Obesity is a growing health crisis around the world. This article provides an overview of the old and new approaches to diagnosing, understanding and treating obesity and metabolic disease. It covers topics like BMI, metabolic syndrome, normalizing disease, and recent pharmacological breakthroughs. The goal is to highlight more effective strategies for reversing obesity and metabolic disease.
Defining Obesity and Metabolic Disease
Body Mass Index (BMI)
- BMI is a simple calculation based on height and weight. It’s a population-level tool to track obesity trends.
- For individuals, BMI has limitations. Very muscular people may have high BMIs. Normal BMIs don’t rule out dangerous visceral fat. Still, BMI over 30 indicates obesity, a disease state with health risks.
Metabolic Disease and Metabolic Syndrome
- Metabolic diseases involve energy dysregulation – too many calories in, too few out. They lead to packing on unhealthy fat.
- Metabolic syndrome is a cluster of five criteria: high waist circumference, blood pressure, blood sugar, triglycerides and low HDL cholesterol. Meeting three qualifies for diagnosis.
- The root cause is insulin resistance. It develops for years before diabetes. Metabolic disease increases risks for top killers like diabetes, heart disease and cancer. Reversing it early is critical.
The Old Way of Treating Obesity and Metabolic Disease
Myth of Calories
- The old model held that “a calorie is a calorie.” This is false. Different foods provoke different hormonal responses. An Oreo impacts metabolism differently than broccoli, though both have calories. Obesity is more a hormone imbalance issue than mathematical calories in/out.
Focus on Types of Food
- The old way focused intensely on types of food – high protein, low carb, no fat, etc. Food quality matters, but an even bigger issue is meal timing.
Normalizing Obesity and Metabolic Disease
- In efforts to be kind, society started normalizing warning signs like borderline obesity and prediabetes. This makes change seem unnecessary when early action is needed. Obesity is a disease requiring truth and solutions, not just positivity.
The New Way of Treating Obesity
Three Levers for Weight Loss
- There are three key “levers” for weight loss: 1) Calorie restriction 2) Meal timing 3) Food quality
- Calorie restriction is challenging – hunger, math, decision fatigue.
- Meal timing (intermittent fasting) is the most powerful lever. Humans aren’t designed to eat constantly.
- Food quality determines hormonal impact. Lower carb tends to be optimal for metabolic disease.
- Using meal timing plus lower carb provides powerful weight loss for most. Calorie restriction only if needed.
New Medications
- Recently, diabetes medications like semaglutide and liraglutide got FDA approval for weight loss in non-diabetics due to incredible results.
- These GLP-1 agonists work by:
- Slowing stomach emptying
- Reducing appetite substantially
- Increasing satiety
- Patients relearn appropriate portion sizes. Cravings fade after meals. Weight loss is equivalent to bariatric surgery.
- Side effects like nausea are usually mild at lower doses. The weekly injections also improve compliance over daily.
Obesity and Metabolic Disease
Obesity and metabolic disease are urgent health priorities. The old advice to “eat less, exercise more” is ineffective for most. A new paradigm focused on meal timing, food quality and medications provides real solutions to reverse obesity and metabolic disease long-term. Early action produces the best results for health and longevity.
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