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– [Presenter] Let me
introduce you to Amanda.
You're just meeting
her for the first time,
but chances are you're
already making assumptions
about how much she eats and
how little she exercises
because she's obese.
But I'm about to show you
that there's much more
than meets the eye when
it comes to obesity.
There are lots of Amanda's out there,
and they need treatment.
Maybe you're one of them,
or maybe you know an Amanda.
It's time to act on obesity.
But in order to do so effectively,
we need to understand obesity.
It's generally accepted that body weight
is determined by a pretty simple formula.
We call it the energy balance equation,
and it works like this.
If the number of calories that you consume
equals the number of
calories that you burn,
your weight remains the same.
If you consume more than
you burn, you gain weight.
And if you burn more than
you consume, you lose weight.
Most people think that those of us
who properly manage our
energy balance remain lean,
whereas those of us like
Amanda who eat too much
and exercise too little become obese.
We view obesity as a lifestyle choice
and the cure for it is simple:
eat less and exercise more.
This may sound logical, but it's wrong.
Let me explain.
First, let's talk about set point.
Now I'm not talking about
the point in a tennis match
when one play is about to beat the other.
I'm talking about the theory that says
that no matter what you
consciously want your weight to be,
your brain has its own sense of how much
body fat it should have on board,
and it has a complex system in place
that very precisely regulates
your energy intake and
expenditure to keep you
within a so called set
point range for body fat.
So that whole energy balance equation,
it's not something that
you control voluntarily.
Your brain regulates your calories in
to your calories out for you.
For your brain to do this,
it needs to know how much
energy you have onboard
at all times, and it
knows this by listening
to hormones like leptin, which
is made in your body fat.
You can think of it like a car.
(car engine revs)
Leptin is the gas gauge
that tells your brain how
much gas is in your tank.
But leptin is just one
piece of the puzzle.
You've got a whole bunch
of other hormonal signals
and sensors that are involved too:
your bones, muscles, pancreas, liver,
G.I. tract and sensory organs.
They all play a role,
communicating with your brain
to give it the information
it needs to do its job.
But that's more detail than
we need for this conversation.
The point is that you have
a complex system in place
that regulates you to within a
set point range for body fat.
So what happens if Amanda
decides to lose weight
by going on a diet?
After all, people with obesity
should eat less, right?
Here's what happens.
She loses weight, but her
hormone levels change.
Her brain hears this, and it starts acting
whatever body fat she's lost.
She feels hungrier.
And although she doesn't know it,
she's also burning fewer
calories than before.
You see, set point is
usually a one way street.
One it's been elevated, the
brain works to defend it
just as vigorously as it
would a lower set point.
Amanda's brain doesn't know
that she needs to lose weight.
It only knows to defend
her current set point.
Back to our car analogy.
Amanda can't help but look
for a gas station to refuel
when she sees that her gas gauge is low.
At the same time, she
becomes more fuel efficient,
burning less energy than before.
This might explain why treating obesity
with diet and exercise
so often fails to produce
the desired results.
It's sort of like telling Amanda
that she needs to be a more careful driver
when the real problem is
that she needs a mechanic
to fix her car.
Okay, so if we've all got this
complicated system in place
that prevents us from losing weight,
why doesn't it also protect
us from gaining weight
and developing obesity in the first place?
How can we explain the obesity epidemic?
Getting back to Amanda, why
did she develop obesity?
The answer is that it
takes a perfect storm
to cause an obesity epidemic
like the one we're seeing now,
and it's our modern environment
that places us, and Amanda,
directly in the path of that storm.
While there's no single
cause for the rising rate
of obesity, changes to the
chemical and nutrient content
of our food, the so-called western diet,
and decreasing physical activity,
increased levels of stress,
inadequate and disrupted sleep
and more widespread use of medications
that promote weight gain all play a role.
Our unique genetics and
developmental histories
cause each of us to respond differently
to these elements of
the modern environment.
And some of us, like
Amanda, respond by sending
hormonal signals that elevate
our set point for body fat.
It's not that Amanda's
system has stopped working.
It's just that it's
working to regulate her
to a set point that's too high.
So you can think of obesity
as a biological response
to the modern environment,
a disease where the body disregulates
to a body fat set point that is too high.
Back to our car analogy.
The size of Amanda's gas tank has expanded
so she carries around too much fuel.
It's time to stop blaming
Amanda for her obesity.
It's time to recognize
that obesity is a disease,
not a lifestyle choice, and
those who suffer from it
deserve treatment, not snap judgment.
It's time to act on obesity.
And now that you've been educated,
here's a simple way for you to act.
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