Obesity is probably the most common chronic disease in our country. As much as 33% of the population is over-weight, with the percentage higher among women and minorities. Obesity results from an imbalance between energy intake and energy expenditure. Genetic, environmental, and behavioral factors (poor appetite control, unhealthy eating habits, lack of exercise) all influence the balance between energy intake and output. When intake exceeds output over the long term, the excess energy is stored as fat. Excess body fat, particularly when distributed on the upper body, increases the risk of hypertension, coronary artery disease, non-insulin-dependent diabetes mellitus, gallbladder disease, sleep apnea, gout, and certain types of cancer (e.g., prostate cancer). Although obesity is a chronic disease with adverse health consequences, in our society it carries such a stigma that many people -- including health professionals -- don't believe that the obese person deserves any sympathy at all, let alone medical treatment for the condition.
Four Common Misconceptions About Obesity David S. Weigle (University of Washington School of Medicine, Seattle)
describes four common misconceptions about obesity:
First, that body weight is not a physiologically regulated variable but is set by acquired food habits and conscious or unconscious desires. Second, that an individual can set his or her body weight to any desired level without adverse effects on health. Third, everyone who weighs more than the numbers set forth in certain life insurance tables is at increased risk of mortality. Fourth, that body fat distribution is not an important health consideration. Despite the trumpeting of the popular press, obesity is not a disorder of body weight regulation. Obese people regulate their weight appropriately, but regulation is around an elevated set point. Body weight is usually highly stable after adolescence, increasing slowly (by a half a pound per year) over the lifetime. "This degree of weight stability implies a precise match between energy intake and expenditure over a prolonged period," says Weigle. Even a slight excess in daily energy intake, such as the calorie content of a single soda cracker, would result in a 2-pound weight gain a year. "This precision in balancing daily energy intake and energy expenditure would be difficult to achieve on a purely volitional basis.