You may have heard that a piece on the TV program called 60 Minutes recently sparked some controversy. A doctor stated that obesity is a brain disease, and the largest contributor to obesity is genetics. To quote her, "That means if you were born to parents that have obesity, you have a 50-85% likelihood of having the disease yourself even with optimal diet, exercise, sleep management, [and] stress management..." She tells us that lifestyle won't make a difference for genetically flawed people.

The 60 Minutes Program then segues into the new weight-reducing medications, stressing how effective they are, potentially leaving the audience with four takeaways: 1) Obesity is a brain disease. 2) Obesity is genetic 3) Lifestyle changes won't work for the genetically flawed. and 4) Drugs are better than lifestyle changes, especially for the genetically flawed. This post will address these issues and more.

Dr. Stanford: The Biggest Loser?

The segment starts with a discussion about the runaway obesity epidemic that started a few decades ago and introduces the new obesity drug called by two names, Ozempic and Wegovy. Then Dr. Fatima Cody Stanford, an obesity doctor at Mass General Hospital and associate professor at Harvard Medical School, speaks with Leslie Stahl. As I mentioned, she first calls obesity a brain disease. Dr. Stanford then says common beliefs about obesity are all wrong. She uses the example of "the Biggest Loser" show, where contestants subject themselves to ungodly amounts of exercise and frightfully small amounts of food. The contestants lose extreme amounts of weight only to gain it right back after the show ends. After claiming obesity is mainly due to genetics, Dr. Stanford said, "Doctors do not understand obesity." I believe she included herself because I have news for Dr. Stanford. Nobody thinks the biggest loser approach is a good idea or sustainable. People will not flourish on a starvation diet, especially when coupled with intense workouts. This has been common knowledge since the 1940s. 

Starvation Is a Bad Strategy

Ancel Keys did his famous Minnesota Starvation Study in 1944. Volunteers were restricted to approximately 1570 calories a day for six months. As a result, they lost approximately 25% of their weight. They were then allowed to eat as much as they wanted. Compared to the start of the study, the participants were far more preoccupied with food.

Many participants started eating several meals at once and developed GI symptoms and headaches. During the first two weeks of the unrestricted diet, participants were allowed to choose their meals and ate between 7,000-10,000 calories daily. Participants described feeling hungrier and using binge-eating and purging behaviors while eating freely. Even after five months of this, they developed body image concerns. Finally, several participants had significant increases on the Hysteria, Hypochondriasis, and Depression scales, indicating increased anxiety. In short, "the act of restriction and extreme dieting impacts an individual's physical, social, behavioral, and psychological well-being." 1

Why Genes Always Get the Blame

Our genes hold the blueprints for every biological process in our bodies. The processes that make me able to move my arm have their basis in my genetic code, but I would not blame my genes if I accidentally hit someone with my arm. Additionally, I have patients that blame their decay on having soft teeth that they say, “runs in the family.” Although some families may have softer teeth, tooth decay did not exist until we started eating processed carbohydrates when we discovered farming. So even though some humans may have had weaker teeth ten thousand years ago, they did not suffer from tooth decay because they ate properly. To blame genes and ignore lifestyles is short-sighted and misleads countless people who could otherwise alter their lifestyles and become healthier. It also can hoodwink people into believing that they are genetically flawed, leading them to believe that medicine is the only option. 

 Obesity Went Through the Roof in One Generation: Genetics Does Not Work That Way

 Sturm and others measured the increase in obesity and extreme obesity from 1986 to 2000. See their graph below. Hardly a generation passed from 1986 to 2000, so the rise in obesity can not be genetic in the traditional sense. 2 

Since the seventies, there has been a clear and sudden rise in obesity, according to NHANES. 3 You can see the trend in the graph below. From 1999 to 2020, obesity in the United States increased 11.4%. During the same time, the prevalence of severe obesity almost doubled. 4 Again, this change is too rapid for it to be heritable genetics. 

 Epigenetics

I wrote about Pottenger’s Cats only two weeks ago. The cats ate a poor diet; after three generations, they were almost all sterile. Those that bred had no viable offspring. It took three to five generations after switching back to their normal diet for the cats to achieve perfect health. The poor diets activated some genes while deactivating others to produce disease. Then, the correct diet stimulated the correct activation of the cats' genes to produce health. The process of the environment changing genetic expression is called epigenetics. So, what we see with our current weight-related problems is epigenetic, not poor breeding.

 Lifestyles Matter

 Although the risks of developing chronic diseases are attributed to genetic and environmental factors, 70 to 90% of disease risks are to environmental causes. 4 Studies of identical twins and people who move to foreign countries bear this out. 5 The term exposome, coined by Christopher Wild, is applied to define this phenomenon. Read my post about the exposome here for more information.

Take type II diabetics as an example. Many people revert to normal blood sugar control with their diet, sleeping habits, and activity level. Those that choose not to change anything can take medications to help. Ultimately the choice is up to the patient. If they don't understand that lifestyle changes are a viable choice, they will opt for medication as their only option. Dr. Stanford leads people away from lifestyle intervention and into the medical-pharmaceutical complex.

 Medicine, Medicine, and More Medicine

 The pharmaceutical industry accounted for 75 percent of the total advertising revenues collected by TV stations in the US in 2020. It amounted to 4.58 billion dollars. 6 TV stations are not going to bite the hand that feeds them the majority of their profits; therefore, it is no surprise that a show promoting prescription medication as the best option to fight obesity while downplaying lifestyle choices and blaming genetics is presented by CBS. Conversely, the pharmaceutical industry would not appreciate a show suggesting alternative treatments. Incidentally, Google does the same thing. Their medic update in 2018 downgraded many reputable alternative health sites. 7

 Weight Loss Medications Ozempic and Wegovy

Semaglutide is the name of a medication that is a glucagon-like peptide-1 receptor agonist. Glucagon-like-1 is a hormone that slows gastric emptying and reduces food intake, so Semaglutide does the same. We feel full and eat less when on it, which leads to weight loss.8 Ozempic is intended for people with diabetes, while Wegovy is intended to cause weight loss in obese people. They are both made by the same company, Novo Nordisk, and they are in very high demand. 

Caloric Intake Reduction Through Pharmaceuticals

As I stated, the drug causes patients to feel lastingly full, so they eat less. One participant went from eating 3000 calories per day down to 1500. 9 However, I could find no other information on the average decrease in caloric intake for participants. But I assume that the participant was typical, making anti-obesity medications approach the 25% to 30% weight loss mark only achieved with bariatric surgery.

Natural Caloric Reduction

For those new to this site, The Paleo Diet is a diet of unprocessed foods similar to how humans ate for millions of years. It is an important part of a healthy lifestyle. A 2010 study compared The Paleo Diet to The Mediterranean Diet. Both resulted in a spontaneous reduction in overall calories consumed, but the people on The Paleo Diet reduced their intake by 24% more. 10 A 2014 study compared The Paleo diet to the Dutch Health Council Guidelines diet. The researchers wanted the groups to maintain their weight, but The Paleo Diet group spontaneously ate fewer calories and lost weight, so the researchers had them eat more. 11 Finally, a 2013 study concluded that The Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes. 12

Nothing Adds Up

If Semaglutide and The Paleo Diet cause us to eat fewer calories and lose weight, why does Dr. Stanford ignore the scientific literature and tell us to take Semaglutide? She dismisses optimal diet, exercise, sleep management, and stress management for weight loss, which is inexcusable. Next, she claims genetics are to blame, even though the rise in obesity has been too short for that explanation to hold up. Epigenetics explains what is going on. Additionally, Dr. Stanford says obesity is a brain disease. Brain disease is not a medical diagnosis, and she offers no supporting information on what kind of brain disease it is. So, is the brain disease due to poor genes? She does not say. Finally, the medication seems to work very well. Like most medications, it has some risks and does not work for everyone. It is $1300 for a month's supply. That is $15,600 per year. The patient is encouraged to stay on it for life. If you stay on it for twenty years, it will total $312,000. Lastly, it is injected once a week by the patient. I believe people should have access to this medication, but I also believe they should have access to the whole truth so that they can make an informed decision about their health.

Dr. Stanford Thinks Diet Doesn't Matter, But Apparently, the Government Wants Her To Tell Us What To Eat

Sadly, Dr. Stanford has been appointed to the president Biden administration's 2025 Dietary Guidelines Advisory Committee. Wow. Why would it matter what we eat? It does not affect our weight or health, according to Dr. Stanford. Please read this post for my take on our government's idea of nutrition. Hint: It isn’t good. Alas, she has both feet planted firmly in the western paradigm of medicine; she believes humans are flawed beings who need big pharma's help.  Additionally, she must believe we need government agencies to tell us what to eat because we are not intelligent enough to care for our own needs.  

The Approach That Has Worked For Thousands of Years

Eat a paleo-type diet where processed foods are eliminated. Sleep consistently for 8 hours each night. Get regular nonburning sun exposure. Destress, especially with people who support you. Avoid sedentary living and try to walk and exercise routinely. Finally, don't believe doctors who promote pharmaceuticals, blame all diseases on genetics, and believe lifestyles don't matter. For more info on healthy lifestyle components, read this quick-start guide.