Tag Archive for: obesity

Adaptation: Recovery

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In this Memo arc, I’m going to lay the foundation to support my opinion that obesity is a man-made disease. I’m adding this idea to that opinion: reducing body weight and maintaining the weight loss can occur with man-made solutions. Actually, it’s utilizing one mechanism we often overlook that the body uses all the time: adaptation.

Let’s begin with something serious that involves a broken bone or recovery from a joint replacement, which is essentially the same thing. After the bones are aligned, the first phase of the recovery is reducing the inflammation and pain to restore joint mobility. That involves multiple systems of the body working together; hormones are certainly involved as well as the muscular, skeletal, cardiovascular, and other systems as well.

The repair process swings into action to heal the bones, muscles, ligaments, tendons, and other tissues involved. Bones take time to heal because all bones start as cartilage, which is then calcified; that takes six weeks or longer. At the same time, the muscular system has to repair muscles that might have been damaged in the process or are being asked to do other tasks than before.

I could continue, but my point is that the repair process is an adaptation process and takes time, often months and maybe even longer to restore full function. Can we use this process of adaptation in a positive way? I’ll cover that on Saturday.

One thing you can do as we approach the first holiday of the summer is to plan your menu and your exercise sessions. Improving your healthspan is easier if you make a plan for the many exceptions to your everyday routine in advance.

What are you prepared to do today?

        Dr. Chet

Obesity: A Man-Made Disease

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In order to determine whether obesity is an untreatable disease without pharmaceuticals, I took a look at BMI data since 1960. In comparing the BMI of people in the lowest income brackets with the highest income from 1960 through 2024, the lowest income group is always about one BMI unit above the highest income group. The adjusted mean is roughly a BMI of 27 for the poor people versus 26 for the richest people. That continues until the mid-1980s. After that point, the mean BMI continues to rise for the next 40 years—a mirror image with the same one BMI-unit difference.

Mid-1980s

What happened in the mid 1980s that caused the surge in obesity? After checking various sources, there appear to be three factors, not ranked in any particular order.

  • The mid-1980s saw increases in two-income families. There are plenty of economic reasons for that, but the net effect was less time spent preparing food in the home and a reliance on convenience food purchases.
  • There was an increase in fast-food drive-thrus and take-out foods. Since COVID, there is more reliance on food delivery.
  • The mid-1980s saw an increase in ultra-processed foods. Using inexpensive ingredients, particularly carbohydrates and fats, and filled with flavor enhancers that accented the salty and umami, the amount of ultra-processed food has risen to over 50% of the typical American’s diet.

She was asked, “If people stop using GLP-1, will they gain back the weight?” She said yes because there’s no other way to maintain weight loss because of the fat setpoint. I just can’t accept that premise.

The Bottom Line

Overweight and obesity appear to be man-made diseases because of the environment we live in today with so much easily available food. However, I cannot accept that the fat setpoint is permanent. Yes, there are many factors in the brain, the pancreas, and the digestive system that control the feelings of hunger and the anticipation of food, but that doesn’t mean you really need nutrition. You and I just have to learn to ignore those signals that say, “what will my snack be?” when we’re still stuffed from dinner. We must take command. I’m not suggesting it will be easy, but it’s not impossible. In my mind, it’s a lot easier than taking a medication every day for the rest of my life.

What are you prepared to do today?

        Dr. Chet

References:
1. Int. J. Environ. Res. Public Health 2024, 21, 73.
2. Stat Pearls. 2025. Obesity and Type 2 Diabetes

Is Obesity a Disease?

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In a podcast about GLP-1 receptor agonists and several new medications that are under development, the expert was a researcher on the cutting edge of what these peptides can do for weight loss. A couple of things she said didn’t sit right.

One was that obesity is a disease of genetic tendencies to store fat more effectively and create a body-fat setpoint. The implication is that in a land of food abundance, specifically ultra-processed food, the setpoint could be raised but never lowered without medical intervention. The second was that these medications are the best solution for obesity, and thus people will have to take the medications for life or they’ll gain back weight.

According to the World Health Organization and just about every other medical society in the world, overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. But is it as simple as that? Based on a recent paper, the risk of getting type 2 diabetes is 7% to 12% in men and women at a BMI of 30; as BMI increases to over 40, the risk goes up to 74% for both men and women. It’s not an excuse to stay obese, but does it mean someone who is obese will get the diseases associated with obesity?  I have more questions, and I’ll cover them on Saturday.

Insider Conference Call is tomorrow night. The topics of the evening are reviewing the top five foods that prevent cancer as well as answering Insider questions. Interested? Become an Insider by 8 p.m. Wednesday and you can join in.

What are you prepared to do today?

        Dr. Chet

References:
1. Int. J. Environ. Res. Public Health 2024, 21, 73.
2. Stat Pearls. 2025. Obesity and Type 2 Diabetes

Clock-Changing Solutions

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We’ve become so obsessed with sleep, even our watches can track the amount of quality sleep we get, so we can expect something unusual tonight. We go to bed at our usual time and for most of us in the U.S., we wake up one hour earlier than planned because the clocks have changed. As someone who adapts to sleep changes well, I empathize with those who don’t. Here are a couple of solutions I’ve found, one societal and one personal.

Don’t Change the Clocks

Researchers from Stanford undertook a very complicated theoretical study. By using county solar light patterns, time policy, and health data with circadian models, they calculated the relationship of those variable conditions and diseases. Let’s just say this would be impossible without the number crunching ability of today’s computers.

What they found was that a shift to Standard Time year-round would decrease the occurrence of stroke and obesity. A permanent shift to Daylight Savings Time would also decrease the occurrence of stroke and obesity as well, although not to the same extent. It should be noted that the impact was dependent on both latitude and longitude of people within the time zone.

How big of an impact? With Standard Time it could potentially reduce the risk of obesity by 0.78% and the risk of stroke by 0.09%. Not a big deal? Based on the current population, that could mean a reduction of the cases of obesity by 2.6 million cases and 300,000 cases of stroke per year in the U.S. While this is an emotional as well as political land mine for many proponents and opponents of time changes, this is one variable that deserves consideration.

Naps

Getting some additional sleep, even as little as a 20-minute nap, can be beneficial. Researchers in Greece found that people who took a nap in the afternoon had a lower rate of death from cardiovascular disease (CVD). How much lower? 37%!

This was confirmed by a study published last month suggesting that naps under 30 minutes reduced CVD outcomes—however, naps longer than 60 minutes increased the risk of CVD events. Speculation was that long naps interfered with nighttime sleep patterns.

The Bottom Line

We all look for an easy way to reduce our risk of heart attacks. Sometimes, the simplest solution is the correct one, and you can’t get much simpler than sleep. It can be challenging to fit in a nap during the day, but if you can do it, it may help you to be more effective in what you’re doing and lower your risk of cardiovascular disease and possibly other diseases as well. As for a permanent switch to Standard Time for more early sunlight? That will be open for debate, so we have to do what we can control.

What are you prepared to do today?

        Dr. Chet

References:
1. https://doi.org/10.1073/pnas.2508293122
2. Arch Intern Med. 2007 Feb 12;167(3):296-301. doi: 10.1001/archinte.167.3.296
3. Pub Health Rev. 2026. doi: 10.3389/phrs.2026.1609013.

The Bottom Line on Full-Fat Dairy

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If you’re a long-time reader, you know that science by headlines really annoys me because they often distort the findings of the research papers to make them seem more important than they are—gotta get that next click! It doesn’t help that research institutions send out press releases that contribute to the hype of their research findings. Such is the case with the two papers I reviewed this week.

In the first paper, researchers claimed blood values of fatty acids found in high-fat dairy products potentially decreased the risk of developing type 2 diabetes in two large cohorts. Of the 3,333 subjects who were free of diabetes when the study began, 277 developed diabetes after 15 years of follow-up. That seems like a low number compared to the general population, although these were studies on healthcare professionals who might have a better lifestyle than the rest of the population.

The problem is that they tested the blood only for dairy fats at the beginning of the study. While they did administer the food-frequency questionnaire every four years, there’s no way of knowing how the dairy fats changed over the years. At best, this is a large study that shows some form of correlation between dairy intake and type 2 diabetes but tells us nothing to help us decide whether we should change the type of dairy we eat.

In the second paper, they also used a similar food-frequency questionnaire to identify what types of dairy products the subjects used. As I’ve said many times, these are fraught with potential errors. On top of that, the difference in body weight gain between those who used the most low- and no-fat dairy products and those who used the most high-fat dairy products was about a tenth of a pound. If you account for the initial BMI and body weight, the results are about two tenths of a pound. That’s not exactly exciting over 11 years, is it?

The Bottom Line

They didn’t state the obvious, but I will. It could be that full-fat dairy keeps women (and probably men) feeling satisfied longer so they don’t eat as much. That’s what fat can do. But we can’t really know because researchers didn’t measure diet carefully enough in either study to be able to analyze it. In these cases, they didn’t collect the right type of data that could really answer the questions; thus results were not very significant.

It always comes down to six words: Eat less. Eat better. Move more. If you choose to eat dairy, you can’t overeat any type because while it may take more of the low-fat foods to reach the number of calories in high-fat dairy, eating too much is just what it says: eat too much and you’ll gain weight.

What are you prepared to do today?

Reminder: Taking Back Your Muscle, Part 2: Protein is tomorrow at 1 p.m. Eastern Time. If you want clarity on creatine, amino acid, peptides, and protein and how to use them for your health, buy the webinar by 11 a.m. ET to watch live, or you can watch the replay at your convenience.

        Dr. Chet

References:
1. circ.ahajournals.org/content/early/2016/03/22/CIRCULATIONAHA.115.018410
2. Am J Clin Nutr 2016;103:979–88.

Does Whole Milk Reduce Obesity?

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The second research paper that was included in many news articles that talked about the potential benefits of full-fat dairy products was a study from the Women’s Health Study (1); researchers collected dietary data and self-reported weight and height from over 39,000 women. The analysis included only about 18,000 middle-aged and older women who had a normal BMI when the study began. They analyzed the change in body weight over 11 years of follow-up.

All women gained weight over time. Contrary to expectations, those who consumed the highest number of high-fat dairy products gained less weight than those who used low- or no-fat dairy products. Of the 18,000 women with normal BMI in the beginning of the study, just over 8,000 became overweight or obese over the duration of the study.

Is it time to switch back to whole milk and cheese? I’ll give you the bottom line on Saturday.

The next webinar, Taking Back Your Muscle, Part 2: Protein, is on Sunday at 1 p.m. ET. If you’ve ever had any questions about protein, amino acids, or creatine, this webinar is for you. I added one more topic that fits with protein and that’s the role of peptides, short chains of amino acids that are a hot topic today. Find out what they are, what do they do, and how much need by joining me Sunday at 1.p.m. Purchase your access to the webinar and/or replay today for $17.95; Insiders and Members get their usual discounts.

What are you prepared to do today?

        Dr. Chet

Reference: Am J Clin Nutr 2016;103:979–88.

Eat Less, Eat Better, Move More—for Life

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In Tuesday’s Memo, Dr. Donal O’Shea suggested that there’s compelling evidence that eating less and moving more won’t result in permanent weight loss because the set point theory is just too strong and will defeat the effort of 90% of the people. However, he didn’t provide any evidence that’s true. I’ll give him the benefit of the doubt, because every study done on diets shows that people do gain back some or all of the weight they lost. He attributes that to the complexity of obesity.

The Complexity of Obesity

Take a good look at the graphic used in the heading. What you can’t read are the 198 determinants (all those gray lines) that contribute to obesity. He narrows them down to just seven categories, five of which are not under the control of people once they are fat. In case it’s difficult to read, here is the list.

  • Societal influences
  • Food production
  • Activity environment
  • Biology
  • Individual psychology
  • Food consumption
  • Individual activity

He also gives a compelling argument that the immune system, working in conjunction with fat cells, causes inflammation in a variety of ways which prevents people from losing weight.

The problem that I have is two-fold. First, it seems the last three are under the control of the individual: eating, moving, and deciding to do so. The exterior forces are what they are, but biology can change. Aging is the perfect example of that.

As for immunity, here’s the real question about the immune system: is it cause or effect? The increase in inflammation is remarkably similar to the increase in cortisol found in people who are obese. Is it the cause of obesity or is it the result of being obese? It makes a difference.

Why Medication Won’t Be the Permanent Solution

Before I get into this, I think that medications may play a role in the solution for some, maybe even most severely overweight people. But they will not be a permanent solution, and the reason may be found in the proteome. You may remember that those are the proteins coded for in our DNA; they range from hormones such as insulin to catalysts for other chemical reactions. There are about 5,000 proteins that are the most researched, but with about 20,000 genes, there may be at least 15,000 more genes that are not researched. That doesn’t count the post-translational modifications, modifications made to the protein as it’s being made; the total could get into the millions.

It’s unrealistic to think that a combination of three, five, or even ten receptor agonists will solve obesity and not cause issues elsewhere in the body by interfering with the production of other necessary proteins. I’m not suggesting that temporary use to get the bulk of weight off an individual won’t be a good way to start, but it’s not a permanent solution as I see it, even if you can afford to take it the rest of your life.

The Bottom Line

The issue with O’Shea’s approach is that it comes from a strictly medical perspective. A nutritional solution isn’t considered and somewhere along the line, just like with gastric bypass, people will exceed their desired caloric intake and regain weight. Why? Because they haven’t learned anything.

Remember, in those seven categories he cited, food consumption and activity levels are under the control of the individual. That means both the quantity and the type of food as well as the amount of activity are under the control of the individual. I’ll say it again: it was, it is, and it will always be about the calories—how much you take in versus how much you use. Take in more than you use, and you gain weight. It’s that simple.

Obesity is complex because our bodies are complicated, but this is still my recommendation: eat better, eat less, and move more. If I were to add two more words that I’ve implied but haven’t stated, they would be “for life” because the only way to hold on to your progress is to keep working on your lifestyle.

What are you prepared to do today?

        Dr. Chet

References:
1. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.
2. Nat Chem Biol. 2018 Feb 14; 14(3): 206–214.

Should You Forget “Eat Less, Move More”?

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Eat less. Eat better. Move more.

If you’ve been reading the Health Memo for any length of time, you know that’s my simplified solution, my mantra, to the problem of excess body fat we face in the U.S. and around the world. That’s why an article about an endocrinologist from Ireland who said “Eat less, move more is not the treatment for obesity—get over it” caught my attention. The quote was taken from a talk and interview given by Dr. Donal O’Shea that included a series of recommendations to primary care physicians on how they should approach the topic of excess body weight with patients. He went on to suggest that in a short time, medicine will have solutions for obesity that will essentially render obesity obsolete. Semaglutide is just the first jab at it—pun intended.

I went a little further and listened to a talk by Dr. O’Shea in which he went into detail about why 90% of weight gain is irreversible in 90% of the people. Then he used this example: if you donate a pint of blood, your body will replace it over the next six weeks to get your body back to its blood-volume set point. He says your body weight also has a set point and once it’s raised, it cannot be reversed; no matter what you do, your weight will return to its set point. Therefore, medications such as semaglutide and the ones being developed that will impact other receptors are the only solution.

Should we just buy stock in pharmaceutical companies and forget about nutrition and exercise? Dr. O’Shea is a good scientist and is certainly compassionate toward patients. But is he correct? No, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. Eilish O’Regan. Irish Independent. 04-28-24
2. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.

Nobody Got It Right

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The topic of the last Memo came from an article co-written by writers from The Examination and the Washington Post. The “exposé” was that credentialed nutritionists and registered dieticians (RDs) were accepting sponsorships and payments from industries they covered, especially the cereal industry. The “angle” was that the influencers were using the anti-diet movement to promote the consumption of cereals to adults and children—not just granola and oatmeal, but every sugar-laden cereal.

I don’t watch TikTok videos, and I don’t have a TikTok account. But to be fair, I used the hashtag #DerailTheShame to check out some of the videos that were mentioned in the article. It was a couple of weeks after the article was posted, so there were responses from some RDs that typically use TikTok. To say they were upset was an understatement. But in the responses, no one addressed the real issues in the TikToks and the article, so I will.

Both Sides Made Mistakes

The writers who collaborated on the article were all investigative journalists with a lot of experience, but none had a nutrition background. How do you know what’s good or bad from a nutrition perspective? This happens a lot in non-scientific journalism. I’m not saying such articles aren’t worth reading, just keep in mind that an important viewpoint is missing.

Some of the RDs certainly made it seem like they were promoting the sugar-laden cereals only. That’s the problem with using short videos; you don’t get to address the issue completely, and it would appear you have to sell yourself more than anything else.

On the other hand, the RDs were using elements of “fat shaming is bad” together with eating all foods. Fat shaming is bad and should never happen; you don’t know what kind of stressors people are dealing with or the medical, physical, psychological, and budget issues that keep them from losing weight right now. But eating as much processed food as you want isn’t a good solution.

At least one of the authors of the article wrote about Big Food and their sponsorships of RDs. The results were new laws legislating that compensation must be revealed when it comes to such influencers. On the other hand, I didn’t find any criticism by the RDs of Big Food companies who oppose new and plainly written food labels to reveal exactly what’s in processed foods.

Partial Solutions

I think the article writers should have spent more time on the Big Food angle rather than the influencers, credentialed or not. Many health insurance companies will not pay for nutritional counseling for obesity. One of the results is that nutrition professionals turn to other venues to be able to earn a living, and sponsorships can help them do that.

As for the credentialed influencers? With all the mind-numbing music, graphics, and dancing around in kitchens, it seems appropriate to post the serving size and calories from the cereal (or whatever food is being promoted) and to emphasize sticking to reasonable portions per day. That solves the issue in my mind. I’m not opposed to earning a living.

The Bottom Line

While cereals and any processed food have their place in a healthy diet, they should be eaten in the proper serving size and servings per day. I am opposed to the anti-diet sentiment. The only way to lose weight and maintain it is to eat less, eat better, and move more. (Ozempic isn’t magic; people lose weight because the drug causes them to eat less.) We all have to figure out for ourselves how to do that, and it won’t be the same for everyone, but it’s the only way to solve the obesity epidemic we face.

However, a physician from across the pond says that eating less and moving more just won’t work. That’s our topic for next week.

What are you prepared to do today?

        Dr. Chet

Reference: 04-03-24. Washington Post. As Obesity Rises, Big Food and Dietitians Push ‘Anti-Diet’ Advice.

What Should You Believe?

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What happens when you mix:

  • Social media
  • Certified expert influencers such as dieticians
  • The food industry paying or sponsoring food influencers
  • The message that dieting is wrong

You get up to 40% of the social media influencers saying, “Why diet? Love yourself and eat whatever you want!”—especially cereals or other highly sweetened grain products. You get partial truths that bastardize the original concepts of loving yourself and end up with people confused and, in some cases, fatter than they have ever been.

Welcome to a new reality. I think we expect that people who talk about health will have their own point of view; I certainly do. Some people believe that being a vegan is the only way to eat while others believe that a ketogenic diet is the absolute best. Both can selectively use research to support their opinion—and do. That seems normal because everyone can have a point of view.

But what if an organic farming association were paying the vegan supporter to promote a vegan diet? How about beef producers paying the ketogenic diet promoter to favor not only meat but especially beef? That connection must be reported in any scientific study about specific diets, but if you’re an influencer, that’s not mandated.

What about nutritionists and registered dieticians that are supported in part by the food industry? Could they take that too far? We’ll see on Saturday.

And just for the record, no company pays me—only you do when you join drchet.com, buy my health-info products, attend my seminars and webinars, or book me to speak to your group. I work for you.

What are you prepared to do today?

        Dr. Chet

Reference: 04-03-24. Washington Post. As Obesity Rises, Big Food and Dietitians Push ‘Anti-Diet’ Advice.