What Causes Obesity?

Almost all diseases are multifactorial and obesity is no exception!

     There are many factors that cause our bodies to gain weight. These include, but are not limited to: Genetics, sleep, stress, activity, environment, medications, environmental toxins, excess calories, processed carbohydrates, and sugar. These, and many other converge on multiple hormone pathways to cause weight gain. The most important hormone is insulin. Insulin is our body’s fat storing hormone. When insulin levels are elevated it signals to our body to store fat and prevents the breakdown of stored energy (fat).

     When we eat, we signal to our pancreas to secrete insulin. Processed carbohydrates and simple sugars spike our insulin levels higher than proteins and fats do. Thus, eating simple sugars and processed carbs raise our insulin levels at a higher rate and continued ingestion of simple carbohydrates can lead to insulin resistin and more fat storage. So, if high insulin causes weight gain, reducing insulin and keeping it low should lead to weight loss.

     So how do you reduce your insulin levels? What matters is what you eat and when you eat. Avoiding sugars and processed carbohydrates will help keep insulin levels down. Eating moderate amounts of protein, healthy fats, unprocessed carbohydrates, and nuts and legumes (which are high in fiber) can help keep insulin from spiking. In addition, intermittent fasting has been shown to also help reduce insulin levels and improve insulin resistance. Although there are many methods, I have my patients start with a 12-hour overnight fast. This means that if you eat at 8:00 pm you cannot eat again until 8:00 am. Some people benefit from longer 14 to 16 hour fasts. For women, I usually do not recommend fasting for longer than 14 hours. An overnight fast is the easiest and most natural approach to reducing insulin because the majority of the fast occurs while your sleeping and you eat only during a 10 to 12 hour window. It is important to maintain a healthy diet during those 10 to 12 hours. A healthy diet consists of healthy proteins, healthy fats, non-starchy vegetables, some fruit, nuts and legumes, and whole unprocessed grains. These foods keep your insulin from spiking. You can eat 2 to 3 meals, preferably without snacking. Every time you eat you raise your insulin so eating only during mealtimes reduces the number of times your insulin is raised during a 24-hour cycle.

     This is why it is important not only what you eat, but when you eat. There is a lot of nutritional advice out there and it is often hard to know what to believe. I am board certified in Obesity Medicine and I stay up to date on the latest research. Nutritional research must be looked at through a critical lens and you should not blindly follow the latest fad without a critical analysis of the science behind it. I am a member of the Obesity Medicine Association and the Obesity Society which gives me access to the latest research. I am very passionate about helping my patients achieve and maintain healthy weights and preventing or reversing chronic diseases associated with excess weight. 

     In addition, other factors such as poor sleep, excessive stress, medications, and other risk factors may be the cause of your weight gain and these issues must be addressed simultaneously. We do not treat heart disease by saying “let’s treat your blood pressure but keep smoking and eating highly processed foods.” Multiple factors contribute to the development of obesity. In order to treat obesity, we must take a multifactorial treatment approach.

To Your Good Health

Dr Betty Keller

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