Obesity is a multi-factorial condition

The lists below detail just some of the contributing factors that you may have thought of.

Factors contributing to obesity

Nutrition related:

• Low-cost, high-calorie foods
  Buy one, get one free (BOGOF) deals in supermarkets.
• Larger portion sizes
  Super size fast food meals, increasing coffee cup sizes.
• Confusing labelling
  Quotas may be based on a smaller portion size than is eaten by one person. Possible confusion with two systems: Food Standards Agency traffic light system and the Guideline Daily Amounts.
• High calorie drinks marketed as healthy
  Milk shakes, fruit smoothies.

Exercise related:

• More sedentary work
  Change in technologies reduces the amount of physical activity required for many jobs.
• Immobile games
  Children more likely to play computer games than sports games.

Genetic and neurobiological related:

• Role of leptin
  Children with leptin deficiency have huge appetites and when given leptin lose weight.
• Inherited body mass
  Studies on twins show it is more inheritable than height or blood pressure.
• Genes susceptible to ‘toxic environment’
  Morbid obesity rising at greater extent than moderate obesity. Overfeeding experiments cause some people to put on more weight than others.
• Gestational imprinting
  Maternal obesity predisposes obesity in a child.

Psychological related:

• Reward eating/feeding
  Parents reward children with sweets. Food is advertised as a reward ‘because you deserve it’.
• ‘Feeders’
  Having excessive high calorific food provided by a significant other.
• To fulfil perspective of self
  Reinforces feeling of being unattractive and unworthiness.

Disease related:

• Underactive thyroid
  Association with hypothyroidism.

Lifestyle related:

• Smoking cessation
  Major weight gain is strongly related to smoking cessation, but it occurs in only a minority of those who stop smoking.

Information related:

• Misinformation in media Contradictory “advice” may be given about healthy eating and fad diets may be promoted.

Age related:

• Post menopause Changes in hormone levels and decline in activity associated with age.
• Increasing age
  Perhaps due to being less active or some other changes in adipose tissue.

Corporate related:

• Association of unhealthy foods with healthy activities
  Sponsorship of the sporting events by fast food manufacturers and soft drink producers.
• NHS acceptance of corporate funds and implicit endorsement of unhealthy foods
  Presence of fast food outlets in hospitals – evidence suggests that this creates an ‘emotional bond’ to the product. Eisingerich and Boehm, (2009) found that 68% of respondents reported that a retailer’s presence in a hospital had a positive influence on whether they would purchase from the business again at another location.

The heart of the problem

Since our genes have not changed we tend to look for changes in society to explain the increase in obesity. These include changes in work patterns, transport and food production and sales.

It is most likely that these changes have exposed an underlying biological tendency possessed by many to both gain weight and retain it.

In other words we have a genetic susceptibility reacting with an obesogenic environment (an environment where obesity is more likely). We have Stone Age genes living in a twenty-first century environment. This was put more eloquently in the Foresight report: ‘At the heart of the problem of excess weight is a homoeostatic biological system struggling to cope in a fast changing world, where the pace of technological revolution outstrips human evolution’.

In evolutionary terms the ability to store energy as fat has been a great advantage for millions of years. However, in just a short period of human existence this bodily ability has become a health burden.

You may have heard the phrase attributed to Winston Churchill, ‘We shaped our environment, and now it shapes us’. Although the phrase was not originally used in relation to obesity it seems particularly apt.

Optional further reading:

Foresight project – Tackling obesities: future choices. A series of reports sponsored by the Department of Health that explored the factors that are contributing to obesity and aimed to identify responses.