Many of us struggle with food with regard to eating properly, knowing when to stop eating, eating out of distress or stress and actually becoming obese. Dr.Mel discusses the disease of obesity with a panel of guests.
Dr. Mel: This is a simple question, or appears to be simple, but can you define obesity for us?
Dr. Essel: When we think about obesity, I typically define it to my students, to my families as obesity is sort of a multi-system complex chronic disease that affects the body in multiple different ways. I think we try to assume a lot from looking at individuals, but we don’t really know anybody’s story by looking at someone. And I think it’s important that we do not do that and stigmatize others by doing that, so I use the word complex. The idea of obesity being a disease is important to really understand. Understanding it as complex really starts to blow that up the way this works is not calories in versus calories out or calories in versus calories. Calories out is part of the picture. We understand it to be a disease and it’s complex. It’s not as simple as we say it is.
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Dr. Mel: What are some of the chronic consequences of obesity?
Dr. Essel: We know that there is a clue or an association with other diseases and obesity being a trigger to some of these other diseases. Some chronic diseases that we often associate with obesity are things like hypertension, so higher blood pressure… We talk about things like prediabetes and diabetes. We talk about things like heart disease, kidney disease, and the list goes on and on and on. We even start to really explore these areas of cancers as well. There are a number of different cancers that we’re starting to explore and understand that they’re associated with increased weight gain as well, especially for longer periods of time.
Dr. Mel: What is the genetic link around obesity? Is there one and is there a different BMI set point for people of African descent?
Dr. Essel: There are definitely associations of what we call genetics and epigenetics which are sort of micro details about individuals, genetics and how that passes on from generation to generation. The reality is when you look at the epidemic that we call obesity, the epidemic sort of the changes over the last 30, 40, 50 years, we link that directly to genes by themselves. But we do know on the individual level, there is a lot of genetic association that we see in terms of set point. We don’t describe in the research a difference between the set point of say African American populations versus Asian populations versus white American populations in particular. So the set point is not necessarily what we would say they’re different, but we would say is the risk for disease based on the BMI criteria.
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