Obesity is Now the Norm

Throughout most of human history obesity was as rare as hen’s teeth. This trend dramatically changed in a relatively short period of time. The rate of obesity rapidly increased between 1976 and 1980, and it’s been going up every year since then. During this time obesity gradually became recognized as a chronic disease by some in the medical establishment, although others still consider it to be a choice—choosing to eat too much, eat the wrong foods, or to be inactive. Despite the array of treatments developed for this apparent disease, the rate of obesity has continued to skyrocket. The medical profession and public have stood by wondering why is it so hard to eat healthy? Let’s take a closer look to find out why nutritious thoughts and physical activity don’t seem to be working.

The Scope of the Problem
Even though obesity is defined as “excessive body fat” or a body composition issue, the academic and government agencies decided that it’s too difficult and expensive to measure body composition, so they elected to use body mass index (BMI), a height/weight formula to define obesity. BMI is a size measure, and I can guess your size simply by looking at you, so their decision has left us with a massive BMI fiasco. BMI is used to define the following categories:

 
When you combine overweight, obesity, and severe obesity, the incidence in adults in the United States it now over 70%. When you measure body composition as I have always done in my medical practice, those in the “overweight” category are clearly obese, and some with a normal BMI have excessive body fat. Thus, the true incidence of obesity in adults in this country is likely over 80%! That clearly indicates that obesity is now the norm.

Why the Norm is the New Normal
When something is “the norm”, humans subconsciously and consciously consider the parameter to be normal, so they tend to stop obsessing about it. For example, if most people around you dress in a certain way and look a certain way, your brain registers this as “normal”. People who don’t fit this normal pattern become “abnormal” and they tend to stand out and attract attention. It’s now normal to be fat and flabby, and thin folks with a normal body composition are the exception. When you look around you, watch TV, or read advertisements, most of the people you see in today’s world will be fat. When something is “normal”, we stop trying to fix it. Obesity is no longer considered to be a disease, so we stop thinking about it. Virtually nobody focuses on how to change your mindset about food to lose weight, because there’s nothing wrong with being a fat person. In this environment a healthy eating mindset is simply out of reach.

This development has had some interesting repercussions for obese folks. Years ago, when they were in the minority and considered to be abnormal, fat people discovered that standard weight loss approaches were generally ineffective. This was frustrating because they wanted to move out of the abnormal category.  As fat folks, they often faced discrimination and ridicule. Instead of focusing on treatment that didn’t work, they started the “fat acceptance” movement. This movement started in 1967 when radio personality Steve Post organized a “Fat-in” protest in Central Park with about 500 people participating. They carried protest signs of thin model Twiggy and burned diet books. They were mainly protesting the discrimination that fat people often experienced in society. I fully support their efforts in this regard, as I believe that nobody should suffer discrimination based on the body size, appearance, skin color, sex, or other physical characteristics.

Fat Acceptance Bites the Dust
What I find interesting is that this fat acceptance movement was killed off when obesity became the norm. Fat people no longer experience obvious discrimination because most people are now physically obese. Today virtually nobody pays attention to obesity, and nobody is trying to fix that which is now considered to be normal. Obesity is no longer in the headlines and if you are obese, your healthcare provider is unlikely to mention it. We now live in a fat world where thinness is considered to be pathological. Your brain no longer registers a person’s fatness because it’s no longer a parameter of interest. The focus on fatness has simply faded away.

Despite Being the Norm, Obesity is Clearly Not Normal
There’s only one problem with this scenario—it isn’t based on solid science. Even though obesity is now the norm, it clearly isn’t healthy or a normal human state. This is where it gets a bit complicated. Subcutaneous fat is the type of fat stored under the skin and around the waste, whereas ectopic or visceral fat is stored inside the abdominal cavity and within various organs. Excessive amounts of both types of fat can be associated with type 2 diabetes, hypertension, coronary artery disease, strokes, and all cause mortality. Obesity has also been associated with various brain disorders, including major depression, anxiety disorders, bipolar disorder, and dementia. There is clearly a food mood connection.

Actually measuring the amount of fat in your body is a bit complex, and there is no perfect way to do so. Humans evolved to rapidly access a person’s fat status by simply looking at them, providing them with an evolutionary advantage. After all, you don’t want to mate a person who is emaciated with low body fat, or someone with excessive fat who likely couldn’t chase down and antelope or other game! We can still accurately read a person’s body fat, but in today’s world we no longer avoid interacting with them because fat folks are now in the majority. That’s because was also evolved to recognize that the people in the majority tend to have the ideal body style.

It’s clear that we now have a major healthcare disaster on our hands, and nobody seems to know how to fix it. That’s where I come in. I believe that the experts have failed to recognize what is driving our current obesity epidemic. I came to this conclusion while treating patients over many decades. In my medical practice I always measured every patient’s body composition at every visit, so I knew who was obese, and who was becoming more or less obese. Years ago I also had an interest in neuroscience, and I belonged to Stephen Stahl’s Neuroscience Education Institute. Therefore I paid careful attention to my patients’ brain dysfunction symptoms. These symptoms seemed to suggest that for some reason, these patients had low levels of monoamine neurotransmitters like dopamine, norepinephrine, and serotonin in their brains.

How to Change Your Mindset About Food
At the time, nobody seemed to know why these monoamines levels might be impaired or low. Over time I discovered that highly processed food was the trigger for this pathology. This eventually led to the development of a new disease model to better explain our twin epidemics of obesity and common brain disorders. I term this disease Carbohydrate Associated Reversible Brain Syndrome or CARB syndrome. This disease is associated with up to 22 brain dysfunction symptoms that overlap with many traditional brain disorders, creating massive diagnostic and therapeutic confusion. The lead symptom of CARB syndrome is having strong cravings for sweet and starchy food, pushing people to consume more of the highly processed food that is frying their brain. In addition to developing obesity, they develop problems like anxiety and binge eating.  People often wonder “why do I think about food all the time?” We now have the answer.

Eat Right Feel Right
Breaking free from emotional eating is best accomplished by suppressing the cravings for sweet and starchy food. The notorious fen-phen combination was very effective at doing so, but fenfluramine was removed from the market due to concerns about rare heart valve problems. Phentermine is now sometimes combined with the serotonin boosting drug Prozac for weight loss. Although such combinations can sometimes help with fat loss, they usually stop working because patients have low levels of the monoamines that these drugs are trying to boost. If that’s the case, how do you increase monoamine levels? The answer is simple—provide the amino acids that your brain needs to make monoamines. That would include L-tyrosine, 5-htp, and dl-phenylalanine. Years ago, I developed a combination precursor product that seemed to simultaneously increase all monoamine levels. I call this product CARB-22. I discovered that when I used this type of precursor product along with advice to limit intake of ultra-refined foods, patients often did well without using any medication. When medications were necessary to jump-start someone’s brain, I combined the medications with CARB-22, and once the patient was headed in the right direction, I tapered them off the drugs. By avoiding highly processed food, the neurotransmitter depletion pathology is disrupted. Thus, once your brain is back on track, it’s important to recognize the difference between processed food vs whole food. Always stick with the whole food.

Patients would often ask me how to get motivated to exercise when depressed or why it’s so hard to eat healthy? Once again this brings in the food mood connection. Treat the underlying CARB Syndrome that’s driving the disease bus, and brain function, mood, and body composition will automatically start to improve. It isn’t rocket science, but it is science. I hope this information will help you to find the path to the improved health and quality of life you seek.

Note:  I would like to thank my friends and colleagues Robert Lustig, MD and Andy Steinfeldt for their help editing this post.