By George Monbiot, published in the Guardian 12th August 2015
Once you become obese, an article published in the Lancet this year explains, biological changes lock you in. Fat cells proliferate. The brain becomes habituated to dopamine signalling (the reward pathway), driving you to compensate by increasing your consumption. If you try to lose weight, the body perceives that it is being starved, and powerful adaptations (such as an increase in metabolic efficiency) try to bounce you back to your previous state. People who manage, against great odds, to return to a normal weight must consume 300 fewer calories per day than those who have never been obese, if they are not to put the weight back on. "Once obesity is established, … bodyweight seems to become biologically stamped in". The more weight you lose, the stronger the biological pressure to get back to your former, excessive size.
The researchers find that "these biological adaptations often persist indefinitely": in other words, if you have once been obese, staying slim means sticking to a strict diet for life. The best you can hope for is not a dietary cure, but "obesity in remission". The only effective, long-term treatment for obesity currently available, the same paper says, is bariatric surgery. This can cause a number of grim complications.
. . . Fat-shaming is worse than useless. Another paper found that the more weight-conscious people are, the more likely they are to overeat: the stress it induces is a trigger for comfort eating. As Sarah Boseley points out in her book The Shape We're In, "the diet industry … is one of the biggest frauds of our time". For the obese, temporary reductions in weight will almost inevitably be reversed.
... The crucial task is to reach children before they succumb to this addiction. As well as help and advice for parents, this surely requires a major change in what scientists call "the obesogenic environment" (high energy foods and drinks and the advertising and packaging that reinforces their attraction). Unless children are steered away from overeating from the beginning, they are likely to be trapped for life.
...Why do we have an obesity epidemic? Has the composition of the human species changed? Have we suffered a general collapse in willpower? No. The evidence points to high-fat, high-sugar foods that overwhelm the impulse control of children and young adults, packaged and promoted to create the impression that they are fun, cool and life-enhancing. Many are placed in the shops where children are bound to encounter them: around the tills, at grasping height.
This is the choice we face. To recognise that the only humane and effective means of addressing the obesity epidemic is to prevent more people from being hooked, by restricting the pushers. Or to continue a programme of fat-shaming, bullying and compulsory treatment, whose only likely outcome is unhappiness. Now ask yourself again: which of these two options is draconian?
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