Obesity As A Disease

In this episode I'm setteling a long time dabte of why obesity is classified as a chronic, complex disease rather than a willpower problem, reflecting insights from the Obesity Medicine Association’s annual conference in San Diego.

Labeling obesity a disease can expand access to medical and surgical care, reduce stigma, and support research including GLP-1 therapies.

00:00 Welcome to the Podcast

00:36 OMA Conference Takeaways

02:20 Willpower Myth Debunked

03:29 Why Disease Label Matters

03:50 Metabolism Fights Weight Loss

04:33 Setpoint Theory Explained

05:10 Genetics and Hunger Signals

05:56 Leptin Resistance and Gut Brain

06:38 Why Rates Rose So Fast

07:08 Obesogenic Environment Factors

07:59 Lifestyle Choices in Treatment

09:15 Benefits of Calling It Disease

10:09 Wrap Up and Share

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Transcript

 Welcome to the Nine to Five Wellness Podcast, a show about corporate wellness solutions with innovators and forward-thinking leaders who are at the forefront of the workplace wellness movement. I'm your host, Aisha here. Hello, and welcome to a new episode of the Nine to Five Wellness Podcast. Today I wanna share with you why obesity is a disease. Two weeks ago, I flew to San Diego, California to attend the Obesity Medicine Association's annual conference. I am an OMA associate and I've been, working with them for the last three years. I became a member in 2023 and I tried to attend their conferences every year. This year, the conference focus was on how different systems come together, and impact our insulin resistance and also how they're impacted by the disease of obesity. So I've come back with so much knowledge on the interplay of different systems within the body. And also I learned a lot of updates on emerging therapies , which I'll be sharing with you on this podcast. But honestly, beyond that, what really stayed with me from the experience of this conference wasn't just what I learned there, but also it was a reminder that the environment we place ourselves in really matters. I was surrounded with like-minded practitioners, and that is such a great feeling to have those who believe in. Patient-centric care. And in comprehensive care strategies because when we are surrounded by people playing at a certain level and who believe in the same interventions as we do, it just naturally raises our own standards. So let's dive into disease of obesity. I understand that today I'm tackling a topic that often sparks heated debate. For decades, the conversation around obesity has been plagued by a single destructive word, willpower. If you are overweight, the assumption has been that you just need to eat less and move more, and actually, that's the reason why I wanted to talk about it on the show today. I wanna tell you that that mindset isn't completely correct. It's actually very incorrect in today's world. The willpower argument is actually masking a much deeper, more complex reality. So today i'm going to be dismantling the myth that obesity is just a personal failure. It's not. I'm exploring why major medical organizations now classify obesity as a chronic complex disease, one that is fundamentally shaped by our biology, our. Our environment and yes, our lifestyle choices. In 2013, the American Medical Association officially recognized obesity as a chronic disease. In case you're wondering, why does this label matter? Because for millions living with it. It isn't just about a number on the scale. Think of it this way. Obesity is a metabolic disease where your body, specifically, your metabolism resist weight loss. When a person who is overweight tries to lose weight, their brain and hormones often turn on a furnace that makes them hungrier and more efficient at storing fat. It's a chronic. Relapse in condition. When you lose weight, your body actively tries to regain it. It's not about weakness, it's about biology, it's about hormones and sometimes even genetics. So I want to explain this disease to you from different components of biological systems. The first one Is the biological setpoint. Our bodies have a built-in defense mechanism, which is called the setpoint theory. When someone with obesity tries to lose weight, their body actually fights back. Their metabolism slows down to conserve energy and hunger hormones like ghrelin skyrocket. Essentially, your body thinks it's starving and does everything in its power to push you back to your higher weight. It's not a lack of willpower, it's a metabolic survival response. The second thing to remember is the genetic blueprint. Research shows that genetics can contribute between 40 to 70% of an individual's weight. Scientists have identified rare monogenic forms of obesity caused by mutations in a single gene like the mc four R gene. This gene acts as a hunger switch in the brain. When it malfunctions, that switch is stuck in the on position leading to constant instant hunger. Most people, however, have polygenic obesity where hundreds of small genetic variations interact with our modern environment to make weight gain more likely. We also have to look at the communication signaling between the gut and the brain. A key player here is the satiety hormone, leptin. This hormone is produced by fat cells that tell your brain when you have enough energy stored. In many of the cases of the obese patients that I see, the body becomes leptin resistant. The fat cells are screaming, we are full, but the brain never gets the message. Instead, it signals for more food. This isn't a behavioral choice, it's a broken signaling pathway. Much like how a person with type two diabetes , struggles with insulin signaling. So here are a few factors which make losing weight difficult for some individuals. I'm not saying that their environment and choices didn't play a role here. Because I get this question from a lot of people , if it's just a disease, why did obesity rates skyrocket in the last 40 years? It's not like our genes changed overnight. They're right. That is correct. Our genetics didn't change overnight. There are a couple of reasons why. The first one is the environment. Today, we live in an obesogenic environment. This means our modern surroundings encourage weight gain and make weight loss difficult. We have delicious, high calorie, ultra processed food everywhere, available 24 7 on a click. Second, our jobs are also sedentary. Technology has changed the way we work, moving us away from physical labor to sitting at desks. And many of my patients experience food swamp in many neighborhoods, especially low income ones. Fast food restaurants , outnumber the healthy options, a concept known as food swamps. When healthy choices are harder, more expensive, or simply unavailable, your environment is directing your health outcomes. . Finally, let's talk about the elephant in the room. I know what you're thinking about. We have to talk about personal lifestyle choices. Does that mean the environment is the only thing? No. Obesity is a multifactorial disease. Lifestyle choices, what you eat, how you move , your sleep quality and stress management play a massive role in how the disease presents. Progresses. There comes a point where the person's cells are so resistant to hormonal signaling that they can't lose weight without medical intervention. However, the key is realizing that lifestyle changes are part of the treatment of the disease, not just a way to fix immoral failing. The problem is when we ask someone to fix a biological disease solely through lifestyle, while living in a toxic obesogenic environment. It's like telling someone with asthma to just breathe better. So obesity is not a personal failure and it's not bad luck. It is a complex disease , shaped by the interaction of our biology, our environment, and our choices . Now, let me tell you the benefits of labeling it as a disease because it opens up access to care. It forces insurance companies to cover medical and surgical treatments just as they would for heart disease or cancer. It reduces stigma. It shifts the conversation away from personal failure and towards. Management of the disease. And then it also opens up possibilities for research. It prioritizes funding for new treatments like recent breakthrough GLP one medications that specifically target these underlying biological pathways. So to summarize, if we want to tackle this epidemic, we need to stop the stigma and focus on comprehensive care, which means better treatment options for biological disease and changing our environments to make healthy choices easier for everyone. Thanks for listening to this show today. If this episode changed how you think about obesity, share it with a friend. Talk to you soon. If you like this show today, please share it with your friends and family members and don't forget to subscribe to our show so that you can get fresh episodes every week.