Multitasking against obesity: Specialists stress complexity of problem

June 12, 2013 by Chuck Leddy, Harvard University
W. Scott Butsch (from left), Nadia Ahmad, Louis Aronne, Caroline Apovian, and Lee M. Kaplan participated in an HMS-MGH forum looking at obesity in the U.S. Credit: Nikhil Pai

Five specialists in obesity came together at Cambridge's Royal Sonesta Hotel on Friday for a forum called "Why Is Weight Loss So Hard?" The event was part of the four-day Blackburn Course in Obesity Medicine, sponsored by Harvard Medical School (HMS) and Massachusetts General Hospital (MGH), during which experts from across the globe gathered to discuss one of America's fastest-growing and most important health issues—the country's increasing levels of obesity.

Complex causes

The panelists agreed on the complexity and interacting issues that underlie the crisis. Genetics and environment are just two of the many factors involved.

"The world is getting heavier," said moderator-panelist Lee M. Kaplan, an associate professor at HMS and director of the MGH Weight Center, "and this is not a personal problem of slovenliness or laziness by the patient."

Nadia Ahmad, former HMS instructor of medicine, now director of the Dubai Obesity Medicine Center, agreed: "There's a lot of research to show obesity is actually a biological problem," she said.

The causes and consequences of obesity are different in every case, Kaplan said. "Obesity isn't the same disease in everybody. Our bodies have 20,000 genes and 4,000 are involved in weight regulation."

W. Scott Butsch, an instructor of medicine at HMS and a doctor at MGH, and Caroline Apovian, an associate professor of medicine and pediatrics at Boston University School of Medicine, pointed to the roles of age and gender.

"As we get older our bodies change: We gain fat and lose muscle mass, which can impact health," said Butsch.

Apovian moved from the physical—"men and women are very different about where they distribute weight"—to the psychological. Additional social pressure on women to be thin, she said, "can create psychological issues" as well as weight issues.

Environmental factors

Increases in obesity stem in part from "all the prescription medications that cause weight gain," said Louis Aronne, clinical professor of medicine at Weill Cornell Medical College. In addition, today's stressed person "sleeps an hour less today than 100 years ago."

Ahmad said, "The obesity epidemic is absolutely environmentally driven," pointing to "more processed food and people working longer hours." Kaplan described all these factors as "a perfect storm" pushing obesity: "We work too hard; we play too little; we eat too much; our circadian rhythms are disrupted; there have been big changes in our food." It all adds up to more weight.

Can we change our environment and lifestyle to reduce obesity? Lifestyle changes in isolation have little chance of fixing the problem, Ahmad said. "Just getting rid of sugar-sweetened beverages won't work," she said. We need to make better food choices, but also "reduce stress and promote more sleep," she continued.

Kaplan agreed that there's no "one-size fits all" remedy, but "we can decide what we eat and how much we exercise and the amount of sleep we get and how much stress we have."

Weight management

Prescribing a weight-management program is maddeningly complex and highly individualized, said Aronne. "In some cases, it's just trial and error."

Diets don't have a great track record, the panelists agreed. "No one diet has been shown to cause more weight loss than any other diet," said Kaplan. Physicians and researchers have to do more to address the epidemic, he said: "We need to do a lot more with research, with community-based care," and other treatment options.

Ahmad was optimistic that more treatments are in the pipeline: "We're going to have more drugs and treatments, but what you do in your lifestyle" is important too, she emphasized.

Explore further: Early-life risk factors account for racial and ethnic disparities in childhood obesity

Related Stories

Early-life risk factors account for racial and ethnic disparities in childhood obesity

June 3, 2013
most of which could be changed—appear to explain the recognized racial and ethnic disparities in the incidence of childhood overweight and obesity. In a report being published online in JAMA Pediatrics, a team of researchers ...

Gene variant appears to predict weight loss after gastric bypass

May 2, 2013
Massachusetts General Hospital (MGH) researchers have identified a gene variant that helps predict how much weight an individual will lose after gastric bypass surgery, a finding with the potential both to guide treatment ...

Adequate sleep helps weight loss

September 17, 2012
Adequate sleep is an important part of a weight loss plan and should be added to the recommended mix of diet and exercise, states a commentary in CMAJ (Canadian Medical Association Journal).

Obese mums may pass health risks on to grandchildren

June 5, 2013
Health problems linked to obesity—like heart disease and diabetes—could skip an entire generation, a new study suggests.

New clinical trial explores use of smartphone application for postpartum weight loss

December 5, 2012
In a first-of-its-kind clinical trial, physician-researchers at University Hospitals (UH) Case Medical Center MacDonald Women's Hospital are exploring the use of "Lose It!," a free Smartphone application (app), for postpartum ...

Obese patients trust diet advice from overweight physicians more than normal-weight physicians

June 4, 2013
When it comes to taking diet advice from a physician—size matters. This is according to a new study led by a team of researchers at the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins University School ...

Recommended for you

Bariatric surgery prolongs lifespan in obese

January 16, 2018
Obese, middle-age men and women who had bariatric surgery have half the death rate of those who had traditional medical treatment over a 10-year period, reports a study that answers questions about the long-term risk of the ...

Evening hours may pose higher risk for overeating, especially when under stress, study finds

January 16, 2018
Experiments with a small group of overweight men and women have added to evidence that "hunger hormone" levels rise and "satiety (or fullness) hormone" levels decrease in the evening. The findings also suggest that stress ...

Sugar-sweetened drinks linked to overweight and obesity in children, adults: Analysis of new studies

December 23, 2017
A new review of the latest evidence on sugar-sweetened beverages (SSBs)- which includes 30 new studies published between 2013 and 2015 (and none of them industry sponsored) - concludes that SSB consumption is associated with ...

As income rises, women get slimmer—but not men

December 21, 2017
(HealthDay)—A comprehensive survey on the widening American waistline finds that as paychecks get bigger, women's average weight tends to drop.

Policy and early intervention can curb obesity rates

December 18, 2017
More information and emphasis on dietary lifestyle changes that prevent obesity, and its comorbidities, have not reduced the rise in obesity in U.S. adults and adolescents, according to a recent study in the New England Journal ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.