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Understanding Obesity (Continued)
Although there are numerous genes that are associated with obesity risk, genetics cannot explain why obesity has become such a serious problem over the last several decades. The gene pool, after all, would not have changed in such a short period of time. What, then, is responsible for the rampant increase in the severity and prevalence of obesity that is now occurring in the U.S. and throughout the industrialized world?
Positive Energy Balance

Weight gain generally happens when an individual consumes more calories than their body uses for energy. This is known as having a positive energy balance and occurs when we do not get enough physical exercise to compensate either for an over consumption of food or for selection of foods that are high in calories and low in nutrients, such as candy, cakes, and chips, and fries.

Our lifestyles today contribute to a positive energy balance. Most of us have sedentary jobs, spending most of our time at work in front of a computer or at a desk. Our children also have less opportunity for physical activity than did young people of earlier societies. Few schools allow time for free play (recess) and most schools do not require that children attend physical education classes on a daily basis. After work or school, children, as well as adults, spend 3 to 4 hours per day in front of the television, an event that burns about as few calories as our bodies uses while sleeping. What leisure time is not spent in front of the TV is often spent at the home computer, further reducing time available for physical activity.

In addition to low physical activity, a positive energy balance occurs when we eat or drink more calories than our body needs for normal functions. High calorie intake may result from a variety of causes including:

• Consuming foods that contain sugar or processed grains that are not only calorie-dense but also cause a rapid rise in blood sugar along with production of a hormone, insulin, that can cause your body to accumulate more fat.

• Drinking sodas, fruit juices, and other beverages that are high in sugar

• Eating meals at restaurants or fast-food facilities where food is generally high in calories and fat.

• Purchasing super-size meals or eating at all-you-can eat food bars.

• Frying foods in oil or preparing foods at home that are high in fat, sugar and processed grains.

• Failing to be mindful while eating, such as occurs when watching TV or performing any other activity that may distract you from those signals your stomach provides when it is full.

Low Intake of 'Obesity Prevention' Foods

In addition to eating foods high in fat, sugar and processed grains, our society has also cut back dramatically on the consumption of foods that that help to protect the body from obesity. Fiber is important to help prevent obesity and the American diet is lower in fiber than anywhere else in the world. Fiber foods include fruits, vegetables, nuts, legumes, and whole grains and these foods help to prevent obesity in a variety of ways. First, foods high in fiber expand in the stomach, causing feelings of fullness. Secondly, these foods reduce the absorption of sugar and fat. Third, fiber foods cause your body to burn more fat and, by lowering certain hormones, such as insulin, also reduce the capacity of your body to accumulate fat. Finally, fiber foods are generally high in vitamins and minerals needed for your body to effectively convert the foods you eat to energy.

Over the last several decades, our intake of dairy and other calcium-containing foods has also fallen considerably. In fact, Americans are obtaining from their diets less than 40% of the recommended daily calcium needs. Dietary calcium, in turn, helps to prevent fat from being taken up and stored in fat tissue and also helps to reduce the number of fat cells available for fat accumulation. Dairy products are even more effective in the prevention of obesity than calcium alone because these products also contain other ingredients that help reduce the accumulation of body fat.

In addition to our not getting enough calcium in our diets or not eating enough fiber, our diets are also very low in an essential fatty acid that can help to reduce the risk for obesity. This essential fatty acid is known as omega 3 and used to be readily available in eggs, milk, and meat prior to our more recent practice of grain-feeding beef, pork, fish and foul for rapid growth. Deficiencies in omega 3 can cause weight gain by: 1) increasing the uptake of fat into fat storage depots, 2) altering certain brain chemicals that cause food cravings, 3) enhancing production of lipids and insulin, and 4) causing the body to handle stress through activation of a pathway that can also cause fat accumulation and food cravings. Foods available today that remain high in omega 3 include salmon, herring, anchovies, and various other sea foods, caught but not grain-fed. Omega 3 is also high in breast milk and may one of the reasons why studies find that children who were breast fed are less likely to gain weight than those who were not.

Obesity as a Cause for Obesity

As is apparent from the above discussion, changes in the amount and kind of food that we now eat, along with the way that food is grown or processed, has contributed to the rise in obesity prevalence over recent years. But, did you know that obesity is also a cause for obesity? With weight gain, there are a number of changes that occur in your body that increase the capacity of your body to store fat. In other words, more of the food that you eat turns into body fat. Furthermore, these changes happen in order to protect your body from the toxic effects that fat can have on your heart, liver, muscle, and all other parts of your body.

Among all the tissues of your body, only adipose (fat) tissue is designed to take up and store high amounts of fat But with weight gain, fat spills over into other tissues, like the liver and heart and cells along the blood vessels and muscle to cause serious complications and disease including heart disease, liver disease and elevated lipids, insulin resistance, diabetes, hypertension and much more. In order to protect non-adipose tissue from the toxic effects of fat, the body increases its capacity for fat storage in adipose tissue, increasing fat cell size and numbers and reducing the breakdown of stored fat. In addition, there is a reduction in the uptake and use fat by non-adipose tissues, such as the muscle, making more fat available for storage.

In addition to an increased capacity for fat storage with weight gain, there are also hormone changes associated with obesity that drive fat into fat storage depots or prevent its breakdown, increasing your chances for further weight gain. To make matters worse, obesity can cause chronic depression and stress which can alter certain brain messengers and hormones in such manner as to increase the uptake of fat into fat storage depots while, at the same time, increasing appetite and interfering with your ability to feel 'full'.

Weight gain also promotes further weight gain by causing joint pain, arthritis, swollen legs and other health problems that impedes mobility or your desire to be physically active. A reduction in physical activity would, in turn, decrease the number of calories your body burns, increasing the risk for further weight gain. Furthermore, many of the health problems caused by obesity are treated with medications that cause even greater weight gain and risk for obesity. This includes many of the drugs used to treat diabetes, hypertension, depression, and inflammatory conditions.

Based on the information discussed above, how is it that you got to be obese? First, you have the 'genes' that enable you to become obese. Secondly, you went through a period of positive energy balance or, in other words, you ate more calories than your body used for energy. Third, you chose foods that promoted weight gain (those high in sugar, processed grains and fat) and you ate too little of the obesity prevention foods (those high in fiber, calcium, and omega 3 essential fatty acids). Finally, your body reacted to the increase in fat by causing conditions that led to further weight gain, setting in motion a vicious cycle and making weight loss extremely difficult, if not impossible, by means other than obesity surgery, as is discussed in the next section entitled, "Why Is It so Hard to Maintain Weight Loss?"
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