#obesogenic environment

[rodrickheffley]

have to do a reading for my anthropology of food class that ik will trigger meeee

[transmutationisms]

@annevbonny yeah so first of all there's the overt framing issue that this whole idea rests on the premise that eliminating fatness is both possible and good, as though like. fat people haven't existed prior to the ~industrial revolution~ lol

more granularly this theory relies on misinterpreting the causes for the link between poverty and fatness (which is real---they are correlated) so that fatness can be configured as a failure of eating choices and urban design, meaning ofc that the 'solution' to this problem is more socially hygienic, monitored, controlled communities where everybody has been properly educated into the proper affective enjoyment of spinach and bike riding, and no one is fat anymore and the labour force lives for longer and generates more value for employers

in truth one of the biggest mediating factors in the poverty-body weight link is food insecurity, because intermittent access to food tends to result in periods of under-nourishment followed by periods of compensatory eating with corresponding weight regain/overshoot (this is typical of weight trajectories in anyone refeeding after a period of starvation or under-eating, for any reason). so this is all to say that the suggestion that fatness is caused by access to 'unhealthy foods' is not only off base but extremely harmful; food insecurity is rampant globally. what people need is consistent access to food, and more of it!

and [loud obvious disclaimer voice] although i absolutely agree that food justice means access to a variety of foods with a variety of nutrient profiles, access to any calories at all is always better than access to none or too few. which is to say, there aren't 'healthy' or 'unhealthy' foods in isolation (all foods can belong in a varied, sufficient diet) and this is a billion times more true when we are talking about people struggling to consume enough calories in the first place.

relatedly, proponents of the 'obesogenic environment' theory often invoke the idea of 'hyperpalatable foods' or 'food addiction'---different ways of saying that people 'overeat' 'junk food' because it's too tasty (often with the bonus techno-conspiricism of "they engineer it that way"). again it's this idea that the problem is people eating the 'wrong' foods, now because the foods themselves are exerting some inexorable chemical pull over them.

this is inane for multiple reasons including the failure to deal with access issues and the fact that people who routinely, reliably eat enough in non-restrictive patterns (between food insecurity and encouragement to deliberately diet/restrict, this is very few people) don't even tend to 'overeat' energy-dense demonised foods in the first place. ie, there is no need to proscribe or limit 'junk food' or 'fast food' or 'empty calories' or whatever nonsense euphemism; again the solution to nutritionally unbalanced diets is to guarantee everyone access to sufficient food and a variety of different foods (and to stop encouraging the sorts of moralising food taboos that make certain foods 'out of bounds' and therefore more likely to provoke a subjective sense of loss of control in the first place lol)

but tbc, when i say "the solution to nutritionally unbalanced diets"---because these certainly can and do exist, particularly (again) amongst people subjected to food insecurity---i am NOT saying "the solution to fatness" because fatness is not something that will ever be eliminated from the human population. and here again we circle back to one of the fundamental fears that animates the 'obesogenic environment' myth, which is that fatness is a medical threat to the race/nation/national future. which is of course blatant biopolitics and is relying on massive assumptions about the health status of fat and thin people that are simply not borne out in the data, and that misinterpret the relationship between fatness and illness (for example, the extent to which weight stigma prevents fat people from receiving medical care, or the role of 'metabolic syndrome' in causing weight gain, rather than the other way around).

people are fat for many reasons, including "their bodies just look like that"; fatness is neither a disease in itself nor inherently indicative of ill health, nor is it eradicable anyway (and fundamentally, while all people should have access to health-protective social and economic conditions, health is not something that people 'owe' to anyone else anyway)

the 'obesogenic environment' is a liberal technocratic fantasy---a world in which fatness is a problem of individual consumption and social engineering, and is to be eliminated by clever policy and personal responsibility. it assumes your health is 1) directly caused and indicated by your weight, 2) something you owe to the capitalist state as part of the bargain that is 'citizenship', and 3) something you can learn to control if only you are properly educated by the medical authorities on the rules of nutrition (and secondarily exercise) science. it's a factual misinterpretation of everything we know about weight, health, diet, and wealth, and it fundamentally serves as a defense of the existing economic order: the problem isn't that capitalism structurally does not provide sufficient access to resources for any but the capitalist class---no, we just need a nicer and more functional capitalism where labourers have a greengrocer in the neighbourhood, because this is a discourse incapable of grappling with the material realities of food production and consumption, and instead reliant on configuring them in terms of affectivity ('food addiction') or knowledge (the idea that food-insecure people need to be more educated about nutrition)

there are some additional aspects here obviously like the idea that exercising more would make people thin (similar issues to the food arguments, physical activity can be great but the reasons people do or don't do it are actually complex and related to things like work schedules and exercise doesn't guarantee thinness in the first place) or fearmongering about 'endocrine disruptors' (real, but are extremely ill-defined as a category and are often just a way to appeal to ideas of 'naturalness' and the vague yet pressing harms of 'chemicals', and which are also not shown to single-handedly 'cause' fatness, a normal state of existence for the human body) but this is most often an argument about food ime.

[blsm-m]

If you live in a larger body, sometimes it feels like you can’t win. If you don’t lose weight, people will criticize you for being “lazy,” “unhealthy,” or “lacking willpower.” But if you take medication to help you, you’ll be criticized for “cheating” or “taking the easy way out,” even if you’ve tried for decades to manage your weight through diet, exercise, and lifestyle changes (sometimes extreme ones). In this article, we’ll be talking about a highly contentious group of medicines—GLP-1 receptor agonist drugs such as semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound). And people have lots of opinions about them. But the opinion that matters most? Yours. At PN, we’re medication agnostic. We’re not here to judge whether a person should or should not take medication for weight loss. Ultimately, that’s a choice left up to you, with the guidance of your primary care physician. Either way, we’re here to support our clients and elevate their results. Whether you take medication or not, a coach can help you optimize nutrition and satiety with the right foods, find exercises that work with your changing body, and help you navigate the emotional ups and downs that come when you attempt to tackle a big, meaningful, long-term goal. However, we also understand that if you’re debating the pros and cons of beginning (or continuing) medication, you might have mixed feelings. If you’re not sure if these new medicines are right for you, we have your back. In the following article, we’ll give you the honest, science-backed information you need to make a confident decision. You’ll learn… Why it’s so hard to lose (and keep off) fat Why taking medication isn’t “cheating,” nor is it the “easy way out” How GLP-1 drugs work, and the health benefits they can have (aside from weight loss) How to determine if you’re at a “healthy weight” (it’s not just about BMI) What actions you can take to minimize side effects and maximize long-term health, if you do decide to take these medications Let’s begin. Over 150,000 health & fitness professionals certified Save up to 30% on the industry's top nutrition certification Help people improve their health and fitness—while making a great full-time or part-time living doing what you love. Learn More First, why is it so hard to lose fat? Fat loss is hard. Period. But for some people, it’s harder still—because of environmental, genetic, physiological, social, cultural, and/or behavioral factors that work against them. Here are a few of the contributing factors that can make fat loss so challenging. We live in an environment that encourages a caloric surplus. Imagine life 150 years ago, before cars and public transit were invented. To get from point A to point B, you had to walk, pedal a bicycle, or ride a horse. Food was often in short supply, too. You had to expend calories to get it, and meals would just satisfy you (but not leave you “full”). Today, however… “We live in an obesogenic environment that’s filled with cheap, highly-palatable, energy-dense foods [that make overeating calories easy, often unconsciously],” says Karl Nadolsky, MD, an endocrinologist and weight loss specialist at Holland Hospital and co-host of the Docs Who Lift podcast. “We also have countless conveniences that reduce our physical activity.” Of course, even in such an environment, we have people in lean bodies, just as we have people who struggle to stop the scale from continuously creeping up. Why? Genetically, some people are more predisposed to obesity. Some genes can lead to severe obesity at a very early age. However, those are pretty rare. Much more common is polygenic obesity—when two or more genes work together to predispose you to weight gain, especially when you’re exposed to the obesogenic environment mentioned earlier. People who inherit one or more of these so-called obesity genes tend to have particularly persistent “I’m hungry” and “I’m not full yet” signals, says Dr. Nadolsky. Obesity genes also seem to cause some people to experience what’s colloquially known as “food noise.”

They feel obsessed with food, continually thinking, “What am I going to eat next? When is my next meal? Can I eat now?” Physiologically, bodies tend to resist fat loss. If you gain a lot of fat, the hormones in your gut, fat cells, and brain can change how you experience hunger and fullness. “It’s like a thermostat in a house, but now it’s broken,” says Dr. Nadolsky. “So when people cut calories and weight goes down, these physiologic factors work against them.” After losing weight, your gut may continually send out the “I’m hungry” signal, even if you’ve recently eaten, and even if you have more than enough body fat to serve as a calorie reserve. It also might take more food for you to feel full than, say, someone else who’s never been at a higher weight. Being in a larger body often means being the recipient of fat stigma and discriminatory treatment. Until you’ve lived in a larger body, it’s hard to believe how different the world might treat you. Our clients have told us stories about being bullied at the gym, openly judged or lectured at the grocery store, and otherwise being subjected to innumerable comments and assumptions about their body shape, health, and even worth. Even in medical settings, people with obesity are more likely to receive poor treatment.1, 2 Healthcare providers may overlook or downplay symptoms, attributing health concerns solely to weight. This can lead to delayed- or missed diagnoses or just plain old inadequate care. All of this combined can add up to an incredibly pervasive and ongoing source of stress. This stress—in addition to being socially isolating and psychologically damaging—can further contribute to increased appetite and pleasure from high-calorie foods, decreased activity, and poorer sleep quality.3 Which is why… Taking medication isn’t an “easy way out.” In 2013, the American Medical Association categorized obesity as a disease. And yet, many people still don’t treat it as such, and rather consider obesity as a willpower problem, and the consequence of simply eating too much and moving too little. (The remedy: “Just try harder.”) In reality, people with obesity have as much willpower as anyone else. However, for them, fat loss is harder—for all the reasons mentioned above, and more. So, just like chemotherapy or insulin isn’t “the easy way out” of cancer or type 1 diabetes, medication isn’t “the easy way out” of obesity. Rather, medication is a tool, ideally used alongside healthy lifestyle behaviors, that can help offset some of the genetic and physiological variances that people with obesity may have, and have little individual control over otherwise. What you need to know about GLP-1 drugs In 2017, semaglutide (a synthentic GLP-1 agonist) was approved in the US as an antidiabetic and anti-obesity medication. With the emergence of this class of drugs, science offered people with obesity a relatively safe and accessible way to lose weight long-term, so long as they continued the medication. How Ozempic and other obesity medicines work Current weight loss medications work primarily by mimicking the function of glucagon-like peptide 1 (GLP-1), a hormone that performs several functions: In the pancreas, it triggers insulin secretion, which helps regulate blood sugar (and also helps you feel full). In the gut, it slows gastric emptying, affecting your sensation of fullness. In the brain, it reduces cravings (the desire for specific foods) and food noise (intrusive thoughts about food). In people with obesity, the body quickly breaks down endogenous (natural) GLP-1, making it less effective. As a result, it takes longer to feel full, meals offer less staying power, and food noise becomes a near-constant companion, says Dr. Nadolsky. Semaglutide and similar medicines flood the body with synthetically made GLP-1 that lasts much longer than the GLP-1 the body produces. This long-lasting effect helps increase feelings of fullness, reduce between-meal hunger, and muffle cravings and food noise.

Interestingly, by calming down the brain’s reward center (the part of the brain that drives cravings and even addictions), these medicines may also help people reduce addictive behaviors like compulsive drinking and gambling, says Dr. Nadolsky. Note: Newer weight loss medicines, for example tirzepatide, mimic not only GLP-1, but also another hormone called gastric inhibitory polypeptide (GIP). Like GLP-1, GIP also stimulates post-meal insulin secretion and reduces appetite, partly by decreasing gastrointestinal activity. Other drugs soon to come on the market, like retatrutide, mimic a third hormone, glucagon. How effective are GLP-1 drugs? Researchers measure a weight loss medicine’s success based on the percentage of people who reach key weight loss milestones of 5, 10, 15, or 20 percent of their weight. These medicines are still evolving, but so far, they have shown to be quite effective: About 86 percent of people who take GLP-1 drugs like Ozempic, Rybelsus, and Wegovy lose at least five percent of their body weight, with about a third of them losing more than 20 percent of their body weight.4, 5 And newer generation versions of these medications—such as tirzepatide, and the not-yet-FDA-approved retatrutide—are only getting better, with up to 57 percent of people losing more than 20 percent of their body weight.6, 7 How do weight loss medications compare to lifestyle interventions? In the past, weight loss interventions have focused on lifestyle modifications like calorie or macronutrient manipulation, exercise, and sometimes counseling. Rather than pitting lifestyle changes against weight loss medicines or surgery, it’s more helpful to think of them all as compatible players. With lifestyle modifications and coaching, the average person can expect to lose about five to 13 percent of their body weight. When you add FDA-approved versions of GLP-1 and other weight-loss drugs to lifestyle and coaching, average weight loss jumps up another ten percent or more. 8, 9, 10, 11 Fat loss often comes with powerful health benefits For years, the medical community has told folks that losing 5 to 10 percent of their body weight was good enough. Partly, this message was designed to right-set people’s expectations, as few lose much more than that (and keep it off) with lifestyle changes alone. In addition, this modest weight loss also leads to measurable health improvements. Lose 5 to 10 percent of your total weight, and you’ll start to see blood sugar, cholesterol, and pressure drop.12 However, losing 15 to 20 percent of your weight, as people tend to do when they combine lifestyle changes with second-generation GLP-1s, and you do much more than improve your health. You can go into remission for several health problems, including: High blood pressure Diabetes Fatty liver disease Sleep apnea That means, by taking a GLP-1 medicine, you might be able eventually to stop taking several other drugs, says Dr. Nadolsky. Experts suspect GLP-1s may improve health even when no weight loss occurs. “The medicines seem to offer additive benefits beyond just weight reduction,” says Dr. Nadolsky. Research indicates that GLP-1s may reduce the risk of major cardiovascular events (heart attacks and strokes) in people with diabetes or heart disease.13, 14, 15 In people with diabetes, they seem to improve kidney function, too.16 The theory is that organs throughout the body have GLP-1 receptors on their cells. When the GLP-1s attach to these receptors in the kidneys and heart, they seem to protect these organs from damage. For this reason, in 2023, the American Heart Association listed GLP-1 receptor agonists as one of the year’s top advances in cardiovascular disease. What even is a “healthy body weight”? Many people say, “I just want to be at a healthy weight.” But what does that even mean? At PN, we believe your healthiest body composition / weight is one that: Has relatively more lean mass (from muscle and healthy, dense bones), and relatively less body fat

Emerges from doing foundational, sustainable health-promoting behaviors (like being active and eating well), rather than “crash diets” or other extreme measures Is relatively easy to maintain with a handful of consistent lifestyle choices, without undue sacrifices to overall well-being (or what we call Deep Health) Allows you to do the activities you want and enjoy, with as few limitations as possible Keeps your health markers (like blood pressure, cholesterol, and blood sugar) in safe and healthy ranges as much as is reasonably possible Feels good to you This is not a specific size, shape, look, body fat percentage, or category on a BMI chart; A “healthy” body composition and/or weight will vary from person to person. … Which can be both freeing and frustrating to hear. Without a specific number to aim for, it’s harder to know if you’ve “arrived” at your healthiest weight or body composition. However, we like this way of qualifying what a healthy weight is because it takes the pressure off a number on the scale, and puts the focus on behaviors you have more control over, and more importantly, how your life feels. 7 strategies to make weight loss medicines more effective—and improve long-term health Here’s what we believe: Weight loss medicines don’t render lifestyle changes obsolete; they make them more critical. When GLP-1 medicines muffle food noise and hunger, many find it easier to prioritize lean protein, fruits and veggies, whole grains, and other minimally processed foods. Similarly, as the scale goes down, people often feel better, so they’re more likely to embrace weight lifting and other forms of exercise. Indeed, according to a 2024 consumer trends survey, 41 percent of GLP-1 medicine users reported that their exercise frequency increased since going on the medication. The majority of them also reported an improvement in diet quality, choosing to eat more protein, as well as fruits and vegetables.17 This is great news, because it further reinforces the idea that medication isn’t simply “the easy way out.” (Of course, sometimes drugs are used as “the easy way out”; After going on medication, people can continue to eat poor quality food—just less of it. This increases the risk of losing critical muscle and bone, and losing less—or even no—body fat.) When used correctly, weight loss medication is a tool that, as mentioned above, can make healthy lifestyle changes easier to accomplish, making both the drugs and the lifestyle changes more effective, and enhancing both short- and long-term success. If you do decide to take weight loss drugs, use these strategies to get the most out of them—and preserve your long-term health. Strategy #1: Find ways to eat nutritiously despite side effects. The slowed stomach emptying caused by GLP-1 drugs can trigger nausea and constipation. Fortunately, for most people, these GI woes tend to resolve within several weeks. However, if you’re experiencing a lot of nausea, you’re not likely going to welcome salads into your life with open arms. (Think of how you feel when you have the stomach flu. A bowl of roughage doesn’t seem like it’ll “go down easy.”) So, try to find more palatable ways to consume nutritious foods. (For example, fruits and vegetables in the form of a smoothie or pureed soup might be easier.) Dr. Nadolsky also suggests people avoid the following common offenders: Big portions of any kind Greasy, fatty foods Highly processed foods Any strong food smells that trigger your gag reflex Sugar alcohols (like xylitol, erythritol, maltitol, and sorbitol, often found in diet sodas, chewing gum, and low-sugar protein bars), which can trigger diarrhea in some Strategy #2: Prioritize strength training. When people take GLP-1 weight loss medicines, about 30 to 40 percent of the weight they lose can come from lean mass.18, 19, 20 Put another way: For every 10 pounds someone loses, about six to seven come from fat and three to four from muscle, bone, and other non-fat tissues. However, there’s two important caveats to this statistic:

1. People with severe obesity generally have more muscle and bone mass than others. (Carrying around an extra 100+ pounds of body weight means muscles have to adapt by getting bigger and stronger.) 2. Muscle and bone loss aren’t inevitable. (As Dr. Nadolsky puts it, “Muscle loss isn’t a reason to avoid treating obesity [with medication]. It’s a reason to do more exercise.”) To preserve muscle and bone mass, aim for at least two full-body resistance training sessions a week. In addition, move around as much as you can. Walking and other forms of physical activity are vital for keeping metabolism healthy—and can help to move food through the gut to ease digestion.21, 22 (Need inspiration for strength training? Check out our free exercise video library.) Strategy #3: Lean into lean protein. In addition to strength training, adequate protein consumption is vital for helping to protect muscle mass. You can use our free macros calculator to determine the right amount of protein for you. (Spoiler: Most people will need 1 to 2 palm-sized protein portions per meal, or about 0.5 to 1 gram of protein per pound of body weight per day.) Strategy #4: Fill your plate with fruit and veggies. Besides being good for your overall health, whole, fresh, and frozen produce fuels you with critical nutrients that can help drive down levels of inflammation. In addition to raising your risk for disease, chronic inflammation can block protein synthesis, making it harder to maintain muscle mass. (Didn’t know managing inflammation matters when it comes to preserving muscle? Find out more muscle-supporting strategies here: How to build muscle strength, size, and power) Strategy #5: Choose high-fiber carbs over low-fiber carbs. Beans, lentils, whole grains, and starchy tubers like potatoes and sweet potatoes do a better job of helping you feel full and managing blood sugar than lower-fiber, more highly processed options. (Read more about the drawbacks—and occasional benefits—of processed foods here: Minimally processed vs. highly processed foods) Strategy #6: Choose healthy fats. Healthy fats can help you feel full between meals and protect your overall health. Gravitate toward fats from whole foods like avocado, seeds, nuts, and olive oil, as well as fatty fish (which is a protein too!)—using them to replace less healthy fats from highly-processed foods (like chips or donuts). (Not sure which fats are healthy? Use our 3-step guide for choosing the best foods for your body) Strategy #7: Consider coaching. It may go without saying, but the above suggestions are just the start. (There’s also: quality sleep, social support, stress management, and more.) While many people choose to tackle these strategies on their own, many others find that the support, guidance, and creative problem-solving that a good coach can provide makes the whole process a lot easier—not to mention more enjoyable and more likely to stick. And that’s the real gift of coaching: A coach doesn’t just help you figure out what to eat and how to move; They help you remove barriers, build skills, and create systems and routines so that habits become so natural and automatic that it’s hard to imagine not doing them. Then, if you do want to stop taking medication, your ingrained lifestyle habits (that coaching reinforced, and medication perhaps made easier to adopt) will make it more likely that you maintain your results. References Click here to view the information sources referenced in this article. 1. Phelan, S. M., D. J. Burgess, M. W. Yeazel, W. L. Hellerstedt, J. M. Griffin, and M. van Ryn. 2015. “Impact of Weight Bias and Stigma on Quality of Care and Outcomes for Patients with Obesity.” Obesity Reviews: An Official Journal of the International Association for the Study of Obesity 16 (4): 319–26. 2. Tomiyama, A. Janet, Deborah Carr, Ellen M. Granberg, Brenda Major, Eric Robinson, Angelina R. Sutin, and Alexandra Brewis. 2018. “How and Why Weight Stigma Drives the Obesity ‘Epidemic’ and Harms Health.” BMC Medicine 16 (1).

3. Tomiyama, A. Janet. 2019. “Stress and Obesity.” Annual Review of Psychology 70 (1): 703–18. 4. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002 5. Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022 Oct;28(10):2083–91. 6. le Roux CW, Zhang S, Aronne LJ, Kushner RF, Chao AM, Machineni S, et al. Tirzepatide for the treatment of obesity: Rationale and design of the SURMOUNT clinical development program. Obesity. 2023 Jan;31(1):96–110. 7. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205–16.. 8. Leung, Alice W. Y., Ruth S. M. Chan, Mandy M. M. Sea, and Jean Woo. 2017. “An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults.” International Journal of Environmental Research and Public Health 14 (8). 9. Jastreboff, Ania M., Louis J. Aronne, Nadia N. Ahmad, Sean Wharton, Lisa Connery, Breno Alves, Arihiro Kiyosue, et al. 2022. “Tirzepatide Once Weekly for the Treatment of Obesity.” The New England Journal of Medicine 387 (3): 205–16. 10. Jastreboff, Ania M., Lee M. Kaplan, Juan P. Frías, Qiwei Wu, Yu Du, Sirel Gurbuz, Tamer Coskun, Axel Haupt, Zvonko Milicevic, and Mark L. Hartman. 2023. “Triple–Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial.” The New England Journal of Medicine 389 (6): 514–26. 11. Maciejewski, Matthew L., David E. Arterburn, Lynn Van Scoyoc, Valerie A. Smith, William S. Yancy Jr, Hollis J. Weidenbacher, Edward H. Livingston, and Maren K. Olsen. 2016. “Bariatric Surgery and Long-Term Durability of Weight Loss.” JAMA Surgery 151 (11): 1046–55. 12. Ryan DH, Yockey SR. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep. 2017 Jun;6(2):187–94. 13. Marx N, Husain M, Lehrke M, Verma S, Sattar N. GLP-1 Receptor Agonists for the Reduction of Atherosclerotic Cardiovascular Risk in Patients With Type 2 Diabetes. Circulation. 2022 Dec 13;146(24):1882–94. 14. Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023 Dec 14;389(24):2221–32. 15. Kosiborod MN, Abildstrøm SZ, Borlaug BA, Butler J, Rasmussen S, Davies M, et al. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. 2023 Sep 21;389(12):1069–84. 16. Karakasis P, Patoulias D, Fragakis N, Klisic A, Rizzo M. Effect of tirzepatide on albuminuria levels and renal function in patients with type 2 diabetes mellitus: A systematic review and multilevel meta-analysis. Diabetes Obes Metab [Internet]. 2023 Dec 20 17. N.d. Accessed May 21, 2024. https://newconsumer.com/wp-content/uploads/2024/03/Consumer-Trends-2024-Food-Wellness-Special.pdf 18. Ida S, Kaneko R, Imataka K, Okubo K, Shirakura Y, Azuma K, et al. Effects of Antidiabetic Drugs on Muscle Mass in Type 2 Diabetes Mellitus. Curr Diabetes Rev. 2021;17(3):293–303. 19. Wilding JPH, Batterham RL, Calanna S, Van Gaal LF, McGowan BM, Rosenstock J, et al. Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity: Exploratory Analysis of the STEP 1 Study. J Endocr Soc. 2021 May 3;5(Supplement_1):A16–7. 20. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002. 21. Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, Castro A, Cebrián-Cuenca A, de Torres-Sánchez A, et al. Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. J Clin Med Res [Internet]. 2022 Dec 24;12(1).

22. Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM. Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes Metab Syndr Obes. 2017 Dec 14;10:513–9. If you’re a coach, or you want to be… You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how. If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification.

[shadowstarkanada]

In my parents' house, the easy food option is the high calorie, high sugar, candy option. No wonder I'm gaining so much weight. How could anyone not gain weight? Go to the fridge for a quick snack, and all the healthy things require preparation. There's meat, there unwashed salad, there's a sad pickle. But look, there's donuts, and cheesecake, and cookies, and multiple types of ice creams, and chips! There's a few different loaves of bread. Jam is right there in your face. Two refrigerators, a freezer, a pantry for canned foods, and almost all of it is highly processed and high calorie.

When I was in California, those were the hard options. I made those the hard options. I didn't keep them in the house. If I wanted ice cream, I could walk my ass to the grocery store and buy a single serving. (I can't even walk to the grocery store here because it's farther away, plus the weather is almost always bad for walking, too hot and humid or too cold... in California, I walked for my lunch break.) If I wanted a quick snack, I had carrot sticks and frozen fruit as the first things I saw if I opened the fridge.

So how do I replicate that in my parents' house? How do I make the extremely obesogenic environment into one that is... less so? Because it's so uncomfortable to be fat. It's so energy draining and tiring to be fat. The heat and humidity makes me so uncomfortable because I'm fat. And yet, in this environment, the easy thing to do is always to eat something that's high calorie.

I'm going to have to do a fast this weekend, I think. Black coffee and tea. If I do that for a few days, it might at least reset my hunger levels. I don't know. I just don't have a solution for any of this. There's so much garbage in this house. If I asked, there might be less around for a few weeks, but then it just goes right back to where it was. It's fucking impossible.

[healthmatters520]

Practice portion control to help manage calorie intake

Practicing portion control by using smaller plates and bowls is an effective strategy to manage calorie intake and prevent overeating. Research suggests that using smaller dishware can trick the mind into perceiving larger portions, leading to reduced food consumption. By visually filling up the smaller plates and bowls, you may feel satisfied with smaller amounts of food, helping to regulate calorie intake. This can be especially beneficial in today's obesogenic food environment. By implementing this simple technique, you can take control of your portion sizes, promote healthier eating habits, and support weight management goals.

Read the full article

[onlinereviewhelth]

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Return Policy: 4.9/5

Money Back Guarantee: 60 Days

Is There any Risk to using the Biolean?: No. There is no risk. Biolean is a 100% natural and safe weight loss supplement. Biolean is approved by FDA And GMP-Certified facility. Plus It has a 60-Day Full money back guarantee. Where You Can get your money back without any single question.

Is There any bonus or discount available?: Yes, Biolean has up to 80% discount Available plus 3 bonuses available.

Ingredients:- Bitter Orange, Banaba Leaf, Korean Ginseng, Cayenne Fruit, Resveratrol, Green Tea Leaf, Cinnamon Bark, Ginger Root.

Biolean Reviews: What Is Biolean?

According to the official Bioline website, these are obesogenic chemicals that can disrupt the normal functioning of hormonal and metabolic systems, thereby contributing to weight gain and obesity.

These substances can be found in a variety of sources, including processed foods, plastic containers, personal care products, and pesticides. They interfere with the body’s endocrine system, which is responsible for regulating metabolism, growth, and development.

There are several mechanisms through which obesogens may increase weight:

Fat cell growth: Obesogens may promote the growth of new fat cells and increase the fat storage capacity of existing cells. This can lead to an increase in body fat even without increasing calorie consumption.

Metabolic disruption: These chemicals can alter the metabolic rate, making it harder for the body to burn calories. This can lead to weight gain over time, as the body becomes less efficient at using energy.

Hormonal imbalance: Obesogens can mimic or interfere with the body’s natural hormones, such as estrogen and thyroid hormone, which play important roles in regulating metabolism, appetite, and fat distribution.

Appetite regulation: Some obesogens may affect the nervous system responsible for appetite control, leading to increased appetite and food intake, which contributes to weight gain.

Insulin sensitivity: They can also affect insulin sensitivity, leading to increased fat storage and ultimately conditions like obesity and type 2 diabetes.

Because obesogens are widespread in the environment and products are in daily use, reducing exposure can be challenging. However, strategies such as eating whole foods, avoiding plastic containers for food and drinks, using natural personal care products, and reducing pesticide use can help limit their effects on health and weight.

Biolean Reviews: How Does It Works?

It is a weight loss supplement that targets a specific enzyme that is responsible for excess body fat. Amylase is an enzyme that converts carbs from food into fat-storing sugars. When we consume high-carbohydrate foods, amylase breaks them down and stores more fat in the body.

According to a study published by Japanese researchers, the enzyme level increases with age. As a result, people over the age of 30 experience sudden weight gain in their bodies.

It is designed to inhibit the amylase enzyme in the body. The formula helps to reduce amylase production in the body and prevent carbohydrate breakdown into fat. The supplement contains four natural ingredients from Japan: white kidney bean extract, bitter melon extract, chromium picolinate, and berberine. This supplement ingredients, according to the manufacturer, have been clinically tested and proven to reduce amylase production and burn stubborn fat in the body. 

They prevent carbs from entering the cells of the body, causing fat retention. According to the manufacturer, you can safely take the biolean amylase-inhibiting supplement fifteen minutes before moderate or high-carb meals, and the supplement will keep most carbs from converting to fat-storing sugars.

Biolean Reviews: Ingredients

Bioline is a unique dietary supplement formulated with a unique combination of eight plant-based ingredients. This blend is designed to help eliminate obesogens—chemicals that can contribute to weight gain by interfering with the body’s hormonal balance—and to support the breakdown of toxic fats that build up in organs and throughout the body. May accumulate.

Bioline’s ingredients are intended to provide a natural increase in energy and help repair and recover from cellular damage that occurs during years of maintaining excess weight.

While no supplement can replace a balanced diet and regular exercise, Bioline’s formulation is poised to complement a healthy lifestyle by potentially enhancing fat loss and supporting various aspects of health, including cardiovascular, cognitive and joint health. Has been done

Bioline positions itself as a supplement that, when integrated with a balanced diet and exercise regimen, can provide a more holistic approach to weight management and overall wellness.

Central to BioLean’s effectiveness is its composition of eight exotic plant ingredients, each selected for its health benefits and ability to combat obesogens. This formula combination includes:

Bitter Orange: For obesogen removal and cardiovascular health.

Banaba Leaf: For shrinking fat cells and blood sugar stabilization.

Korean Ginseng: For metabolism enhancement and sexual health.

Cayenne Fruit: For headache reduction and obesogen removal.

Resveratrol: For stress relief and blood pressure management.

Green Tea Leaf: For metabolism boost and toxin removal.

Cinnamon Bark: For liver health and joint pain alleviation.

Ginger Root: For digestion improvement and cardiovascular health.

According to the official website, these ingredients work together not just for weight loss but also to improve overall health, from enhancing energy levels and metabolic functions to supporting heart, brain, and joint health.

Pros

All ingredients are plant base as well as organic.

All Ingredients Are Safe And Natural.

Biolean helps to boost metabolism in the human body.

Biolean helps to control fat production in the body.

Biolean Boosts Energy Level.

Biolean Promotes Healthy Weight Loss.

Biolean Promotes Healthy Blood Pressure.

Biolean Gives You a 60 days money back guarantee.

Biolean is approved by FDA and GMP-Certified Facility.

Biolean is a NON-GMO Product.

Cons

Biolean Is Available On The Official Website Only.

It has limited stock available.

Results may vary from person to Person.

Biolean Consumers Reviews:

“He lost 8.8 lbs! ”

“When The Biolean Supplement arrived I started using it right away. I was skeptical, but after 6 days I started to notice some changes.

I lost more than 8.8 lbs! I am so happy! I can not wait to see how much I lose after using Biolean for almost 3-4 months.”

– Harry

“Amazing Results Because Of Biolean!”

“Biolean supplement really works! I lost almost 11.8 lbs in just 24-days which is a lot for me. I could not believe my eyes when I saw the scales and my weight! I have recommended Biolean to family as well as friends. They all can not wait to try Biolean.

I actually had to give them a few bottles of Biolean supplement from my second order, which I just received. Obviously, I’ll keep taking these Biolean because I am blown away by the results.”

– Charmaine

“Lisa Peterson Feels Boosts In Energy”

Everyone should have this Biolean Supplement. I feel like I have more and more energy now. Biolean supplement helps to improve stomach health and digestion. I would like you to recommend this supplement if you want to improve your gut health or want to lose weight.

Biolean Reviews: Pricing And Discount

Here are the pricing,

1 Bottle Of Biolean Costs $59 Only.

3 Bottle Of Biolean Costs $49/Bottle Only.

6 Bottle Of Biolean Costs $39/Bottle Only.

And Biolean Gives You Up To 80% Huge Discounts On It..

Is Biolean A Scam?

The Answer Is No. But In market there are so many fraud people who run scams under the name of Biolean. They have duplicate websites like Biolean and they sell products similar to Biolean. If you want to avoid this type of scam then I would like to tell you that buy Biolean only from the official website of Biolean. Do not buy Biolean from amazon or other sites and avoid the scams under the name of Biolean.

Where To Buy Biolean Supplement?

Here is the official website link of Biolean.

Biolean Reviews: FAQs

Q) Is The Biolean Safe?

Yes, Biolean is totally safe. Biolean weight loss supplement is approved by FDA And GMP-Certified facility. Plus Biolean Has 100% natural and safe ingredients.

Q) Where Is The Biolean Manufactured? 

Biolean Is Manufactured In The United States Of America.

Q) How To Consume Biolean?

If You Want To Get Best Results Then Take Biolean 2 hours before or after any other medication or supplement to insure interaction between them.

Q) Are There Any Hidden Charges?

No. Biolean has a one time payment option. Biolean does not have any hidden charges or any hidden subscription. So don’t worry about this.

Q) What If The Biolean Does Not Work For Me?

If Biolean does not work for you then Biolean has a 60 days full money back guarantee, In this period if you want to get a refund then you can ask for a refund. 

You will get all your money back without any single question.

Biolean Reviews: My Final Verdict

In my opinion Biolean seems like a 100% legit natural supplement. The Ingredients which are used in the Biolean are tested to be 100% natural, very effective and safe. Thousands of users give positive reviews of the Biolean. Biolean does work as well as gives you positive results.

I would like to say if you want to lose weight then you can go with Biolean. This will definitely work. And In case Biolean does not work then Biolean has a 60-day full money back guarantee. If you want to get your money back then you will get your money without any single question.

BioLean Reviews 2024: A Comprehensive Examinatio

BioLean is a popular weight loss supplement that has gained significant attention in recent years. With its bold claims of promoting fat loss and boosting metabolism, BioLean has attracted the interest of individuals seeking a solution to their weight management struggles. This comprehensive review delves into the claims, ingredients, mechanism of action, clinical evidence, user experiences, and safety aspects of BioLean, providing a thorough analysis for informed decision-making.

Deciphering BioLean's Weight Loss Claims

BioLean asserts that it can aid in weight loss by stimulating metabolism, suppressing appetite, and enhancing fat oxidation. These claims are based on the purported effects of its active ingredients, which include green tea extract, caffeine, and L-theanine. However, it's crucial to approach these claims with a critical lens and evaluate the available scientific evidence to determine their validity.

Ingredients: Exploring BioLean's Composition

BioLean primarily relies on a blend of natural ingredients, including green tea extract, caffeine, L-theanine, chromium, and cayenne pepper. Green tea extract contains catechins, which have antioxidant and thermogenic properties. Caffeine is a stimulant that can increase energy expenditure and suppress appetite. L-theanine is an amino acid that promotes relaxation and may mitigate the jittery effects of caffeine. Chromium is a mineral involved in glucose metabolism, while cayenne pepper contains capsaicin, a compound that may stimulate metabolism.

BioLean's Mechanism of Action: How it Works

BioLean's purported mechanism of action involves several pathways. Green tea extract and caffeine are believed to increase thermogenesis, the process by which the body burns calories to produce heat. They may also stimulate the release of fat from fat cells, making it available for oxidation as fuel. L-theanine is thought to modulate brain activity, reducing stress and improving mood, which may indirectly support weight loss efforts.

Evaluating BioLean's Clinical Evidence

Despite BioLean's claims, limited clinical evidence directly supports its efficacy for weight loss. Some studies have shown modest weight loss effects when combined with diet and exercise, but the results are not conclusive. More rigorous research is needed to establish BioLean's effectiveness and determine the optimal dosage and duration of use.

Real-Life Experiences: User Testimonials

User testimonials provide anecdotal evidence of BioLean's effects. Some users report experiencing increased energy, reduced appetite, and modest weight loss. However, it's important to note that individual experiences may vary, and testimonials do not substitute for scientific studies.

Potential Side Effects and Safety Concerns

BioLean generally appears to be safe for most individuals. However, it may cause side effects in some people, such as jitteriness, anxiety, insomnia, and gastrointestinal discomfort. Individuals with underlying health conditions or sensitivities to caffeine should exercise caution before using BioLean. It's always advisable to consult a healthcare professional before starting any new supplement.

BioLean vs. Competitors: Comparative Analysis

BioLean competes with several other weight loss supplements in the market. Some comparable products include PhenQ, Instant Knockout, and Leanbean. These supplements may have different ingredient profiles, mechanisms of action, and price points. Comparing BioLean to its competitors can help individuals make informed choices based on their specific needs and preferences.

Pricing and Value for Money: Assessing the Cost

BioLean is sold in various package options, with prices ranging from $59 to $199. The cost per serving varies depending on the package size and frequency of use. It's important to consider the potential value for money by evaluating the product's effectiveness, safety, and overall experience compared to other options in the market.

Where to Buy BioLean: Authorized Sources

BioLean is available for purchase through the official website and authorized retailers. It's crucial to purchase from reputable sources to ensure product authenticity and quality. Beware of counterfeit products or unauthorized sellers that may offer lower prices but compromise the supplement's integrity.

Conclusion: Weighing the Pros and Cons

BioLean presents itself as a potential weight loss aid with various ingredients that may support metabolism, appetite suppression, and fat oxidation. While some user testimonials suggest positive experiences, the scientific evidence for its efficacy remains limited. Potential side effects and safety concerns should also be considered. Individuals considering BioLean should carefully weigh the pros and cons, consult healthcare professionals, and approach weight loss with a holistic approach that includes diet, exercise, and lifestyle modifications.

Future Prospects and Research Directions

Further research is warranted to establish the long-term safety and efficacy of BioLean. Clinical trials with larger sample sizes, longer durations, and rigorous methodologies are necessary to determine the optimal dosage, duration of use, and potential benefits of BioLean. Additionally, exploring the interactions between BioLean's ingredients and other medications or supplements could provide valuable insights.

[biolean]

What is BioLean Weight Loss?

BioLean Weight Loss Support is among the top nutritional supplements that promote a slim and healthy body by reducing the body's fat storage. Consistent use of this supplement may help achieve desired results effortlessly, aiding in the removal of harmful fats. Containing antioxidants, BioLean Weight Loss Support facilitates the easy release of excess body fat. With its antioxidants sourced from natural origins, the supplement supports weight loss and the pursuit of a toned physique. Many individuals are incorporating BioLean Weight Loss Support into their routines due to its positive reviews, which demonstrate its effectiveness in weight loss without requiring extra effort. Being able to maintain a proper physique even during busy schedules makes it a popular choice, particularly among those leading hectic lives. BioLean is remarkable for its detoxification prowess, effectively removing obesogens from your body. Its unique mechanism involves absorption through the liver, facilitating the efficient excretion of these harmful substances. By harnessing the body’s natural processes, BioLean provides an incredible solution for cleansing and purifying, supporting your journey toward optimal wellbeing. Experience the transformative effects as BioLean empowers your body to rid itself of obesogens efficiently, promoting a cleaner and healthier internal environment.

How Does BioLean Works?

BioLean is a state-of-the-art dietary supplement designed to support weight management and overall wellness using natural ingredients. Its effectiveness lies in its unique blend of herbs, vitamins, and minerals that work together harmoniously to enhance metabolism, curb cravings, and boost energy levels. One of BioLean's primary mechanisms for supporting weight management is by increasing thermogenesis in the body. This means it raises your core body temperature, leading to increased calorie burning throughout the day. Additionally, BioLean contains ingredients that help suppress appetite and reduce cravings for unhealthy foods, making it easier to adhere to a healthy eating plan. Furthermore, BioLean includes essential nutrients like vitamin B6 and B12, which play a vital role in converting food into energy. By supporting these metabolic processes, BioLean helps you feel more energized and focused throughout the day, facilitating the maintenance of an active and healthy lifestyle. In summary, BioLean offers a comprehensive approach to weight management by addressing multiple aspects of health simultaneously. By incorporating this innovative supplement into your daily routine alongside a balanced diet and regular exercise, you can proactively work towards achieving your wellness goals effectively.

#BioLean

[ecweightloss]

Maintaining a healthy, stable weight remains no easy feat given today’s obesogenic environment filled with stressors and quick-eat temptations thwarting even the most stoic over months. Rather than wasting years locked in exhausting weight rollercoasters through ineffective fad diets, identify when professional treatment finally makes sense for you or your struggling loved ones. If you are looking for the best Weight Loss program in Greenville, USA, contact the East Carolina Weight Loss clinic today. At East Carolina Weight Loss, our expert team of professionals offers the Best Weight Loss Treatment Greenville that is created keeping the science of weight loss in mind. These weight loss plans effectively reduce weight without endangering your health because they strike the right mix between activity and nutrition. If you’re looking for a trustworthy Weight Loss Clinic Near Me, visit us today.

[moazdijkot]

All About the New Weight Loss Drugs #health #fitness

The United States and much of the industrialized world has an obesity problem. The environment is obesogenic. The food is delicious and engineered by PhDs to target and titillate our brain reward systems. The portions are enormous. Half of our waking hours are devoted to sitting slumped over in a chair staring into an electronic device—for work and for pleasure. We eat carbs we don’t need, use…

[skinbodyu]

All About the New Weight Loss Drugs

The United States and much of the industrialized world has an obesity problem. The environment is obesogenic. The food is delicious and engineered by PhDs to target and titillate our brain reward systems. The portions are enormous. Half of our waking hours are devoted to sitting slumped over in a chair staring into an electronic device—for work and for pleasure. We eat carbs we don’t need, use…

[lemondzest]

Understanding Obesity (Part 2): Whose responsibility for obesity?

Now that we know obesity is a public health crisis requiring urgent action, we may wonder - what causes it? After all, effective solutions require tackling the root causes of the problem. This part therefore aims to shed light on five of the many contributing factors to obesity. 

1. Choices

Nothing much to elaborate here; choosing to eat more and moving less will result in weight gain. More calories in, less calories out - basic law of thermodynamics. Boring. However, many people are quick to go down the reductionist route by placing ALL the blame on the individual’s personal choices. If it’s just a matter of people needing to make the right choices, if it’s really that simple, we would have tackled obesity long ago. Blaming obesity solely on individual choices does not answer WHY we are increasingly eating more and moving less. Take a look at this timeline of adult obesity in the U.S below by the CDC, similarly reported in other countries across the globe. 

The rate of obesity has tripled worldwide since the late 1970s. If obesity is simply caused by a lack of personal responsibility, what happened in the late 1970s? Did everyone collectively lose their rationale - maybe everyone got together, decided to YOLO and go buffet in life? Definitely possible (cue the entrance of conspiracy theorists), but highly unlikely. Did some form of transcendent power strike the DNA of humans collectively that made us evolve into a bunch of lazier and much more ravenous creatures? Scientists have studied evolutionary changes during this period and concluded that nope, our gene pool has remained constant; any changes in the gene pool would take hundreds of years to produce an obvious effect across a global population anyway. This means that:

the global rise in obesity is not because of any significant genetic changes,

people did not willingly choose to eat more and move less, 

there are other external factors that mainly drives the obesity epidemic.

Consider a class of 10 pupils. When only one pupil gets very low grades in an exam and the other nine got full marks, the one pupil is considered mainly at fault. Perhaps they need to study more and work harder to get a good mark. But when six out of ten got very low grades, is it still the pupils’ fault? Would we then tell the children to study more, while everyone else (i.e the teacher, parents, education system) just remain in inertia, or goyang kaki? 

Similarly, when 63% of the people in Brunei are living with overweight and obesity -- is it still entirely their fault? 

2. Environment

(Please bear with me, I’m trying my best not to turn this section into a whole thesis).

The environment is one of the largest contributors of the rise in the obesity epidemic. This is based on rigorous academic evidence and decades of research. Essentially, the environment has generally promoted the increased consumption of unhealthier food through a rapid increase in its:

availability : since the 1970s, the food environment underwent a shift from predominantly fresh produce to a more ultra processed diet. Food are being processed to the point where they look nothing like what they originally look like, stuffing them with cheap ingredients such as sugar, salt, trans-fats and flavourings to enable mass production to be sold at cheap prices and for easy consumption. These products are called ultra processed food, and examples include soda, sausages, nuggets, sugary cereals, instant noodles, crisps, chocolates and so on.  Because of its poor nutritional profile, ultra processed food has confidently been associated with higher risks of obesity, heart disease, type 2 diabetes, cancer, depression, asthma, etc. And we, especially young people, are consuming more of this than ever. 

exposure : we're talking about the aggressive marketing strategies that has been employed especially by the fast food industry and beyond. I remember going back home from the airport after my 14-day COVID quarantine being bombarded by roughly 10 billboard ads, majority of which are advertising for fast food. As I went out and about for the next few months, I realised that we are exposed to food companies constantly fighting for our attention through their advertisements, whether in the form of billboard ads, physical outlets, leaflets, newspaper ads, TV ads, social media ads, social media influencers, event sponsorships, - the list just goes on! In fact, 46% of the annual advertising budget in the UK goes to soda, confectionery and snacks, while only 2.5% goes to fruits and vegetables. Imagine if it was the other way around.. One can only dream... The point is, we as humans are constantly being tempted with unhealthier food rather than healthier food, which in turn, drives up our purchase and consumption of unhealthier food products. I also particularly like this photo taken in the UK that just showcases the pedestal unhealthier food ads are being placed on, i.e. same level as public health ads. Oh, the irony! (Good news for Bruneians - a code of conduct on responsible food marketing has been implemented recently to shield our children from these ads! Just what we need, priority on children’s health > anything else.)

portion sizes : certain food such as pizza and soft drinks underwent a significant increase in portion sizes from the 1970s to 2000s. Just a few days ago I went to to a fast food outlet and noticed that, as usual, the default drink choice is soda, but the default size is now the large one as compared to the smaller one that I remember seeing 3 years ago before I left the country. I was also informed that some other outlets have been asking customers to upsize their drinks by default. Just how necessary is this? We may think this is not a problem because people supposedly eat according to their physiological needs and can simply stop when they’re full, and so they wouldn’t need to finish the whole portion. But research leading to the discovery of what is known as the portion size effect (PSE) has suggested otherwise; the more energy-dense food people are served, the more they tend to eat. 

The 21st century environment is also promoting physical inactivity and a sedentary lifestyle compared to the past centuries. Opportunities for physical activity especially in high-income countries have declined possibly due to the rapid urbanisation, rise in 9-5 jobs and more people relying on motorised transportation methods. Although research has shown that physical activity (PA) among adults done during free time have increased in the past ~30 years, a simultaneous decrease was found in physical activity done while working in the past ~50 years. Young people are also observed to be more physical inactive levels throughout the years, though locally... I like to think that our younger people are getting more physical-activity-conscious nowadays since applaudable efforts to widen opportunities for PA such as the launch of Bandarku Ceria and the opening of numerous hiking sites and gyms booming in 2019-2020. But this could just be my skewed perception looking at a small and specific demographic of the population - more formal research needs to be done.

So, we know that the environment is the main factor that drives up the obesity pandemic. But if we are all living in an environment which predisposes us to develop obesity, why don't we ALL have obesity? This tells us that there are other factors that makes an individual more likely to act on the environment's impulses - such as their socioeconomic status (income, education) and especially their genes.

3. Income

Research among developed countries such as the UK, Australia, Germany and Singapore has shown that people who are from lower income level are significantly associated with a higher risk of obesity. This graph below just shows how stark the inequality is between the most and least deprived areas of the UK. Note also how rapidly-widening the gap is over the years!

Why are poorer families in developed countries more likely to live with obesity? 

Food that are more nutritious are often less affordable than nutritious food. I particularly love this infographic showing how in order to meet the general recommendation of a healthy diet in the UK, the poorer families would have to spend 39% of their income on food alone, while this percentage steadily decreases as your income increases, to as low as 8% for the richer families. The same pattern is reflected in many other countries including the USA, Australia and

This inequality is not just seen within countries, but also across countries. One study across 18 countries identified that in order to meet the recommended guideline of 5 servings of fruits and vegetables per day, families in lower income countries would need to spend 52% of their income on them, those in middle income countries would need to spend 17% while those in higher income countries would need to spend a mere 2% of their income.

The price gap between healthier and unhealthier food can then affect people's purchasing behaviour, where families from lower income are forced to prioritise quantity of food over quality. For some of us, we are privileged enough to be able to choose food that are delicious, nutritious, and of different variety each time. But for some others, especially among families with poorer background battling food insecurity, they can only afford to eat in order to feel full and get through the day. Research has shown how poorer families always have to 1) balance out their choices of food with the utilisation of scarce resources, and 2) make judgment of food prices relative to other food prices. Combining this with the known fact discussed above that unhealthier food are FAR more aggressively marketed (almost 20 times more) than healthier food - we are left with a group of the population who are predisposed to choosing food that are mainly satiating, and less nutritious than the recommended guideline.

In fact, we know that even more factors than those discussed above can contribute to people from poorer families having an unhealthier diet. One of them is, on top of the price gap of groceries, we have the price gap of fast food. Parents who are busy and don't have much time to cook nutritious and homemade food often resort to fast food to sustain their family. Sure, we have a plethora of fast food options to choose from (and they just keep increasing - don't get me started). But what kind of fast food is both affordable and nutritious? Nasi katok costs $1 while a balanced meal costs $5 (minimum), and this disparity is seen all around the world.

Given all this, we still have the audacity to say that obesity is simply caused by a lack of willpower?

Gimme a break. It is clear that people who are not as financially privileged requires additional support in order to maintain a healthy weight. If not through finance, through education (further explained in Cause 4), or even better - both!

Side note: Despite the overwhelming evidence that having low income is associated with higher risk of obesity, there is also emerging evidence showing the possibility of the opposite (reverse causality); living with obesity is ALSO associated with having low income due to stigmatisation and discrimination. So basically... living with low income may cause people to live with obesity, and likewise living with obesity may cause people to live with low income. This syndemic is similar to the that of obesity and mental health issues discussed in Part 1.

4. Education

Health is not formally taught in most schools. Health starts at home. Because of this varying education level and awareness about health across the population, each family has very different approaches of ensuring how their family can grow up adopting healthy behaviours.

Generally, the likelihood of having obesity increases with decreasing level of education. This was observed in many countries including Taiwan, Saudi Arabia and Iran. The trend is similarly reported in OECD countries such as Australia, Canada, England and Korea as shown below.

This may be because more educated families tend to have healthier lifestyles and are more aware of what the causes and consequences are of obesity. If a family is lacking awareness and knowledge on certain aspects of health, such as in nutrition - eg: what the importance of consuming enough fibre is, what exactly constitutes a balanced diet, how to cook nutritious meals under time constraint etc - then their family will be less likely to adopt healthy (protective) behaviours.

Awareness on the causes and consequences of obesity indeed remain low within many communities. In one study, 76% of young people surveyed believe that "obesity has a genetic cause and that there is nothing much one can do to prevent obesity". Almost 30% of them also believe that even when substantial changes were made to one's lifestyle, obesity cannot be prevented. In the UK, around 3 in 4 people didn't know that obesity can cause cancer - the leading cause of death worldwide.

Not only are people unaware of the causes and consequences of obesity, many people even show a general lack of understanding of obesity itself. It was found that among 401 Malaysians surveyed, 92% of those with obesity underperceive their weight, thinking that their weight is at a normal range or lower than it actually is. This is particularly concerning, because any intervention efforts to reduce obesity rate within a community will just bounce back by the majority of the target group who think the messages are 'not for them because they don't have obesity' when they actually do.

All in all, if you come from an educated family background - good for you. If you have the opportunity to study more about health, or human/medical sciences - good for you. But what about those who do not have all these privileges?

Side note: There is also evidence showing how having lower education level is not just associated with higher level of obesity in a direct manner, but also indirectly where having a low education level may contribute to households having a lower income, and as discussed above in No.3 -> may result in a stacked effect on obesity. This is called the mediation effect and more explanation can be found here (pg 133).

5. Genetics

Over 200 genes influence our body shape and size. This include genes that affects how frequently we feel hungry, the rate that we burn calories, our metabolism rate, and many more! Some of these individual genes can increase our likelihood of becoming heavier while some other genes tend to make us lighter depending on whether it is 'switched on or off'. And this mix of 'on and offs' for EACH gene is always going to be different between individuals (polymorphism).

Because of our own 'mixed bag' of ~200 obesity-related genes interacting with each other, some people will find it much harder to resist that bar of Kinder Bueno sitting on the cashier till, while some others wouldn't even bat an eye. Some people naturally feels full after a bowl of rice, while some others would need three bowls. Some people can store a large amount of fats while some others can store only half of that amount before those fats (lipids) seep into other tissues instead such as muscles and potentially cause diseases (lipotoxicity).

Our genetic differences within the population explains why some people respond differently to the obesogenic environment we live in. It is not as simple as our genes determining whether we develop obesity or not. We simply can't be saying "Oh it's in my genes, got it from my parents~" to justify our lack of effort to address obesity. There's no single gene that makes people develop obesity. But rather, our mixed bag of genes determine our susceptibility to obesity. For people with many of those genes that makes it likely for them to gain weight easily 'switched on' -> they will be more susceptible to obesity because their own biology makes it much harder for them to fight back the temptations of the obesogenic environment.

Because this concept is so difficult to be understood by people who have always had a healthy weight all their life, privileged with not having the genes raising the likelihood of obesity 'switched on' -> they tend to blame obesity solely on the individual's personal choice. Because their own biology makes it easier for them to resist the temptations of the obesogenic environment.

As Joslin - an American doctor - described almost a century ago which pretty much summarises the role of genetics in obesity:

Genetics probably loads the gun, while lifestyle in our obesogenic environment pulls the trigger for the spreading of the obesity epidemic.

Does this mean that people who have genes that makes it more susceptible to develop obesity can simply blame their genes for their weight?

No! Not entirely. They can and should apply the same general concept of weight loss to counteract the risk of obesity, i.e. - eating balanced meals, doing plenty of physical activity (going back to the boring law of thermodynamics: more calories out than in = weight loss). However, it will be especially harder for these people to achieve it due to their obesity-encouraging genes. They have to put in more effort to lose 1kg than someone with less of the obesity-encouraging genes.

What this means for those with obesity: Your own genes and biology is one of the factors why your BMI is considered high at the moment and why it feels so difficult to lose weight. It is important for you to understand this, so that you don't beat yourself up too often! It is not entirely your fault. It will be hard, and in fact it will be harder than many people, but what matters is for you stay focused in putting in the work to get there!

What this means for those with healthy weight: It's about time for you to stop blaming everything on the individual's personal choice when you don't even know how difficult they have it and how much they have been trying to fight their own biology. Don't act like you know their struggles just to shame and stigmatise them because you don't and neither do I. Leave it to their close family and personal doctor to consult them.

What this means for policymakers: We have a duty in making sure that 1) the environment is as conducive as possible to live a healthy lifestyle to avoid 'triggering the gun', and 2) people are aware that genes play a big factor too (of around 40-70%) in determining someone's weight and its not just entirely down to the individual.

Side note: The genetic explanation above which acknowledges the role of hundreds of different genes in the development of obesity is applicable to the majority of people living with obesity (polygenic obesity). However, there are also the minority of people who develop obesity due to mutation in single genes (monogenic obesity / syndromic obesity) which warrants a separate and more technical explanation.

Bottom Line

To summarise the cause of obesity:

As mentioned in Cause 1, how we develop obesity is always down to the individual eating more and moving less. But as explained in Cause 2, 3, 4 & 5, the complex interaction between the environment, the individual's socioeconomic conditions, and their own biology explains why it is so difficult for some people to eat less and move more.

To summarise the cause of the obesity pandemic:

Personal choice explains why one individual may develop obesity, but the environment explains why more people across the whole world is developing obesity. Our socioeconomic conditions and especially our genetics then explains why not ALL people develop obesity as a response to the change in environment.

So what should I do with all these information?

That's entirely up to you and how much you understood! But the reason why I brought this topic up is because I'm personally sick and tired of hearing people living with obesity being blamed for their "poor choices in life", "lack of self-control", for "being gluttonous", "lazy", etc.

As I have hopefully explained, obesity is undoubtedly very complex and a result of so many factors. These five things I mentioned above? There's. So. Much. More.

Click here for a clearer view.

So the next time we blame it all on people with obesity - check your privileges. You're rich? You're naturally slim? You're educated? You don't have as much obesity-encouraging genes? Good for you. Perhaps that tends to make you feel entitled to say that people who are living with obesity just needs to make "better choices".

But understand that you have it easier in maintaining your healthy weight, while people with obesity most likely have it harder. The least you could do is really be sympathetic and understanding, acknowledge their struggles, and certainly avoid shaming and stigmatising them. Make it easier for them by providing healthier choices and support them physically and emotionally in their goals of achieving a healthy weight!

Aren't you just giving an excuse for people to live with obesity?

Disclaimer: My BMI sits quite well on the healthy range at 23 kg/m^2. I am nowhere close to having obesity, nor do I have any family members, partners or close friends living with obesity. I literally gain NOTHING to be making up an excuse for people to live with obesity. Quite on the contrary, I understand its dire consequences as I have outlined in Part 1, and I have even mentioned personal choice as one of the causes above. It's not about giving excuses, but simply an effort to give voice and justice to those who has been silenced.

I hope I have gotten my point across through this post and the previous one in my Obesity Series! Let's all be more-informed members of the society and support each other in achieving our health goals :)

*Note: For simplicity purposes, ‘unhealthier food’ in this post refers generally to food lower in nutritional profile, and food high in fat, sugar and salt (HFSS). In reality, we should understand that food does not exist in a binary manner.

Unlinked References:

Gene Eating by Giles Yeo (Book)

CMO Independent Report: Time to Solve Childhood Obesity by Professor Dame Sally Davies

[transmutationisms]

i have a name for that sort of "restating the obesogenic environment thesis while being superficially a dissident of diet culture/structural fatphobia/societally mandated restriction" situation. i call it the broccoli problem. its where you say structural fatphobia is bad, and racialized, and classed, but your analysis stops at the endgoal of everyone having more access to broccoli

ok i may adopt this phrase, because.... many such cases

[newsfind]

Set points exist, but they are overwhelmed in our obesogenic environment, leading to runaway weight gain.

Set points exist, but they are overwhelmed in our obesogenic environment, leading to runaway weight gain.

submitted by /u/SomethingIWontRegret [comments]

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[awed-frog]

What I don't understand is how angry people get when they are told that obesity and being overweight are both risk factors for poor covid outcomes. I was already working on losing weight but that lit a fire under me. I shared some of my weight loss journey to help. The pushback was insane. It's not a moral judgement, I'm overweight too! Boomers can't help their age, but weight is changeable. Diseases don't care about hurt feelings. Anything we can do to better our chances should be priority one.

Hey, first of all congrats on making good decisions! It’s not easy but you’re right - if you’re overweight or obese, now is a great time to take care of your health and reduce your risk to catch this thing, so KUDOS!

(Really: I know we’re all panicked af, and I’m not shaming anyone who’s gaining weight because of a stressful home situation or emotional eating or anything, but developing healthier coping mechanisms is absolutely crucial, and we all need to do our best there.)

As for the why, I think there’s several reasons.

First, nobody knows anything about nutrition. Even doctors barely study the subject in med school, and for most of them it doesn’t go beyond ‘What foods to avoid if you have turtle vomiting disease’ and the like. The idea that nutrition may be the best form of preventive medicine is still beyond reach for most healthcare professionals. As for regular people, we’re not better off. Most of us discussed nutrition maybe twice in formal education - I remember a two-hour lesson on what calories are, and about six cooking lessons which only featured party-appropriate foods and a few cakes.

Second, the issue is complicated by the fact food is not just how we keep our bodies alive. For mostly everyone, food is about culture, tradition, habits, personality, comfort, being shown affection and showing affection to others. Food is not neutral, and that’s one reason why recovery is so difficult for people with eating disorders, and why people who need to change their diet because of specific health concerns find it so challenging to let go of certain foods. 

Finally, and possibly most importantly, the food industry profits off low-quality stuff and it will fight to the death to protect its turnover. Politically, they lobby against any kind of regulation, from safe working conditions in their factories to clearer labels for consumers, but they also target people directly. On top of increasingly sophisticated marketing and lab-perfected recipes, the industry actively funds biased research and makes sure disinformation is spread. Back in January, during my no-sugar month, I read a French book detailing how this works in France - it’s beyond scary. As with smoking and climate change, the goal is not winning the argument but confusing people. ‘One day you hear [food] is bad, the day after they say it prevents heart disease’ - one of those two facts is complete bullshit, but the damage is done. People are fed up and automatically revert to the path of least resistance, which is littered with soft drinks and junk food.   

(I don’t want to add fat activists to this list because I’ve never seen any studies on how influential they are and how many people they brainwash, but while their ideology may not be a huge contributing factor to the mess we’re in, they certainly don’t help.) 

The result of all this is that people mostly grow up steeped into what some call ‘fat logic’ and never manage to claw their way out of it. We live in an obesogenic environment; we accept the idea people put on weight during college, with pregnancy, as they age; that weight gain is mostly inevitable and irreversible; that how much you weigh is out of your control, down to genes and luck. And for most of us, disastrous attempts at fad diets only reinforces the belief nothing can be done and you should just find a way to accept yourself and be happy. 

If you buy into these arguments, then yes, you’re going to be angry and resentful af. It makes complete sense. You’re surrounded by enticing high kcal food and encouraged to snack all day long. Meanwhile, you’ve got fat activists on one side, actively spreading the idea that telling people to lose weight is basically conversion therapy, as weight is as unchangeable as your skin colour or your sexuality, and governments on the other, focusing on the ‘personal responsibility’ message, which further reinforces the idea weight gain is a moral failure. It’s a complete catastrophe.

On the whole, I’m not surprised people react so negatively. I want to hope this virus can be a watershed moment and bring about systemic change, but for now it doesn’t look likely. Still, I’m dreaming of a better future of sustainable food production and the industry heads being dragged to the Hague. No law against optimism, is there?

[liesmyteachertoldme]

Avoid Endocrine-Disrupting Chemicals

Endocrine-disrupting chemicals (EDCs) are linked to many negative health effects and it is important to avoid exposure as much as possible.

EDCs lurk in food packaging, nonorganic food, nonstick cookware, detergents, cosmetics, medicines, fabrics, pesticides, carpets and furniture that are treated with flame retardants.

An endocrine-disrupting chemical that exerts permanent and even transgenerational changes to fat cells is sometimes called an obesogen.

Research shows obesogens are highly correlated with obesity and diabetes.

There are many practical, commonsense ways to avoid exposure to endocrine-disrupting chemicals and obesogens.

Endocrine-disrupting chemicals (EDCs) are among the most destructive chemicals in our environment. Exposure to them is linked to growth, neurological and learning disabilities, obesity, diabetes, male and female reproductive dysfunction, birth defects, cardiovascular disease and some cancers.

EDCs are not just harmful — they are also found almost everywhere and hard to avoid. They lurk in food packaging, nonorganic food, nonstick cookware, detergents, cosmetics, lotions, products with fragrance, antibacterial soaps, medicines, toys, fabrics, carpets, furniture, construction materials treated with flame retardants, pesticides and more.

When an endocrine-disrupting chemical exerts permanent and even transgenerational changes to fat cells it is sometimes called an obesogen. Experts believe obesogens encourage the growth of fat cells and fat accumulation through metabolic and appetite alterations that increase the number and size of adipose cells.

Examples of obesogens are bisphenol-A and parabens, and other obesogens may be found in flame retardants, pesticides and other chemicals.

[eviev]

Conspiracy time

Except it isn't a conspiracy theory!

The 1960s were a jam packed decade. In this decade of many notable events, a quiet, almost unnotable event happened. Except, it shaped the American diet in profound ways

NPR links, which links to other sources. 1 and 2

In the 1960s, a battle for our diet was underway. In a tale of corporate espionage we will likely never see on the big screen, the sugar industry paid for scientists to publish research linking fats to heart disease and also silenced research linking sugar and heart disease together.

The NPR articles go over this in more detail. and I think they're both good reads. But also, I've been in labs that conducted research on the effect of both high fat diets and high sugar diets

(Note: 2 different labs. 1 focused on only high fat, 1 focused on only high sugar - the western diet is generally accepted as both high fat and high sugar so these do not fully encapsulate the modern american diet)

(Also: After doing a fair amount of reading on diets, I respect nutritionists a LOT more. I can't begin to understand what makes an objectively "good" diet so when a nutritionist sits down to tell you something you LISTEN TO THEM- they know the secrets to life)

Moving on, the fat that was most implicated in heart disease was unsaturated fat. This most commonly comes from animals. So Americans pivoted toward using saturated fats. These come from plants, think peanut oil, grapeseed oil, and (the most popular one) soybean oil.

What is soybean oil? It's sold as vegetable oil, it's cheap, and it's in everything. Honestly, take a look. Check your peanut butter, your crackers, your cookies. If you bought it from the store and it uses fat, chances are very good that fat is soybean oil.

Anyways, turns out a high fat diet where most of your fat comes from soybean oil is about as obesogenic and diabetogenic as a high fat diet where most of the fat comes from lard.

Which, isn't to paint soybean oil in a bad light. It contains a fatty acid human bodies can't make, we rely on the environment to get it.

It just really drives home to me the idea of "everything in moderation". Until I joined a lab which was interested specifically in soybean oil, I didn't realize how common it was (now I can't un-see it)

But anyways I wrote this to say: Use all the fats. Sometimes when I'm at the store I'll look at an oil I haven't tried before (gonna buy avocado oil next) and just, go for it. When I cook, I like to save fat from whatever I'm cooking. (I've seen so many foodie articles recommend this, too! Do not be shy!)

Be a magpie, an oil gremlin. Try all the fats! They all taste so different and I didn't appreciate it until after I made an effort to use as many different cooking fats as possible. Live the life of luxury my friends