This is a perfect example of how on-line weight loss "experts" can confuse and harm the American consumer. . . The Obesity Debate?

During a dinner conversation with a friend, the topic of laziness was brought up. From there, we some how got around to the topic of obesity. He said to me, "A great example of how bad laziness can be is obesity. "

"Excuse me," I coughed out (almost chocking on the last bite).

"You know, obese people don't do anything. They are fat because they are lazy," my friend said as if from a position of authority. This was going to be a long dinner I could tell.

It turns out, my friend read an article posted on the net that started with a statement similar to my friend's words that almost made me choke. Unfortunately, he didn't remember the author's name but the title was Fitness and Exercise -- I haven't found it. . . yet.

What blows my mind is how easily people believe what is written on a website by someone calling himself an expert! The real experts need to start making noise!

Laziness does not cause obesity. If that were so, obesity would be the norm and not considered a problem. I recently found a wonderful definition of obesity. . . it covers all the possibilities in one clear sentence:

The etiology of obesity is complex, determined by the interplay of genetic and environmental factors -Andrea Baessler, from her recent article in Diabetes, Jan, 2005.

There has never been a debate about what causes obesity. We have always known that obesity is multifactorial in etiology. The "real" debate topics are which environmental factors and which genes increase the risk or incidence of obesity. The rest of the article reviews recent work around two genetic links to obesity.

SREB-1 Gene

Delphine Eberle's work (Diabetes, Aug, 2004), with the sterol regulatory element binding protein transcription factor, found that the two isoforms are linked to the "plasma leptin concentrations in American obese families. "

His group hypothesized, ". . . genetic variations of the SREB-1 gene could be associated with obesity and obesity-related metabolic traits such as insulin resistance, type 2 diabetes, and dyslipidemia. "

Interestingly, SREB-1 gene polymorphisms were found among obese cohorts when compared to nonobese cohorts. This means they are on to something and possibly not far from marking the SREB-1 gene as a clear link to obesity (1).

Ghrelin Receptor Gene (GHSR)

The importance of ghrelin in the central regulation of feeding has been demonstrated in animals and humans. Ghrelin increases appetite and food intake in normal subjects and patients with decreased appetite, such as those suffering from cancer cachexia. Recent evidence suggests that obesity is associated with an impairment of the entire ghrelin system (2).

Besides its biological function, the ghrelin receptor gene is located in a quantitative trait locus or QTL strongly linked to six phenotypes of obesity (1).

This is a second strong genetic association to obesity. Both groups will soon have conclusive evidence to support their arguments for SREB-1 and GHSR genetic links to obesity.

As far as I can tell, laziness wasn't mentioned once. How many wonderful people avoid treatment because they actually believe it's their own fault?

Educate at all costs.

Healthy Living!

Michael A. Smith, M. D.

Additional Information is available at The Weight Loss Professional

References:

Baessler A, Hasinoff J, Fischer M: Genetic linkage and association of the growth hormone secretagogue receptor gene in human obesity. Diabetes, Jan, 2005.

Eberle D. SREB-1 gene polymorphisms are associated with obesity and type 2 diabetes in French obese and diabetic cohorts. Diabetes, Aug, 2004.

Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999-2000. JAMA 288:1723-1727, 2002

Dr. Smith is the primary physician and consultant for the Weight Loss Professional Website. His interests include preventative medicine, the genetic etiology of obesity, and several others too numerous to list. Please visit his website at http://www. weight-loss-professional. com and let him know what you think.

Author:
Michael Smith, MD