There is no hotter topic in nutrition than weight loss and weight loss resistance. With nearly 1 in 3 adults and 1 in 6 US children classified as overweight (NIDDK with the NIH, 2021), and with the numerous detrimental health effects of the extra weight, this is not surprising. In addition, 2 in 5 adults are classified as obese and 1 in 11 are severely obese, while 1 in 5 children are obese and 1 in 16 are severely obese (NIDDK with the NIH, 2021). The number of adults in America who are considered obese has risen from 30.5% in1999 to 41.9% in 2017 (CDC, 2022).
With nearly 70% of Americans now considered overweight and roughly 42% considered obese, it is clear something needs to change to stop this alarming trend. (Fryar CD, 2020) Being overweight or obese increases your risk of heart attack, stroke, type 2 diabetes, hypertension, asthma, and depression to name a few. (CDC, 2022) These co-occurring conditions only increase that cost for our health care system and decrease the quality of life for those individuals who suffer from them. Obesity in the United States costs an estimated 173 billion dollars a year, with much of that cost going to managing co-morbidities. (CDC, 2022) With all of this said, the most frustrating statistic for people in the US, undoubtedly, is that only 1 in 5 people who attempt to lose weight are actually able to drop 10% or more of their body weight for a year. Even more frustrating is that more than half that weight is regained after 2 years and over 80% is regained after 5 years. (Kevin D. Hall, 2018)
The prevalence of people who are overweight and the desire/need to lose this weight has spawned an entire industry and culture around dieting and weight loss. This industry is great at making money and selling pseudo lifestyles, but not good at actually helping people lose weight, keep it off, and get healthy. It also helps perpetuate many of the myths and partial truths about weight gain and loss, leaving so many people in need of real answers and solutions to this health epidemic. There are many things that have transpired in the US over the last 70 or so years that have contributed to this alarming trend, including the transition from small family farms to supermarkets and corner stores stocked with hyper processed convenience foods.
The issue of weight loss and obesity is not a simple one, as what we eat is tied up in our various relationships and our culture. There are some shocking studies that show just how powerful the connection between food and relationships are. In one study done at Harvard, people who have a close friend who is obese increased their risk of being obese themselves by over 57%! (Nicholas A. Christakis, 2007) It’s often difficult, if not impossible, to separate food from family and culture. Imagin showing up to Thanksgiving dinner and turning down grandma’s ultra famous super-secret pumpkin pie she has spent the better part of 3 decades perfecting. If you don’t handle that situation well, grandma will feel like you are turning her down, not just her pie.
Insulin resistance is one of the main culprits behind weight gain and greatly contributes to the difficulty in losing it (Hubert Kolb, 2018). Moden diet culture and conventional nutrition advice treat all calories as equal, place blame on overweight individuals and do not distinguish between the quality of the foods consumed. Blaming individuals for weight gain and inability to lose weight helps to perpetuate the unhealthy cycle that we have found ourselves in as a culture. This cycle goes something like this: An overweight person sets out to lose weight on a diet; the diet is based on conventional advice which is solely focused on calorie reduction; at the same time the person increases exercise in order to burn more calories, making the caloric deficit more pronounced; this level of caloric restriction and exercise is unsustainable long term so inevitably the person “cheats” or fails to maintain the diet; they go back to eating habits they had before, and gain back any weight that was lost plus a little more; they feel hopeless and worthless, because they are told they failed and that they don’t have enough willpower to stick to the diet. This is also known as yo-yo dieting, and its roots are steeped in blame and failure of the individual to lose weight.
This diet culture does not address the root cause of insulin resistance and lack of nutrient dense low toxin foods in the diet. The real cause of the obesity epidemic is highly processed simple carbohydrate foods paired with the use of rancid proinflammatory vegetable oils and a lack of fresh whole foods cooked at home. The standard American diet (SAD) is the driving force behind this epidemic, and neither diet culture, nor conventional advice, address this issue. Willpower alone will never overcome the biological mechanisms that are not working as they should because the SAD diet is messing it up.
A mind shift is needed when it comes to food in this culture. Instead of seeing food as simply energy (calories in, calories out), it needs to be seen as information for the body. Epigenetics has proved that our environment influences our genetic expression, and diet is a huge part of our environment (Abraham, 2023). Instead of seeing calorie restriction and exercise as the way to weight loss, we need to shift eating and lifestyle habits that are more conducive to a healthy metabolism and biochemistry. Weight loss will follow those small shifts in daily habits. Small changes made over time eventually add up to large changes that are sustainable.
One such shift in dietary habits is ensuring adequate water intake. Many people in the United States are chronically dehydrated, not to a level that will cause death, but at a level that is not optimal for metabolic functioning. (Kory Taylor, 2022) This is a good habit to start with as it is usually something people can do if they put a little thought into it and have a target. Adults should aim for ½ of their body weight in ounces of water per day. In one study adults who substituted caloric beverages for water lost an average of 2.5% of body weight in 6 months, showing how impactful this one change could be (Tate, 2012).
Another holistic nutrition intervention that will help with long term sustainable weight loss is the intake of adequate protein. Adults should be consuming 2g/kg of body weight per day, unless the individual has kidney failure or there are signs of that present. (G., 2016) Protein will help to maintain lean body mass and reduce cravings for carbohydrate foods which will aid in weight loss efforts. (Campos-Nonato, 2017). Protein should be a part of every meal and snack when weight loss is the goal.
In addition to these dietary changes, there are several supplements that have been shown to aid in weight loss efforts. One study took 40 overweight adults and put them into two groups, one that was using a weight loss diet alone, and the other received 1020mg of omega 3 fatty acids supplementation daily. At the end of 12 weeks, while both groups lost weight, the fatty acid group lost more weight overall and lost more abdominal fat, which is a key indicator of metabolic health. (Salman, 2022) Omega 3 fatty acids lower inflammation, and since obesity is largely driven by inflammation, it is a great addition to a weight loss effort.
Probiotics are another great supplement that should be added to a weight loss protocol. There are several studies that show the significant connection between obesity and microbiome health which link gut dysbiosis to being overweight or obese. (Valentina Álvarez-Arraño, 2021). Dysbiosis and leaky gut will increase systematic inflammation by increasing endotoxins (LPS) in the blood. This inflammation will increase weight gain and make losing it more difficult. It is important to address gut dysbiosis in any weight loss efforts to reduce chronic inflammation.
In conclusion, obesity and weight gain are a systemic issue in our current culture, and both conditions increase the prevalence of chronic disease, making this epidemic extremely important to public health. Conventional diet recommendations focus heavily on calories and make no distinction between quality of foods or lifestyle factors that have a significant impact on weight loss efforts. In order for our society to stop packing on the pounds we have to address the root cause of weight gain and make sustainable changes to reverse metabolic disfunction instead of throwing fad diets and blame at the issue. Long term weight loss is possible if the individual has the right information and support to enact the necessary changes in their life.
References
Abraham, M. J.-D. (2023). Restoring Epigenetic Reprogramming with Diet and Exercise to Improve Health-Related Metabolic Diseases. Biomolecules.
Campos-Nonato, I. H. (2017). Effect of a High-Protein Diet versus Standard-Protein Diet on Weight Loss and Biomarkers of Metabolic Syndrome: A Randomized Clinical Trial. Obesity facts.
(2022, July 14). Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Retrieved from cdc.gov: https://www.cdc.gov/obesity/about-obesity/why-it-matters.html
CDC. (2022, May 17). Adult Obesity Facts. Retrieved from CDC.gov: https://www.cdc.gov/obesity/data/adult.html
Fryar CD, C. M. (2020). Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. Retrieved from NCHS.
G., W. (2016). Dietary protein intake and human health. Food & function.
Hubert Kolb, M. S. (2018). Insulin translates unfavourable lifestyle into obesity. BMC Medicine.
Kevin D. Hall, P. a. (2018). Maintenance of lost weight and long-term management of obesity. Med Clin North Am.
Kory Taylor, E. B. (2022). Adult Dehydration. StatPearls.
Nicholas A. Christakis, M. P. (2007). The Spread of Obesity in a Large Social Network over 32 Years. New England Journal of Medicine.
NIDDK with the NIH. (2021, September). NIH. Retrieved from Overweight and Obesity Statistics: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
Salman, H. B. (2022). The effect of omega-3 fatty acid supplementation on weight loss and cognitive function in overweight or obese individuals on weight-loss diet. Nutricion hospitalaria.
Tate, D. F.-M. (2012). Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. The American journal of clinical nutrition, 555-563.
Valentina Álvarez-Arraño, S. M.-P. (2021). Effects of Probiotics and Synbiotics on Weight Loss in Subjects with Overweight or Obesity: A Systematic Review. Nutrients.
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