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Judynyc
Tue, Aug-20-13, 07:07
Obesity May Be More Than One Disease, experts say

http://gma.yahoo.com/obesity-may-more-one-disease-experts-034549976--abc-news-wellness.html

When the American Medical Association classified obesity as a disease, Nikhil Dhurandhar, a researcher and vice president of The Obesity Society, said he welcomed the news as an acknowledgment of the challenges people face fighting the battle of the bulge. But he wondered if the declaration went far enough.

Like a growing number of experts, Dhurandhar believes the accumulation of excess fat is likely to have multiple causes beyond a potato-chip-and-couch-potato lifestyle.

Dhurandhar likens obesity to other chronic diseases. Just as the term cancer covers the numerous conditions that occur when abnormal cells divide out of control, obesity may not be a single disease but rather, a group of diseases tied together by the symptom of too much body fat, he said.


"It may look the same on the outside, but what triggers the condition varies from person to person and may require a different treatment to control," he said. "Down the road, we need to figure out why people become fat and then tailor their treatment to address the underlying causes."

Dhurandhar's own studies at Pennington Biomedical Research in Baton Rouge, La., focus on obesity-causing viruses. He discovered the viruses in chickens back in the 1980s and has since associated the presence of certain viral antibodies in the bloodstream of humans to increased body weight.

In one of his landmark studies of 500 people, 30 percent of the obese patients tested positive for the virus, compared to only 11 percent of the lean individuals.

Dhurandhar is quick to point out that he doesn't believe most obesity is infectious in nature, but said that the discovery of a "fat bug" should be a wakeup call to researchers, physicians and anyone struggling with their weight that there may be more to shedding surplus pounds than simply cutting back on calories and putting in a few extra treadmill sessions.

"What good does a starvation diet do if obesity is caused by a virus?" he asked.

Beyond viruses, scientists have identified at least 84 other potential contributors to obesity, Dhurandhar said. They range from genetic to biological to psychological to environmental. Currently, there are about a dozen of these obesogenic culprits under serious study in labs around the world, he noted.
For example, numerous studies now associate lack of sleep with an expanded waistline. Other studies have found that exposure to certain insecticides and plastics disrupt gut bacteria, which may stimulate appetite, slow digestion and accelerate fat storage. And some studies propose a link between the lifestyle habits of great grandparents and their great grandchildren's weight status.

"Not all the causes will wind up being treatable or preventable -- you can't do anything about what your great grandparents ate -- so we will have to focus our efforts on the ones we can control," Dhurandhar said.

Christopher Ochner, director of research development and administration at the Mt. Sinai School of Medicine in New York said he agreed with Dhurandhar's idea that there could be multiple contributors to obesity, but said it complicates matters to classify obesity as multiple diseases.

"At the end of the day, we still have the law of energy balance to contend with," he said. "If you ingest more than you expend you are going to gain weight, period."

Dhurandhar conceded that eating and exercise play a significant role in obesity, but said that role is not as well understood as the general public thinks.

"We've focused almost all our resources on the so-called 'Big Two' of diet and exercise for more than 50 years and it hasn't helped," he said. "We will have to move beyond 'eat less and move more' if we want to make progress."

Ochner said he agreed that trying to lose weight and keep it off in the long term by exercising and cutting back on calories has less than a 1 percent chance of succeeding. He acknowledged that the reasons for weight gain vary greatly for each individual and the precise formula for energy balance through diet and exercise is nearly impossible to determine.

"There is literally, there is no difference between an emaciated person starving to death and an obese person on a healthy weight loss diet in terms of physiological reactions," he said. "That is going to be a tough problem to solve."

Obesity: The Big Picture Tweet Chat Today at 1 PM, ET

So what do you think? Do you believe obesity comes down to personal responsibility or are there other factors at play that thwart weight loss efforts? Share your thoughts in the comments section below. Better yet, voice your opinion during today's obesity tweet chat at 1 p.m., ET.

Our ABC Health tweet chat is moderated by Dr. Richard Besser, ABC News' chief health and medical correspondent. The American Medical Association, The Obesity Society and the Robert Wood Johnson Foundation are among the health groups and distinguished experts joining the conversation on this important health topic. If you'd like to join in too, click here for more details.

rightnow
Tue, Aug-20-13, 07:29
Dhurandhar is quick to point out that he doesn't believe most obesity is infectious in nature, but said that the discovery of a "fat bug" should be a wakeup call to researchers, physicians and anyone struggling with their weight that there may be more to shedding surplus pounds than simply cutting back on calories and putting in a few extra treadmill sessions.

"What good does a starvation diet do if obesity is caused by a virus?" he asked.
Good point.

Christopher Ochner, director of research development and administration at the Mt. Sinai School of Medicine in New York said he agreed with Dhurandhar's idea that there could be multiple contributors to obesity, but said it complicates matters to classify obesity as multiple diseases.

a) because it's not a disease it's a symptom doh.

b) because making things simple is so much more important than making them accurate?

"We've focused almost all our resources on the so-called 'Big Two' of diet and exercise for more than 50 years and it hasn't helped," he said. "We will have to move beyond 'eat less and move more' if we want to make progress."

Ochner said he agreed that trying to lose weight and keep it off in the long term by exercising and cutting back on calories has less than a 1 percent chance of succeeding. He acknowledged that the reasons for weight gain vary greatly for each individual and the precise formula for energy balance through diet and exercise is nearly impossible to determine.

"There is literally, there is no difference between an emaciated person starving to death and an obese person on a healthy weight loss diet in terms of physiological reactions," he said. "That is going to be a tough problem to solve."

And I was thinking gee, this guy momentarily sounded like an idiot but there he sounds so rational. But then:

"At the end of the day, we still have the law of energy balance to contend with," he said. "If you ingest more than you expend you are going to gain weight, period."

But then he's a moron.

This so reminds me of Taubes writing he was talking to the scientist who had himself the studies most obviously proving that obesity wasn't just about calories, and the guy was insisting that people in the airport were fat because they were taking the escalator (hence not exercising enough), or whatever it was.

Are they suffering from extreme cognitive dissonance?

Or funding fears about what they say?

PJ

PS This reminds me of a show I once watched where this man who had worked very closely with wolves for like two decades, was talking all about them. And then at the end, the big question the show focused on was basically, did animals have sentience, and seemingly contradicting literally everything he had said previously about his experience with them, he promptly said no, no way, it's nothing but instinct. Now anybody who has ever been close to any animal for an extended length of time -- sentience increases in animals with human interaction -- would find that bizarre, but for someone who spent decades working closely with animals as smart as wolves? I couldn't decide if he felt he 'had' to say that because the show was controversial, or if he could really be that oblivious.

M Levac
Tue, Aug-20-13, 09:07
I keep this bookmark to remind me of those other factors: http://www.why-low-carb-diets-work.com/unexplained-weight-loss.html

Nancy LC
Tue, Aug-20-13, 09:49
I don't think he's a moron at all.

The energy balance has a role to play, but why do some of us have such screwed up metabolisms that we can't expend more than we take in unless we starve ourselves in an unsustainable way?

The only fault I have is that it is over-simplified in such a way that people think you need to exercise more and eat less, not recognizing that doing either one of those simply affects the other one, not necessarily your weight.

Eat less, you'll move less. Exercise more, you'll eat more.

rightnow
Tue, Aug-20-13, 13:26
Yes, there's some truth to it (a ton for ordinary people), but the way it was phrased appeared to completely negate everything else he said.

PS I actually tried to edit my post to add an additional note that I was over-harsh there, but apparently I waited too long as I can't do it now. :-)

PJ

teaser
Tue, Aug-20-13, 18:07
Christopher Ochner, director of research development and administration at the Mt. Sinai School of Medicine in New York said he agreed with Dhurandhar's idea that there could be multiple contributors to obesity, but said it complicates matters to classify obesity as multiple diseases.

I agree with the idea that there could be multiple contributors to cancer, but I think it complicates matters to classify cancer as multiple diseases.

Sheesh.