New Findings Revive Controversy

One of the ongoing debates in the obesity world is whether anyone can really reduce their body weight effectively and, most of all, lastingly. A couple of interesting stories came out last year about research that might turn out to be game-changing. The traditional pattern is that some attempts work for some people, some of the time, and nothing works for everybody all of the time. That includes what are considered to be the two major factors, diet and exercise. Then, this happened:

Scientists from Baylor College of Medicine and other institutions have proposed an explanation: Obesity is actually a neurodevelopmental disorder… If that is true, people could be predisposed to being obese…

The familiar backstory is that obese expectant moms are more likely than slim ones to suffer such complications as gestational diabetes, preeclampsia, and miscarriage. They also tend to bear children prone not only to obesity, but to asthma, growth problems, and assorted congenital disorders. OB-GYN specialist Dr. Cindy Celnik told a reporter, “We think that what’s happening in utero is that nutritional excess […] can lead to permanent changes in the metabolic pathways of your child.”

The Baylor paper, published by Science Advances in September, suggests that brain development makes a big difference in whether a person becomes obese. The study’s first author, the behavioral scientist Dr. Harry MacKay, says,

It’s difficult to lose weight because you’re fighting against stuff that was ingrained in your brain’s architecture.

It looks like that probably occurs during the fetus’ late developmental stages, but nobody really knows for sure. Despite not knowing everything, the science is pretty definite about the idea that obese mothers will have kids who tend toward obesity in addition to other problems. Talking about “developmental programming, Dr. MacKay estimates that body weight is likely determined half by genetics, and half by other factors, and “it’s likely that brain development plays a significant role.” He is quoted as saying,

Whatever it is that establishes your kind of ‘target body weight,’ or your appetite, or whatever you want to call it, it has to be something that happens early, before you really have a lot of control over it. Because it’s just so pervasive, it’s so hard to resist once it’s set.

Of course, this recalls the often-disparaged notion that there is a “set point” for each body, which it stubbornly clings to and insists on maintaining despite the person’s best efforts to shed pounds. Journalist Evan MacDonald explains,

The researchers focused on a region of the brain called the arcuate nucleus of the hypothalamus, which acts as a “master regulator” influencing appetite, metabolism and the energy available for physical activity. They discovered the arcuate nucleus undergoes extensive epigenetic programming — or changes in the way genes work — during a mouse’s suckling period, and is also very sensitive to developmental programming of body weight regulation.

In the U.S., the sheer number of obese adults has tripled since 1975. That basically equates to at least 42% of adults being classified as obese. Baylor’s Dr. Robert Waterland said, “If maternal obesity actually promotes obesity in children, then what happens over generation after generation is that this is just going to snowball and get increasingly worse.” Apparently, the snowball effect has already taken firm hold.

Your responses and feedback are welcome!

Source: “Baylor scientists believe obesity should be considered a neurodevelopmental disorder,”, 10/04/22
Image by Pete/Public Domain

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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