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Time to Act on Obesity

Causes of Morbid Obesity

The causes of morbid obesity are multiple and complex. Despite conventional wisdom, however, it is not simply the result of overeating. Research has shown that in many cases the cause is genetic – obesity tends to run in families. Studies have demonstrated that efforts such as diet and exercise programs have a limited ability to provide effective long-term relief for morbid obesity.

This video explains why obesity is a biological response to the modern environment, and how surgery can change your body’s metabolic “set point”.

Science continues to search for answers, but until the disease is better understood, weight control is something that patients must work at their entire lives. That is why it is very important to understand that all current medical interventions, including weight loss surgery, are not medical cures. Rather, they are tools to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease.

    • Contributing Factors
    • Genetic Factors
    • The Pima Paradox
    • Environmental Factors
    • Metabolism
    • Eating Disorders and Medical Conditions
Contributing Factors

The underlying causes of morbid obesity are not known. Many factors contribute to the development of obesity, including genetic, environmental, metabolic and eating disorders. Other factors can be medical, such as intake of steroids
or hypothyroidism.

Genetic Factors

Numerous scientific studies have established that genes play an important role in the tendency to gain excess weight. For more information click here.

          • The body weight of adopted children shows no correlation with the body weight of their adoptive parents, who feed them and teach them how to eat. Their weight does have an 80 percent correlation with their genetic parents, whom they have never met.
          • Identical twins, with the same genes, show a much higher similarity of body weight than do fraternal twins, who have different genes.
          • Certain groups of people, such as the Pima Indian tribe in Arizona, have a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.
The Pima Paradox

The Pima Indians are known in scientific circles as one of the heaviest groups of people in the world. In fact, National Institutes of Health researchers have been studying them for more than 35 years. Some adults weigh more than 500 pounds, and many obese teenagers suffer from diabetes, the disease most frequently associated with obesity.

But here’s a really interesting fact – a group of Pima Indians living in Sierra Madre, Mexico, does not have a problem with obesity and its related diseases. Why not?

The leading theory states that after many generations of living in the desert and often confronting famine, the most successful Pima were those with genes that helped them store as much fat as possible to sustain them during times when food was unavailable. Now those fat-storing genes work against them.

Though both populations consume a similar number of calories each day, the Mexican Pima still live much like their ancestors did, putting in 23 hours of physical labor each week and eating a traditional diet that is very low in fat. The Arizona Pima live like most modern Americans, eating a diet consisting of around 40 percent fat and engaging in physical activity for only two hours a week.

The Pima apparently have a genetic predisposition to gain weight. And the environment in which they live – the environment in which most of us live –
makes it nearly impossible for the Arizona Pima to maintain a normal, healthy body weight.

Environmental Factors

Environmental and genetic factors are obviously closely intertwined. If you have a genetic predisposition toward obesity, then the modern American lifestyle and environment may make controlling weight more difficult. Fast food, long days sitting at a desk, and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage. For those suffering from morbid obesity, anything less than a total change in environment usually results in failure to reach and maintain a healthy body weight.


We used to think of weight gain or loss as only a function of calories ingested and then burned. Take in more calories than you burn, gain weight; burn more calories than you ingest, lose weight. Now we know the equation isn’t that simple. Obesity researchers now talk about a theory called the “set point,” a sort of thermostat in the brain that makes people resistant to either weight gain or loss. If you try to override the set point by drastically cutting your calorie intake, your brain responds by lowering metabolism and slowing activity. You then gain back any weight you lost.

Eating Disorders and Medical Conditions

Weight loss surgery is not a cure for eating disorders, and there are medical conditions, such as hypothyroidism, that can cause weight gain. That’s why it is important that you work with your doctor to make sure you do not have a condition that should also be treated with medication and counseling.

*Ogden CL,, Prevalence of Obesity in the United states, 2009-2010, NCHS Data Brief 2012; Jan:1-8