and families focused on food are some examples.

Next is the choice of foods and the average level of activity. High calorie, high fat foods you get at the drive through without leaving your car says it all.

There is very strong evidence hormones are involved in appetite controls. Pregnancy and the accompanying hormone changes obviously stimulate eating. While some women do not gain excessive weight in pregnancy, others do. Post menopausal hormone changes cause increased weight gain in some women as well.

Studies have shown high calorie foods stimulate extra insulin production. The insulin increase remains high and stimulates additional food intake. In order for the insulin level to decease, the person has to have lower caloric intake, in particular, lower concentrations of calories at a meal, and resist the appetite stimulation for several days before the insulin levels drop. In other words insulin production responds quickly to stimulation but only slowly returns to baseline levels when the stimulation ceases.

Exercise, by the way, decreases insulin production which directs cells to store fat, and increases glucagon which directs cells to release fat for needed energy. That is probably why exercise is more effective than diet control in weight loss. It still isn't a panacea mind you. That's an oversimplification.

A person may or may not have gained weight due to appetite drive, or it may have been only lack of appetite brakes coupled with external factors. There are important interventions that should be undertaken to prevent excessive weight gain in persons where the brakes are the issue. This is the one time personal actions have the best chance of success. Clearly it is easier to maintain one's weight than to lose weight.

Again, the idea our drive to eat is extremely strong and in fact not always controllable by the overweight person trying to actually lose weight does not mean there are no interventions a person can make to lose weight. It is easy to go from either 'you might as well give up' to 'it's all your fault' and forget there is an in between there.

In order to find successful methods of weight loss, we have to first understand what the mechanisms of weight control really are. Food choices, exercise and awareness of environmental stimulators to eat are changes people can consciously make. But an overweight person must understand that refusing that donut is not just will power. The body actually is trying to obtain high calorie foods.

Some people refuse to believe it is more than willpower and just keep telling the person they made a conscious decision to eat the donut. The evidence that is a false premise is the number of people who cannot resist the donut. And, when people do manage to resist the donut, they often cannot resist indefinitely. The physiological drive to get back to that weight set point or beyond is too great and the weight is regained.

I recall an analogy in my field that was one of those minor revelations. For months I had done everything I could to get staff to follow the procedure for exposure to blood. Nothing changed. Then one of the education people said to me, maybe it wasn't a knowledge deficit. [light bulb!] You can go over the procedure, print it out and put it on the BB, send it home in paychecks, but when you see that isn't working, you have to realize your premise was wrong. Getting information out about the procedure assumes the staff do not know what the procedure is. But if they do know and there are other reasons they still don't follow it, then acting on the wrong premise will never fix the problem.

So we have had behavior modification including different food choices and encouraging increased exercise in every shape and form for weight loss and weight management. These methods only work in a very small number of persons.

We have had drug therapies that suppress appetite that have been successful only temporarily in most cases, so the benefit has not outweighed the risk. The drugs prove appetite suppression does work. In fact it works very well, considering how poorly behavior mod works. The problem has been all of the drug therapies so far are eventually compensated for by that very strong physiological drive to keep that overweight set point. We have to wait for research to find out more about appetite control and find drugs which are safe and to which tolerance doesn't develop.

So what would I recommend in the meantime as a health care provider treating an overweight person? The things that are easiest to control are exercise, avoiding appetite stimulators and some food choices.

Exercise is easy. Just don't get frustrated if the pounds don't drop off. And for people with no time, find ways to move while you are doing other things, at least at first. Having to walk your dog is one way it's hard to skip your walk.

Avoiding appetite stimulators is not too hard though it is very individual. So first you have to start looking for what they are, then make changes.

But for food changes, this is where I have very different recommendations. First, find out how many calories you actually are eating every day. You have to keep a food diary and you have to know what portion sizes you are actually eating. Don't give it a second thought that the numbers are high or even very high.

The first changes you should make are to substitute highly concentrated calorie foods for the same number of calories but in lower concentration. This does not mean you go from a cookie to a pound of carrots, though I suppose you could if you like carrots. :wink: But you can go from a cookie to a piece of toast. So you are going from sugar down to bread. It's a start.

As you start to decrease the concentration of calories you are eating and increasing your exercise, you will be affecting one physiological appetite control factor, insulin. Slowly, over time, keep substituting lower calorie foods while keeping the same total calories. Try to eat less more often. If you find yourself still craving the donut, that is a clue you are either changing your diet too fast or not avoiding the appetite stimulators, or maybe both.

Well, this is just one idea that I think fits the evidence better. There has not been research on such a plan, and there is no evidence yet how many people insulin production is even a factor in their weight control, nor, how big of a factor it even is.

It's really going to take more research before we may see any gains in weight loss therapies. One thing is fairly clear though, behavior modification has been a big failure in all but a few cases. It should be tried, but failure should not be viewed as merely a failure of choices. Prevention of weight gain and healthier eating habits is certainly no less important, especially for kids. But, again, if you cannot chose the apple instead of the donut, it isn't just a matter of willpower, no matter how obvious the opposite may seem. We can see that when the person who chooses that apple still craves the donut and goes back for it anyway.

[beskeptical]

You could say your mother made you autistic because it is genetic. I agree with you though.

We don't know that for sure yet. Genetics may not be the only factor in autism. Besides, it could be a defect on the Y chromosome. :wink:

[mike alexander]

I have a close relative who has tried to lower his average weight all his life, with mixed results at best. As he told me, dieting as his doctor suggested was both physically and psychologically painful. As in pain, not inconvenience. He was unable to sleep, too tired to exercise, and the physiological responses created a continuous and unrepressible obsession with the next meal. In addition, it actually hurt. As a result, he couldn't work properly.

He has had some limited success with a very small change in caloric type and amounts in his diet and some exercise. But as he noted, if being slim means suffering he would rather carry a few pounds extra.

[teddyv]

You could say your mother made you autistic because it is genetic. I agree with you though.

We don't know that for sure yet. Genetics may not be the only factor in autism. Besides, it could be a defect on the Y chromosome. :wink:

I though autism was caused by vaccinations?

Just kidding!

[Moose]

Ah, the old "nature" vs "nurture" debate.

I suspect, like most things, the truth lies somewhere in between the two extremes.

[gethen]

Beskep, I read an article and I wish I could remember where (maybe in Time magazine?) in which the author said that once you've gained weight, your body does its best to maintain that weight. If you stop consuming a certain level of calories, your body may compensate by slowing down so that your weight holds steady. However (the theory went) if you maintain your same level of caloric intake, but increase your activity level (start walking 20 minutes a day) your body does not interpret that as deprivation and will not react by slowing things down. Therefore, exercise alone is a better method of weight loss than just dieting. Any thoughts?

(And I hate the word "diet." I don't "diet" but I do eat differently than I did 10 years ago because once I hit a certain age, the same foods I'd been eating all my life contained too many calories and I put on 10 pounds. ops

[tuffel999]

So this is where you have run to.........

Well I am going to make one post on this so that people understand that you are directing an attack at a person under the guise of being helpful and are board jumping with a topic from another board when you didn't like how it was going. I feel this was a very dishonest and underhanded thing to do on your part.

I will start with exactly what I said on FWIS and quote it here so it is clear what I was saying:

The way I look at it is this. The environment can not force anything to occur that is outside the parameters that are encoded by the genes.

So if you have the following items: iron, tin, limestone, copper, and coke in a normal person you could get a range of items from iron to brass to copper to steel with the right pressures and influences. Now say you only have tin, copper, and iron. You can no longer get steel but the rest of the possibilites can still occur with the right pressure and influences.

you aren't going to get me to agree that people are helpless victims of eating or alcoholism so long as it requires active input, I understand the genetic predispositions however, I understand that not everyone with those dispositions is obese or an alcoholic so that tells me that people are responsible for keeping themselves away from the slippery slope. I have seen enough people when properly motivated break addictions to know that it can be done and be done successfully. If noone could break an addiction then I would agree with you but since many people can there has to be some level of control innate to everyone to allow it. I don't expect the blind to see because it isn't something they have an active part in....the obese do though.

I also stated that noone could be genetically obese.......rather they could be genetically predisposed to obesity. If someone gains weight when expending more calories than they take in they have somehow violated the conservatoin laws.


1) People have genetic dispositoins to certain disorders. That much is easily established.

2) Things that are done consciously like eating are contolled by a person......otherwise it would be unconscious. This is why your holding breath is a logical fallacy...........it is a false analogy. You are comparing breathing which is unconscious to a series of conscious movements. If someone has some sort of need to eat they could eat something other than a triple cheese burger with fries. Celery is a good choice....low in calories high in fiber and if they cant "control" their eating it will curb their weight but yet people who are obese rarely if ever eat just good healthy balanced food. If you look back and honestly look at it you find most if not all people who are obese have a history of poor choices in what to eat.............and those choices are voluntary........noone forces you to eat the triple cheese burger over the salad (Foods that are high in calories, fat, and low in things that are neccesary like vitamins and minerals ie vegtables.....which too hate but I eat anyway becasue I should).

Skepti please DO NOT respond to this post. I have no need to get banned becuase of you getting under my skin because you attack a positoin other than mine and attribute it to me. I post this here solely so people understand what you are doing, what I said initaily, and why it is at the least rude and underhanded behavoir on your part.

[gethen]

Looks like I missed something. [scratches head]

[Gillianren]

me, too, but I just got here. I will say, however, that the post (sorry I can't remember who said it) saying that it's better to increase activity level is right. your body wants to retain that caloric intake.

[worzel]

Control of Food Intake in the Obese

...There is no mechanism that can detect a positive energy balance per se or that can implement a sufficiently strong correction to behavior to maintain body weight in an environment that promotes consumption.

Of course there is, an environment that promotes body beautiful obsessions. I find it interesting that the country with the most obesity has the most "perfect" looking people too.

[paulie jay]

There's a heck of a lot to read here - I'll only add that I'm not one for the advocation of "fat acceptance" societies. Education, activity and support (without gimmicks) is available for people who want to lose weight. But of course I'm not saying it's easy. Sadly a lot of people get swept up in the latest diet fad, fail, and then conclude that there's nothing that they can do.
Will power alone won't be enough - nothing motivates a person more than seeing actual results!

About 10 years ago I lost a significant amount of weight - 20kg in fact (44 lbs). I had convinced myself that I was destined to be a fat person, that there was nothing I could do, and the resulting depression saw me seeking comfort in food. A deadly cylcle. I even lied to myself about what and how much I was eating.

Then I decided enough was enough. I was fortunate enough to have a friend give me a sensible eating schedule, and I exercised regularly by which I mean really exercised. I stripped off 20kg of fat, toned up and got a part time job at the local gym. This didn't take very long (only a matter of months) and I've kept the weight off ever since. The thing that kept me going was that every time I stepped on the scales I was lighter. When you have that kind of motivation you feel that there's nothing you can't achieve.

I have tried to help several friends lose weight. Some were successful, some weren't. But every one of the unsuccessful people admitted that they were sneaking food and pretending that they had done the exercise.

What I'm slowly getting to is that it's my opinion that these people aren't lacking "will power" as such - its more a matter of how far out of their comfort zones they are willing to go. For some people its just easier to say that nothing works rather than actually doing it.

[SciFi Chick]

...For some people its just easier to say that nothing works rather than actually doing it.

I know exactly what you mean. I gained quite a bit of weight in a short period of time due to the combination of emotional trauma and the lovely comfort that is food, not to mention quitting smoking. Then, my life got so crazy that it was impossible to concentrate on a diet.

It took a year, but I was able to meet all of the goals that were interfering with my weight loss and rearrange my life so that the only important goal I have this year is eating right and exercise. It really does take a combination of both.

[Brady Yoon]

You made some very good points, but I disagree somewhat. \

I remember being in elementary school... and I was really fat and unhealthy and I was on risk for several health problems. I ate horrible food and practically never exercised. But now that I am in high school, I make better food decisions and eat lots of vegetables and fruits, and run 3-4 miles daily, and I have joined the school's cross country team (don't go there ) . My weight has dropped from 147 lb from when i was in 7th grade to 140 in 9th grade (right now), and I know I got a lot taller and more muscular during that time. Plus, blood tests told me that I was extremely healthy.

Of course, this is only one case, but I definitely know that better eating habits and exercise do help. For most people, it's a mix between the two. Some people have a greater chance of being obese, yes, but these are the same people who must try harder to stay healthy. You can't just blame everything on genetics, at some point, you must take action.

[Brady Yoon]

Oh yeah, I ordered a cheeseburger at In n out. A person about a foot shorter than me ordered a double double, french fries, and a large drink... Shows you that the eating habits of America aren't that healthy.

[SciFi Chick]

Bravo, Brady Yoon! I hate running, but I love this one ski machine that they have in my fitness center. I can just go and go, and it actually feels good.

[sarongsong]

Maybe they had more money than you---just kidding---dang!---now it's time for a munchie run.

[Brady Yoon]

Bravo, Brady Yoon! I hate running, but I love this one ski machine that they have in my fitness center. I can just go and go, and it actually feels good.

Yeah, it's weird. Exercise actually feels good...after you do it.

Maybe they had more money than you---just kidding---dang!---now it's time for a munchie run.

Hmm...seems I'll have to start thinkin outside the box. :x

[beskeptical]

Beskep, I read an article and I wish I could remember where (maybe in Time magazine?) in which the author said that once you've gained weight, your body does its best to maintain that weight. If you stop consuming a certain level of calories, your body may compensate by slowing down so that your weight holds steady. However (the theory went) if you maintain your same level of caloric intake, but increase your activity level (start walking 20 minutes a day) your body does not interpret that as deprivation and will not react by slowing things down. Therefore, exercise alone is a better method of weight loss than just dieting. Any thoughts?

(And I hate the word "diet." I don't "diet" but I do eat differently than I did 10 years ago because once I hit a certain age, the same foods I'd been eating all my life contained too many calories and I put on 10 pounds. ops

Interesting. The metabolism slowing down to compensate decreased intake is well documented. The idea of increased exercise and same diet looks like a promising direction of research for sure.

[beskeptical]

Interesting post. But do you think that the role of hormones and other chemicals in the body accounts for the majority of overweight or obese people out there? Or are we talking about a few people with a genetic disposition toward over consumption? I'm wondering why we're all not "fat".
Not in any way arguing with your point, beskep. Just curious as to how widely this is thought to affect the population.

I just re-read this and realize I missed the first question. I have no idea what the percentages of various mechanisms of weight gain are. It does seem like there are many factors involved. But resistance to weight loss may turn out to be more consistent. Only research will tell.

[beskeptical]

Ah, the old "nature" vs "nurture" debate.

I suspect, like most things, the truth lies somewhere in between the two extremes.

Yes and no. Yes it's nature and nurture that cause obesity. But my point is it's 95% nature that prevents weight loss once you are overweight. That's what the research and the failure of 'nurture' to reach successful weight loss is indicating.

[teddyv]

There's a heck of a lot to read here - I'll only add that I'm not one for the advocation of "fat acceptance" societies. Education, activity and support (without gimmicks) is available for people who want to lose weight. But of course I'm not saying it's easy. Sadly a lot of people get swept up in the latest diet fad, fail, and then conclude that there's nothing that they can do.
Will power alone won't be enough - nothing motivates a person more than seeing actual results!

About 10 years ago I lost a significant amount of weight - 20kg in fact (44 lbs). I had convinced myself that I was destined to be a fat person, that there was nothing I could do, and the resulting depression saw me seeking comfort in food. A deadly cylcle. I even lied to myself about what and how much I was eating.

Then I decided enough was enough. I was fortunate enough to have a friend give me a sensible eating schedule, and I exercised regularly by which I mean really exercised. I stripped off 20kg of fat, toned up and got a part time job at the local gym. This didn't take very long (only a matter of months) and I've kept the weight off ever since. The thing that kept me going was that every time I stepped on the scales I was lighter. When you have that kind of motivation you feel that there's nothing you can't achieve.

I have tried to help several friends lose weight. Some were successful, some weren't. But every one of the unsuccessful people admitted that they were sneaking food and pretending that they had done the exercise.

What I'm slowly getting to is that it's my opinion that these people aren't lacking "will power" as such - its more a matter of how far out of their comfort zones they are willing to go. For some people its just easier to say that nothing works rather than actually doing it.

What is brought up is important, because if you "diet" you must be able to live essentially for the rest of your life with that regimen. The fact that many diets fail in the long run is because they are not sustainable.

[beskeptical]

So this is where you have run to.........

Well I am going to make one post on this so that people understand that you are directing an attack at a person under the guise of being helpful and are board jumping with a topic from another board when you didn't like how it was going. I feel this was a very dishonest and underhanded thing to do on your part.

Excuse me tuffel, but I have come here because the rules allow reasonable exchange of ideas without ad hominems and belittling of persons in posts. In addition, the BA does not delete or edit posts of other people unless there is specific offensive content or copyright infringement, and then only that material is deleted.

I have run nowhere. I have chosen to leave FWIS because the board is not moderated in a way that makes posting there very satisfying personally.

[beskeptical]

Looks like I missed something. [scratches head]

Nothing important.