Some Binge-Eating Basics

In the dawning days of civilization, there were different kinds of shelters, various food sources, and many ingenious ways to get hold of edible plant and animal products. The inhabitants of this Colorado cliff dwelling ate rice, maize, pine nuts, squash, beans, seeds, berries, nuts, and roots. Vegetables were sun-dried so they would last. Of course, the residents availed themselves of fish and small game, both of which would have been very difficult and labor-intensive to obtain even in the best weather, let alone when the ground was frozen and covered with snow for months on end.

Our source says, “Food was stored in large pits, often sealed in baskets or pottery for protection from insects, animals and moisture.”

But what about people? If binge eating existed then, that would make it one of the most ancient bad habits on Earth. Also, the earlier in human history it happened, the more serious the infraction would have been. In much of North America, early communities had one thing in common. When cold weather set in, sure, the occasional animal could be caught — but there were no guarantees. There was only a certain amount of stored food, and it had to be enough to last through the winter, for everybody.

One binge-eating episode, committed by one individual, could seriously affect the whole settlement. Of course, a factor in the community’s favor was the difficulty of sneaking food. In long-term storage, few casual munchies would be available. By and large, whatever you hoped to eat would need to be shelled, ground, parched, peeled, chopped, pitted, boiled, or in some other way prepared, as a prerequisite to consumption. This would not be easily accomplished on the down-low. In a small, close-knit population, sneaking food would be difficult, if not impossible.

More modern times

We will review (not in the sense of critical judgment, but in the sense of taking another look at) previous Childhood Obesity News posts that mentioned binge eating. For instance, it is a startling fact that some binge eaters don’t even get fat!

Some “make up for” binges by eating very frugally the rest of the time, to find a crude kind of balance and maintain normal weight. This can backfire — and usually does — because the enforced hunger is just as likely to trigger another binge.

How might you know if your consumption is at binge level?

Do you have episodes of eating a lot in a short time frame? Of eating until you are uncomfortably or even painfully stuffed? Does this happen once or twice a week? Do you hide food, or furtively consume it alone? Do you feel embarrassed and ashamed? Does this habit interfere with other aspects of your life? Do you feel like you just can’t stop, as if you are the pawn of some ungovernable force?

Binge-eating seems to run in families, although that could just be the “monkey-see, monkey-do” effect, rather than anything anatomically genetic. When kids grow up watching parents self-medicate with a particular substance, it should come as no surprise if they continue the family tradition.

Another thing about binge eating is how very easy it is for a person to rationalize, justify, defend, self-excuse, self-extenuate, self-validate, and self-vindicate. Even after seeking professional help, this is the sort of problem that a patient can waste a whole lot of time exploring the details of, rather than healing from.

Your responses and feedback are welcome!

Source: “Agriculture and Other Food Sources,” CliffDwellingsMuseum.com, undated
Image by Boston Public Library/CC BY 2.0 DEED

Binge-Eating Self-Talk

You’re out of balance, and definitely out of control. You want — no, you need — to eat ALL the food. A whole lot of it at once, until it hits the button that says “Enough!” Except, when is that going to happen? And then you coast through a good patch, where you seem to have some semblance of control, and everything just rolls along merrily for a while. Maybe that whole ghastly chapter of your life is over. Maybe you’ve outgrown it, or discovered some more healthy obsession to take its place. For a while, there is a degree of relief. Until…

And you know what? So what. Even at the best of times, the body doesn’t look that great, and maybe it’s time to just stop caring about that. It’s the mind that really matters, and the spirit. There is no real health problem going on, and instead of fretting and beating yourself up about the occasional food orgy maybe you should just sit back and be grateful that you’re not one of the millions of people on earth who are still starving.

Maybe it’s simply time to stop feeling “depressed, disgusted, ashamed, guilty or upset,” to quote the Mayo Clinic’s list of negative emotions. After all, it’s not like you’re vomiting the food up after you eat it. That would be really disgusting, and you’re not there yet. Not even close! You don’t dabble in laxatives, you’re not that far gone. You’re not out there compulsively exercising for six hours every day.

Okay, once in a while you get a little crazy and “put away” a whole bag of groceries, but not in the cupboard. There was that time last week when after about five minutes, you weren’t even hungry anymore, and you kept on eating for — what, two hours? Not quite two hours.

So what? Take a look at the world. People are out there shooting up schoolrooms full of kids, right in front of God and everybody. At least I keep my problems to myself. The door is closed, the shades are down, I’m eating a whole large pizza with breadsticks and dipping sauce on the side, and not hurting another soul. So, all you haters out there, just deal with it.

And what’s the big deal? Once in a while I slip up and eat too much. And okay, it’s been going on for decades, but here I still am, standing upright and able to tell the tale. Thanks for pointing out that my jeans don’t zip up all the way, but you know what? I have others. And if I still need some new ones, with an even bigger waist, I can afford another pair of pants. I got that stuff handled. I’m doing fine at my job, no complaints. Yeah, that one boss keeps looking at me sideways, but he’s retiring next year anyhow.

Anyway, my best friend growing up had monstrous eating orgies. Maybe I caught it from her. And she got over it. At least I think she did. I haven’t seen her in a few years, but I’m sure she’s fine. She did graduate, after all. Oh wait, I wasn’t going to think about how I lost that scholarship anymore. It’s making me think about that bag of chips I stashed in the basement to make it harder to get to. But you know what? Maybe I’ll just take a little walk down there right now. Stairs are good exercise.

I’m taking care of business. Sure, I have stress and maybe a negative self-image, but who doesn’t? None of us are perfect, and at least I’m not out there attacking strangers or dynamiting power stations. I get bored, sometimes I eat too much. At least I don’t drink. Shoot, I know people who should be institutionalized, and I’m nowhere near as crazy. Sure, I have anxiety and depression, who doesn’t? I don’t have insomnia or diabetes or sleep apnea. I’m not socially isolated, I got plenty of friends, and most of them are in worse shape than me…

And blah-blah blah, blahblah blah blah blah blah, and blah, blah-blah, blah-blah blah, blahblah blah blah blah blah, blah, and blah-blah, and blah-blah blah, blahblah blah blah blah blah, blah, blah-blah…..

Your responses and feedback are welcome!

Source: “Binge-Eating Disorder,” MayoClinic.org, undated
Image by Pat Hartman

A Very Heterogeneous Group

The description of obese individuals as a very heterogeneous group is quoted from correspondence between Dr. Pretlow and another professional. That is Adrian Meule, Ph.D., who researches “eating behavior, eating disorders, obesity, and other topics in health and clinical psychology,” to the point where his published articles and book chapters number more than 200, in addition to two entire books.

Of course that is not all. His credits also include reviews, for scientific journals, of over 150 manuscripts. On the more active side of both mental health and obesity science, he is certified in the fields of nutritional counseling, personal training, and fitness instruction.

Dr. Meule has said a lot about the danger of making unwarranted assumptions, for instance, about certain eating disorders and their relation to classically-framed addiction. He has spoken with Dr. Pretlow about W8loss2go and opined that, although people who do not self-identify as addicted might disagree, the app would be a helpful intervention for many.

He pointed out, for instance, that bulimia nervosa patients and binge-eating disorder patients are also drawn to addictive drugs…

He also went on to note other interesting similarities between the two populations, stemming from the fact that “…eating patterns can show addictive qualities, with similarities to substance use disorders on behavioral and neurobiological levels.” Patients with anorexia nervosa, on the other hand, do not tend to be on board with addictive drugs.

Dr. Meule mentioned to Dr. Pretlow the tendency of obese people to manifest at least three symptoms identified with food addiction. But (among other reasons) because food is not an illegal substance, the abuse of it is often not so destructive to the quality of life. These patients do not meet the “significant impairment” requirement of the official description, and therefore are excluded from the ranks of bona fide addicts.

He also cited the “many obese who are not concerned about their eating behavior,” (and who, presumably, do not know or care if they are some variety of junkie.) He endorsed the Yale Food Addiction Scale (YFAS) “as a standardized measuring device,” but with some reservations:

When I administered the YFAS to obese individuals seeking bariatric surgery, I experienced that — although some 40% received a diagnosis — many persons told me that all those questions did not apply to them at all.

In 2020 Dr. Meule published The Psychology of Food Cravings: the Role of Food Deprivation, which concerns the science behind dieting and other things, and a main point here is that…

[…] experimental studies also show that food craving can be understood as a conditioned response that, therefore, can also be unlearned.

Can be unlearned! And what happens then? Intervention studies indicate that “long-term energy restriction results in a reduction of food cravings in overweight adults.” More recently, Dr. Meule was editor of the 2023 publication Assessment of Eating Behavior, described as…

[…] essential reading for researchers working in clinical and health psychology, consumer psychology, psychiatry, and nutrition science as well as practitioners, including psychotherapists, physicians, nutrition counsellors, who assess eating behavior and related aspects in their daily work.

The book’s contents include an exploration of such abstruse topics as intuitive and mindful eating, food neophobia, disgust sensitivity, and orthorexia nervosa. The descriptive paragraph uses quotation marks for food “addiction.”

Your responses and feedback are welcome!

Source: “The Psychology of Food Cravings: the Role of Food Deprivation,” NIH.gov, September 2020
Source: “Assessment of Eating Behavior,” BarnesAndNoble.com, 05/08/23
Image by Johan Söderqvist/CC BY-ND 2.0 DEED

Fooling the Body With Filler

While bariatric surgery makes the stomach smaller, so less food will fit inside, a patient dedicated to non-compliance can definitely stretch that pouch back out again. Another method seeks to reduce the space available for food, not by tailoring the stomach itself into a smaller receptacle, but instead by filling it with non-food.

This work was done at Peking University First Hospital in Beijing, China:

Oral intragastric expandable capsules taken twice daily before meals reduce body weight in adults with overweight or obesity…

The tactic can cause “mild gastrointestinal adverse events,” but it has the advantage of being a non-invasive, non-permanent intervention. Another desirable feature is a lack of the many side effects that pharmacological methods too often trigger. Oral and intragastric, the capsule enters the mouth and lands in the stomach where it “expands to fill about one quarter of average stomach volume and then passes through the body.”

In the Chinese study, it took 24 weeks (six months, or half a year) for study participants to lose as little as 5% of baseline body weight, which seems paltry compared to some other methodologies.

Much more remains to be discovered about this way of doing things, because of the limitations of this small study in which only fewer than 4% of the subjects had type 2 diabetes. Also, they are characterized as “relatively young,” so they did not experience metabolic or cardiovascular effects that might kick in later. Here is an interesting detail:

Gastrointestinal disorders were reported in 25.0% of participants in the intragastric expandable capsule group compared with 21.9% in the placebo group, with most being transient and mild in severity.

To put it another way, a quarter of the participants taking the real stuff experienced unpleasant side effects — and so did almost as many of the subjects taking imaginary medicine. When people ingest something that is totally inert and inactive, and yet are visited by adverse results, that is the nocebo effect. “A nocebo effect can occur if a person takes a real or active medicine, and can also occur if they are given a placebo.”

Both placebo and nocebo effects are fascinating areas in which a whole lot of additional investigation is obviously needed. There is a lot going on in this realm, including controversy over the ethics. One article says,

Unfortunately, guidance for informing trial participants about trial intervention harms, in a way that is ethical, understandable, and does not produce nocebo effects, is currently under-researched. A recent study suggested that information provided to trial participants often fails to tell them what they wish to know, and that it is presented in a way that is difficult to understand.

What is this stuff, anyway?

Intragastric expandable capsules consist of two naturally derived components, food-grade carboxymethylcellulose cross-linked with citric acid, forming a three-dimensional polymer matrix that rapidly absorbs water and occupies the volume of the stomach and small intestine when administered orally with water before a meal, subsequently producing satiety. Each capsule contains no less than 10 000 highly absorbent cellulose-based hydrogel particles…

Dietary fiber comes in two varieties: soluble and insoluble. Soluble dietary fiber has long been recommended for its stomach-filling effect. It has been found to slow gastric emptying, increase perceived satiety, and significantly aid in appetite regulation. But its usefulness appears to depend on such variables as molecular size and solubility, and food matrix.

In addition, “Viscous soluble dietary fibres are believed to be more capable of inducing satiety compared to non-viscous soluble dietary fibres.” So apparently, “soluble fibres are not all created equal.” One vital area for additional research is the possibility that combinations of soluble fibers might be even more effective than any single type.

Your responses and feedback are welcome!

Source: “Premeal Stomach-Filling Capsule Effective for Weight Loss,” MDedge.com, 02/13/24
Source: “Placebo effect,” Vic.gov.au, undated
Source: “Harmful placebos,” Ox.ac.uk, 12/11/18
Source: “Efficacy and safety of intragastric expandable oral capsules in adults with overweight or obesity,” Doi.org 01/22/24
Source: “Unravelling the Effects of Soluble Dietary Fibre Supplementation on Energy Intake and Perceived Satiety in Healthy Adults,” NIH.gov, 01/06/19
Image by Edward Russell/CC BY 2.0 DEED

Upgrade the Parenting Tools

We have been exploring the realm of role modeling, also known as setting a good example. Anyone who tries it will discover that the magic word really is “example,” as in “Show, don’t tell.” Not nagging, not preaching, not blaming others for their lax habits. The more you talk about it, the less effective the lesson is. A good habit is to be quietly demonstrated over and over again, and eventually, a parent can be pleasantly surprised at what a young person has incorporated into his or her own life.

If there is a discussion about why the family is going on a three-mile hike, it’s better to keep it general. We don’t have to make a big deal out of how the excursion is supposed to help prevent a certain family member from getting fat. Not everything that can be said ought to be said.

Sometimes, we become exasperated with adult friends, for being so sloppy, careless, and neglectful of their health. But if their parents didn’t teach them good ways, how are they supposed to know? Let’s not let our kids grow up to be bad examples! Who wants that? Nobody.

Help is out there

It’s always a good idea to look around and learn what sort of free educational help is available from churches, schools, institutions, universities, and government bodies. Depending on the program and its intended audience, parents might learn how to cook basic healthful meals, how to prepare homemade “baby food,” how to understand the nutrition labels on food products, how to accurately judge whether a child is hungry or just bored or seeking attention, and many other very useful skills.

There are some things that many of us just never had the opportunity to hear about — for instance, as previously mentioned, it might require a dozen failed introduction attempts before a child will accept a new food. But the mere awareness of such a random fact can be incredibly encouraging.

Here is a thoughtful quotation from a pediatrician:

As parents, we have to set an example and to promote within our families healthy eating and healthy exercise. However, children are beset on all sides by their non-parental environment as well, which includes access to cheap, high-caloric foods; glitzy advertisements; a raft of screen and video entertainment; low-nutritional value school lunches; and on and on. Parents can be perfect role models, and still lose in this effort. But at least they stack the odds more favorably for their kids.

And we are reminded that when it comes to role models, kids are much more likely to be influenced by their own contemporaries:

Whether it is reassessing what foods we offer in vending machines, in the school cafeteria or at school celebrations, we need to set up the school environment so that the healthy choice becomes the “easy” choice and the “cool” choice. When kids see their peers and role models eating healthy, hydrating, and exercising, they are more likely to engage in those behaviors themselves.

That was educator Crystal Lim on the role that can and should be played by school districts and administrators, in creating a healthy school environment.

The astonishing track record of P.E.T.

Dr. Thomas Gordon’s Parent Effectiveness Training has been an incredible benefit to millions of families. With luck, a class might be found, but all the material is online for free anyway. P.E.T. examines the limitations of control, the power of attention, the difference between being authoritative and authoritarian, the emotional climate of the home, and a whole lot of other concepts that are equally valid whether the offspring are infants or teenagers.

Responsibility, labeling, genuine needs, rewards, responsibility, acceptance, problem ownership, active listening, conflict resolution, and many other topics are covered while the ideas around them are shown to be actionable and effective.

It is quite possible that the word “obesity” is never mentioned in any of the Gordon material. What you get instead is the map to a doable lifestyle, where many of the conditions that lead to childhood obesity simply don’t exist.

Your responses and feedback are welcome!

Source: “69% of Doctors Say Parents are Completely or Mostly to Blame for Childhood Obesity,” PRNewswire.com, 08/26/15
Source: “This Childhood Obesity School Program Works Best,” Futurity.org, 02/20/23
Source: “Free Parent Resources,” GordonTraining.com, undated
Image by Frédérique Voisin-Demery/CC BY 2.0 DEED

Be a Role Model Every Day

Imitation is the sincerest form of flattery, and that fact is both one of the most destructive and one of the most redemptive features of human nature. So we need to take the advice of Julia Olech, who wrote,

Be a role model: Children often mimic adults, so show them you also choose healthy options. When you make good food choices and limit your junk food intake, they’re more likely to do the same.

Parenting is difficult, so hard sometimes that parents conveniently forget the basic “home truths.” One of those inconvenient verities is that our children watch our every move. Not only that, but all too often, they imitate what we do. How else are they supposed to learn to be human? From the media? Really? Don’t we believe that we present a better example than some of the nonsense that appears on TV and in video games?

To be fair, a lot of parents do a pretty good job of keeping their kids separated from random violence, irresponsibility, stupidity, and other undesirable traits. If you are one of those conscientious citizens, congratulations. There is, however, another very important principle involved. In addition to protecting kids from bad influences, you — yes you, Mom, Dad, Grandma, Grandpa, older sibling, etc. — need to provide the counterbalancing good influences.

Who is that in the mirror?

A now-defunct website called BlissTree.com once published a piece claiming that 75% of parents ignore the problem of overweight in their children. Doubtless, other authors would find research claiming different percentages. At any rate, that writer made the argument that 50 years ago, there were bakeries and fast-food outlets and television, but the childhood obesity rate was less than one-third of today’s, so how can we blame “society” for making our kids fat?

That argument of course is not sturdy, because a lot of things are here now that were not present then, like antibiotics in the water and plastic in the food. At any rate, the point the author mainly intended to make was that no matter how much we would like to blame “society” for everything that goes wrong, eventually, we have to ‘fess up and acknowledge that society is us. We are a society, especially at home. After all, who do our kids see the most, especially in the early years? Their caregiving relatives, aka role models.

What ought we to demonstrate?

Corny as it sounds, a daily workout of some kind is something it wouldn’t hurt for children to witness their parents doing. Carolyn Williams, Ph.D., R.D., says, for example,

Moderate-intensity exercise actually decreases appetite by increasing the hormone that suppresses appetite and decreasing the hormone that triggers hunger… A strenuous workout frames the next 24 to 36 hours in a positive health perspective, meaning you’re more likely to make good food choices, monitor portions, and resist temptations.

But it doesn’t have to be all noisy and sweaty, it can be as gentle as a regular session of chair yoga — as long as the young’uns catch some kind of a notion. The subliminal messages are,

— You are valuable, and the physical machine that you live inside of deserves good care.
— Your routine does not need to be strenuous or lengthy.
— Just do this nice thing for yourself every day.

An area worth putting some effort into

What really needs to be nipped in the bud is the whole picky-eater scene. Dr. Suanne Kowal-Connelly told The New York Times,

Children look up to us, they model our behavior and notice what we enjoy. Parents should serve children the same foods they eat, though in smaller portions, and not offer something else saying, for example, “There are chicken nuggets in the freezer if you don’t like the broccoli I made.”

Parents can talk about the beautiful colors of various foods and why they’re good for us — make it a learning game. A new food may have to be introduced many times — 12 or 13 — just to get children to try it.

Your responses and feedback are welcome!

Source: “Junk Food Marketing Study: What Are Kids Being Fed?,” CyberGhostVPN.com, 02/13/24
Source: “To End Childhood Obesity, Parents Need To Learn To Say ‘No’,” BlissTree.com, 01/04/12
Source: “9 Things That Make You Eat More,” Yahoo.com, 05/05/16
Source: “Using Shelter-in-Place Time to Foster Better Family Food Habits,” NYTimes.com, 04/06/20
Image by It’s No Game/CC BY 2.0 DEED

Obesity Villains, Inadequate Premises, and Unclear Conclusions

This blog has been taking a second or third look at various phenomena that have been deemed responsible for, or at least conducive to, childhood obesity. Most recently, it looked at sleep debt which, blame-wise, proves to be a very elusive target.

Today’s post checks out the remaining causes that were examined in the 2009 paper, “Ten putative contributors to the obesity epidemic,” to see how they have held up over time.

Endocrine disrupters

The targets of blame in this area are chemicals whose presence in the natural environment has increased alarmingly. Of particular concern is their effect on the embryos of mammals, including humans — although exposure is in no way beneficial to adults, either. According to the paper,

PBDE, BPA, and other EDCs exposure have been implicated as contributing to obesity in both humans and model animals, possibly by interfering with estrogen and androgen signaling… [T]he human population is widely exposed to BPA and it appears to accumulate in the fetus.

[D]isruption of the activity of estrogen and testosterone signaling by EDCs during fetal development can lead to permanent changes in reproductive organ development, which can later in life impair homeostatic systems, such as the regulation of body fat and weight.

The chemicals suspected of endocrine disruption come at us from every direction. Anyone who enjoys guilt-tripping themselves or others can ponder the personal and societal effects of consumer products, incineration, atmospheric transport, agricultural runoff, harbor contamination, industrial and municipal effluents, and pulp mills in the ever-increasing plasticization of the environment and of our very own innards.

Proving the connection in a lab is tricky, because not much is known about endocrine disruptors’ hormonal activity, and that is the problem. Some aspects are more obvious and easier to catch on to, like the effect of estrogen on white adipose tissue. Fortunately for the scientists who track this sort of thing, much evidence is easily captured, for instance, BPA that is detectable in the urine of 95% of Americans.

Pharmaceutical iatrogenesis and obesity

Many of the most widely used types of pharmaceuticals have been observed to cause a concerning amount of weight gain — including antidiabetics, antihistamines, antihypertensives, steroid hormones, contraceptives, protease inhibitors, and psychotropics. The risks extend to the damage done by poor patient compliance when the obesogenic effects show up and patients decide, “No thanks, I’d rather risk high blood pressure and mental imbalance than be fat.”

Ambient temperature and obesity

Who would have thought that a difference of one and one-half degrees could cause a significant life-altering difference? But for week-old infants, it was found that despite identical feeding, the weight of babies in 36.5-degree incubators was greater than the weight of babies in 35-degree incubators. Here is another unsettling discovery:

[W]eight gain during the first four months of life is positively correlated with childhood overweight status, and weight gain during this period is greater for infants born in the spring (and presumably reared in warmer ambient temperatures) than infants born in the fall…

In their summary and departing remarks, the authors of this paper stated their desire to see scientists “remain skeptical of simplistic conclusions about complex phenomena which public health advocates in the obesity field, in particular, seem prone to accept as complete and adequate explanations.” Why? Because…

[A]ny one explanatory theory must be viewed in the context of the constellation of plausible, interrelated, and in many cases still unproven hypotheses.

Your responses and feedback are welcome!

Source: “Ten putative contributors to the obesity epidemic,” November 2009
Image by Towfiqu barbhuiya on Unsplash

Sleep Debt, an Obesity Villain Suspect

According to “Ten putative contributors to the obesity epidemic,” the factor known as “sleep debt” has not really made its case as a major obesity villain. The multiple authors say,

For all of these putative causes, we believe further research is warranted. For some such as sleep debt, research is warranted to determine whether the factor is indeed contributing to obesity levels.

For some, such as sleep debt or ambient temperature effects, studies involving manipulation of these factors in human randomized controlled trials to evaluate effects (if any) on weight seem warranted, and indeed some such studies are underway.

To put the question colloquially, is sleep debt actually “a thing”? Interesting cases to consult would be those of people who have suffered sleep deprivation as one aspect of a planned, calculated agenda of interrogation and/or punishment. But in that extreme instance, food deprivation and several other factors would have been present, so such individuals would make unhelpful experimental subjects. When undergoing sleep deprivation, they were not concurrently in a position to experience weight gain.

Still, the “Sleep Debt and Obesity” section takes up a rather large proportion of the “Ten putative contributors” paper, which includes 231 instances of the keyword itself.

Does sleep duration affect the biological mediators of energy homeostasis and appetite? Apparently, yes. Over the past five decades or so, among humans of diverse ages and nations, and among animals, the connection between decreased sleep and obesity has been increasingly noted. But there is more to it than that. Depending on other variables, sleep deprivation seems capable of causing either weight loss or weight gain.

Sleep, or a deficit of it, affects ghrelin, leptin, galanin, orexin, thyroid stimulating hormone, glucose, insulin, peptides, and no doubt other important chemicals produced by the body. Sleep debt is associated with an appetite for masses of energetic high-carbohydrate foods.

How humans do it

The truly delightful thing about people is our ability to generate self-perpetuating cycles of damage. Eat too much; get fat; lose sleep over your increasing obesity; stress out and eat more food and the wrong kinds of it; get fatter, etc.

Sleep debt has been attributed to “insomnia, stress, social pressures, desire to get more work accomplished, night-shift work, medications used to treat colds, allergies, pain and cardiovascular problems, and modern-living habits such as late-night TV viewing and use of the internet.” Those add up to a lot of variables, making it much more difficult to track the consequences of sleep deprivation in the wild. But it is said that…

Epidemiological research studies as well as wide-scale polling by the National Sleep Foundation (NSF) suggest that American adolescents and adults are chronically sleep deprived.

The NSF survey found that “individuals that self-reported to be short sleepers (less than 6 hours a night on workdays) were significantly more likely to be obese than those that self-reported to be normal or long sleepers (8 hours or more on workdays).”

There has been controversy over the effects of physical activity. An entire area of curiosity on this topic has to do with sleep apnea and other sleep-related breathing disorders. Then, there is a confusing relationship between too much sleep, not enough sleep, and mortality rates, and the additional relationship between those factors and obesity. Also, according to a major study, “African Americans had substantially higher obesity rates than did European Americans,” and…

The possibility that differences in sleep duration can contribute to the higher incidence of obesity among minority populations is supported by a recent finding by Hale and Do (2007). In this study of over 32,000 adults in the United States, the investigators found a higher risk of short (<6) and of long (>9) sleep hours, both extremes attributed to increased rate of health problems, in black vs. white respondents.

A notable conclusion from numerous studies all over the world is that “Sleep debt may have the most potent and adverse effects on body weight in children and adolescents.”

Your responses and feedback are welcome!

Source: “Ten putative contributors to the obesity epidemic,” ncbi.nlm.nih.gov, November 2009
Image by Jon Tyson on Unsplash

Obesity Villains Examined

Over the years, Childhood Obesity News has pointed the finger at numerous villains who share varying degrees of culpability for obesity. Many of these have been the same entities mentioned in “Ten putative contributors to the obesity epidemic.”

Its roster of 22 authors included Dr. Joe C. Eisenmann who by now has accumulated 30 years of experience as a coach, professor, researcher, educator, applied sport scientist, and strength and conditioning coach. Children’s health, fitness, and athletic development are his missions, and “tested, trained, energized” are his watchwords.

For his own website, Dr. Eisenmann has written that,

The benefits of exercise on the child and teenage brain include:

– improved concentration, cognition, memory and academic performance
– better self-esteem
– stress reduction
– decreased likelihood of mental health issues like anxiety and depression
– decreased severity of ADHD symptoms and autism spectrum disorder

An immature, growing brain needs to assemble itself from a lot of moving parts, and research has shown that taking into account the needs of both structure and function, physical exercise plays an enormous part in helping it to do so.

Returning to the subject of obesity villains, what newsworthy candidates did the multi-author project mention? Regarding epigenetics, there is said to be basic in vitro evidence, animal evidence, and epidemiological evidence that the area is worth scrutinizing:

Animal models and human data illustrate that dysregulation of epigenetic processes can cause obesity. Recent molecular studies provide an additional link by showing that genes critical to energy balance are regulated by epigenetic mechanisms…

If the intrauterine environment of an obese woman induces developmental adaptations in her developing fetus that then predispose her offspring to obesity, feed-forward transgenerational amplification of obesity could result.

The subheading “Intrauterine and intergenerational effects” is ticked for animal evidence, ecological correlation evidence, and epidemiological evidence. Speaking of bariatric surgery patients, the report says, “Children born after maternal weight loss have a lower risk for obesity than do their siblings born before maternal weight loss.” This leads to an area called metabolic imprinting, suggesting that body weight could be regulated by epigenetic means.

Another factor discussed here before is “assortative mating,” the tendency of humans to become intimately involved with others who have similar characteristics. But they also become involved with others who have very different characteristics, and lust has always been like that. Also, it pretty much guarantees that if two obese people have a child, that child is likely to be obese.

It also implies that an overweight person is more likely to ask an overweight person on a date, having learned from experience that potential partners of normal weight don’t really consider themselves as potential partners. According to folk wisdom, it takes a lot of personality to overcome a serious weight differential. Still, as the paper indicates,

The consequences of assortative mating are complex and dependent on the “genetic architecture” of a particular trait. Given that obesity is a complex polygenic trait, models of assortative mating are quite complex.

Your responses and feedback are welcome!

Source: “Ten putative contributors to the obesity epidemic,” ncbi.nlm.nih.gov, November 2009
Source: “New Year. New Platform. New Logo,” JoeEisenmann.substack.com, 01/03/23
Source: “Exercise and Brain Health for Young People: Another Puzzle Piece to Achieving Optimal Well-Being,” Substack.com, 10/29/23
Image by Loco Steve/CC BY-SA 2.0 DEED

A Putative Contributor, Continued

We were just saying how researchers have determined that the little bugs inside us have global implications, including the obesity epidemic. Human adenoviruses can evade our body’s immune response, and just hang on forever, sapping our physical resources and convincing us that life is not worth living.

Scientifically they are known as HAdV, and the tiny pests come in more than a hundred varieties or serotypes, of which at least 67 cause disease in humans. They have been sorted into groups A through F, of which groups A, C, and D contain serotypes linked to obesity.

A particularly ornery specimen, known as E4orf1-D36, has a dire potential in humans. It “activates adipogenesis and metabolic glucose and lipid regulation, potentially contributing to obesity-related disorders.” Very recent research has led to suspicion that the bug might be able to regulate the immune responses of its host, and if so, that would be a very big deal:

Modulating E4orf1-mediated adipogenesis, metabolic pathway activation or pro-survival functions in model systems could be a powerful tool for identifying potential therapeutic targets for obesity-associated diseases.

In laboratory glassware, a similar substance is now viewed suspiciously:

Meta-analyses support the association or risk between HAdV-D36 infection and the development of obesity but seems to be more linked to the accumulation of subcutaneous fat rather than visceral fat.

Another member of the gang, known as MCP-1, “plays a role in adipogenesis and recruiting monocytes and macrophages into adipose tissue, potentially contributing to insulin resistance and obesity development.”

The usual suspects

There is a very great temptation to blame the designers of roads, public spaces, and neighborhoods for the ever-growing obesity of humans all over the globe. But some skeptics scoff at that theory, and it is no wonder. Presently, the fattest people in the world inhabit geography where modern infrastructure has infiltrated the least — Samoa, Cook Islands, Niue, and the like.

However, it is possible in this case to suspect the other half of the “big two.” This would be the distribution process, such as importing to remote locales only the worst kinds of food.

The impulse to blame the built environment is understandable, and so is suspicion toward the wiles of advertisers and the complicity of manufacturers who dump all kinds of exotic chemicals into food. After all, we do need targets on which to cast the blame. Because if it’s the fault of the people themselves — if they are messing up, living incorrectly, and willfully persisting in being overweight — then we return to Square One.

It is so easy to slide back into the judgmental, punitive version of theorizing about obesity’s origins. The compulsion is strong, to specifically and definitively blame every obese person, and condemn them all as lazy, irresponsible individuals who care nothing for themselves or others.

Bring on the blame

When other factors can be credibly discounted, then it all comes back to an individual eating too much, too often. And if it is all the individual’s fault, then each overweight person is responsible for holding back human progress, as well as for costing society tons of money.

It is all too easy to conclude that every bit of ridicule and fat-shaming is well-deserved. Maybe “those people” ought to be refused airplane seats. Maybe they really don’t deserve to fly. In fact, they ought to be fat-shamed more often, because then they might quit their antisocial ways, slim down, and give the rest of us a break.

And that is just the start. Unfortunately, blame goes on from there and leads to all kinds of unacceptable thinking which, even if it were technically correct in every aspect, any attempt to turn it into public policy would be unthinkable. Aside from being morally reprehensible, it would be ineffective, which we already know from previous implementations.

Going back to “Ten putative contributors to the obesity epidemic,” we recall how its authors are suspicious of simplistic explanations like blaming the “built environment” or the way food is sold. They say,

Our point is merely that we do not have conclusive evidence that the big two or their individual elements are the preeminent contributors to the obesity. Despite the lack of solid evidence that clearly demonstrates the “culprits” are chiefly responsible for the obesity epidemic, researchers are quick to blame them even in the public eye… Such confidence in one “culprit” is then often contradicted by public health proponent advancing their favored target for intervention.

Your responses and feedback are welcome!

Source: “Perspective on Adenoviruses: Epidemiology, Pathogenicity, and Gene Therapy,” NIH.gov, August 2019
Source: “E4orf1: The triple agent of adenovirus…,” ScienceDirect.com, June 2024
Source: “Ten putative contributors to the obesity epidemic,” ncbi.nlm.nih.gov, November 2009
Image by Dr. Yale Rosen Atlas of Pulmonary Pathology/CC BY-SA 2.0 DEED

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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:

Presentations

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.

Food & Health Resources