Friday, February 20, 2009

A good point worth posting....

Because it's school vacation week I haven't had any opportunity to write, but I have been doing lots of reading in the evenings. It's sad, but true, that I've been reading a journal supplement entitled "Obesity: etiology, treatment, prevention and application in practice". I came across a statement by one of the experts in the field that I wanted to share with you. It's about obesity and how we assume that energy balance is a simple concept i.e. energy intake is what we eat, energy expenditure is what we burn through physical activity and just being alive and, if we do gain weight, it's because we are eating more than we burn off. This expert states:
"Another limitation of the concept of energy balance as the cause of obesity is the implication that if one is getting fatter; it is one's fault. One need only to control his or her energy intake and energy expenditure to control the problem. This implies that we should blame our children for their obesity. This seems grossly unfair. If obesity were easily controlled by moderating energy intake, the US military would not discharge up to 5,000 men or women yearly for failing to meet its weight standards. If loss of livelihood is not sufficient motivation to lose weight, then the problem must be more complex" (Bray & Campagne, 2005; ADA;105:S17-S23)

Like every other chronic disease, obesity is a complex condition. We need to consider genetics, the effect of drugs, intrauterine events, and disease conditions. In the US, dietary patterns have changed in the past 30 years - excess calories from dietary fat and high fructose corn syrup are major contributors to weight gain. As a society we are exercising less, working more and dare I say it, not taking 'time out' from our busy schedules like our ancestors. For most people, excess energy intake, or lack of physical activity, is the cause of weight gain, but health professionals should keep an open mind regarding the cause of weight gain in patients.

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