70% of the time, obesity is passed down from our parents. Research studies indicates that the inheritance of obesity is almost same as inheritance of a height of a person i.e. genetically predetermined. These genes of obesity are mostly in the brain. We each have unique sets of genes that determine our appetite systems and our adult weight is regulated via these genes through this appetite system.

There are 3 layers of appetite system, which play a very integral role with each other, they are:
1) Homeostatic system (Hypothalamus)
2) Motivational/Reward system (Amygdala)
3) Executive system (Prefrontal cortex)

This 3-layer Appetite system was evolved during a time when calories were hard to find and our ancestors had to hunt for calories. They had motivation to go and get food for calories/energy needed for their survival.

Our understanding of obesity is that our primitive system has collided with our current day, modern, obesogenic environment, which is full of Ultra processed food, Sugar, Salt, Fat, and is Large portioned, Tasty, Everywhere, Anywhere, Easily accessible, At our doorstep, and Advertised to look healthy.

The current situation of obesity pandemic can be best explained with the picture to the right, where HUMAN GENETICS which is programmed to Gain Weight (meteor) colliding with our CURRENT OBESOGENIC ENVIRONMENT (Earth). This explains that very less is in our hands to modify. There are many non modifiable factors working against us.  Hence, this condition should be considered as a disease  and not a problem with willpower.  Therefore we encourage that you seek  professional help.

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The challenge with our genetic heritage and our present environment is that our environment is not favorable to maintain a healthy weight.

Our Food Environment consists of fast food chains within a 5km radius of our homes. They are super cheap, convenient, time saving, tempting, all which helps our busy and on-the-go lifestyle. With the progression of our current environment, it is not designed to support our human genetics. That is why every 1 in 4 Canadians suffer from Obesity (PHAC, Stats Canada) 

We have very limited control on how  we can change our current environment, however, we can train our executive system aka the Tired Sleepy Boss (reference to Weight Story) to be more mindful rather than lose control. This requires behavioural support and education. 

(Reference: courtesy to Obesity C.A.R.E Module 1)

The concept of people living with Obesity that they ‘eat more and move less’ is wrong, and a myth. Only a part of it is due to lifestyle, in fact, modern research says:

“Overeating does not cause Obesity, Obesity causes Overeating.”

The researchers have indicated that we need to ‘re-brand’ exercise because it is not a ‘weight-loss’ tool, but rather, a weight maintenance tool. Studies have shown that physical activity alone is less effective for weight loss than dietary changes alone.

Exercise and diet are important for weight loss, not exercise alone. But, exercise has other benefits, like:

• Reduce Cravings & Wanting
• Reduce Stress
• Improved Mood
• Improve Sleep
• Improve Energy Level

A Krispy Kream original glazed donut has ~ 200 calories; in order to burn that, a 30-min brisk walk is required. That is why exercise alone is not a good weight-loss tool. And, it is good news for the people living with chronic pain, who unfortunately gave up on losing weight because they think they are unable to exercise, and have put all the blame on exercise.

See the graph above, that shows that people who exercise for weight loss (black line on graph) and people who don’t do any exercise or interventions (i.e, control group red line on graph) lose only a small amount of weight (~2%) and their weight loss is about equal regardless of whether they are exercising or not. What we can take from this is that exercise AND diet/calorie restriction is important for weight loss, not exercise alone. 

Keep in mind that the word ‘dieting’ is no longer used for weight loss in regards to calorie restriction. The correct medical terminology as per guidelines is Medical Nutritional Therapy (MNT)

So what is the best MNT that provides optimal results? 

According to the meta-analysis done in 2014, it was concluded that ANY diet is better than NO diet at all. Studies have shown that all diets generally work for 6 months only and by the 12th month, weight gain starts again. Therefore, the Best Diet is one that you can stick to in the long run. At the end of the day, it is important you enjoy what you eat in order to achieve healthy and sustainable weight loss.