Four Overlooked Obesity Contributors

Obesity Is About So Much More Than Diet and Exercise

by M. Rami Bailony

A recent study of the Journal of the American Medical Association shows that society’s and health care’s are misunderstanding the obesity epidemic.

The study found that more Americans than ever are dieting these days, and yet weight continues to trend up. The number of people dieting increased by 23% compared to 15 years before. Today, nearly half of adults in the U.S. have gone on some sort of diet. There were sharp decreases in reported candy and sugar consumption, along with sharp increases in reported vegetable consumption.

That type of dieting should help combat the ongoing obesity epidemic, right? Trends indicate the opposite. During the same time frame in which dieting behavior increased, weight among adults in the U.S. increased by 4.6%.

Proper obesity treatment is multifaceted, and diet and exercise are only a small part of the solution.
The findings of this study are of no surprise to obesity medicine physicians.

The cause of the obesity epidemic is far more complex than a calories equation. It is the result of interactions between environmental, behavioral, psychological, medical, genetic, and microbiomic factors. Proper obesity treatment is multifaceted, and diet and exercise are only a small part of the solution.

Weight loss is more complicated than a willpower game, science shows us that this is the case. Here are four causes of obesity which contribute between 10% and 40% of the obesity epidemic, that demonstrate that weight is about much more than diet.

Viral obesity

Adenoviruses are a group of common viruses that cause cold symptoms. One strain, adenovirus 36, is three times more prevalent in adults and kids who struggle with their weight. When you infect mice and monkeys with adenovirus, they gain weight without eating more than their noninfected counterparts. Of course, viruses are not the only explanation for the obesity epidemic, but evidence continues to mount that they represent a key source.

Circadian obesity

Alarm clock on white plate with fork and knife. Yellow background

Night work and decreased sleep affect both your metabolism and appetite hormones. Sleep insufficiency decreases leptin (a hormone that diminishes hunger) and increases ghrelin (a hormone that stimulates hunger). When people switch from morning shifts to night shifts, their metabolism drops by 2–5%. Asking people who are sleep-deprived and work nights to lose weight with sheer willpower ignores the biological disadvantage that goes along with their lifestyle.

Drug-induced obesity

Weight gain is a common side effect of many widely used drugs, including many antidepressants, corticosteroids, anti-seizure medications, allergy medications, and others. While the weight gained as a result of taking some of these medications may be as little as a few pounds, this adds up on a population level. More importantly, these medications make it very hard for people to lose weight and keep it off. One study found that people who take medication that has weight gain as a side effect are 37% less likely to achieve a 5% weight loss when they enroll in a weight loss program as compared to those not taking weight-promoting drugs.

Chemical obesity

There are many chemicals commonly found in plastics, cleaning supplies, and cookware that have been linked to weight gain. The most common ones are bisphenols, phthalates, atrazine, organotins, and PFOA. A recent study found that children with obesity have higher concentrations of urinary bisphenols (a common ingredient in plastic). Researchers at the University of California, Irvine have shown in multiple studies that mice and rodents exposed to these plastics gain weight. The really bad news is that exposure to chemicals can be passed down to your offspring by altering expression of your genes.

This list of contributors to the obesity epidemic is only the beginning — there are many other complicating variables. Simply put, this epidemic is far more complex than our food choices. The causes of obesity listed above help shed light on the fact that while Americans may be eating healthier and dieting more, nationwide struggles with weight gain persist. This isn’t happening because people are making a “minimal level of effort” as they diet. Rather, there are myriad forces at play — many of which frequently go ignored.

It’s high time for us to start treating obesity as a complex disease that requires multifaceted treatment. Diet and lifestyle fads that masquerade as solutions won’t solve this considerable challenge. It’s time we start treating this disease like the medical epidemic it is.


The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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