Is Obesity About Willpower Or Wiring?

What Makes Some Of Us Fat May Be Tied To Brain Chemistry And Genetic Makeup

(CBS)  For Scottie Hill, losing weight has always been a case of one step forward, two steps back.

She's 28, a social worker in New York City, and has spent most of her adult life either starting a diet or breaking one, CBS Evening News anchor Katie Couric reports. Hill says it's "extremely frustrating, and extremely tiring" to diet, only to have the weight come back.

Hill has weighed as much as 283 pounds, and she says it infuriates her when people assume she is undisciplined.

"I work like crazy. And I have not spent my life filling my mouth with food and lying around the house all day," she says.

In fact, there is a growing school of thought that what makes Hill heavy is determined by her brain chemistry and genetic makeup.

"It's like your eye color, or your height or your blood pressure," says Dr. Rudy Leibel, a molecular geneticist at Columbia University Medical Center. "These are all instances of very strong genetic predispositions."

Leibel has been studying the science of weight for 30 years. He says people like Hill have actually been blessed with the heartiest of genes that have helped the human race survive. But in today's society, where food is everywhere, those genes are more of a curse.

"There are a set of genes that we have acquired as a result of evolution over the past several millions of years that are designed to save energy; to make us efficient; to favor the ingestion of food," Leibel says.

Doctors have isolated at least 30 to 40 genes that affect body weight. Some of those genes produce hormones like grehlin, which tells your body that it's hungry. Another hormone is leptin, which is secreted by fat cells. It signals the hypothalamus that you have enough stored fat to survive and don't need to eat. But in many overweight people, the brain may not be getting the message the leptin is sending ... the message of: "I'm full."

You can even see this in mice with a mutation in the leptin gene. "This animal is much fatter, virtually inactive. And if we were to measure its food intake, it would be eating more food," Leibel says, describing the mice in his lab. But if the mice were given very low doses of leptin, the obesity would go away, he explains.

Leibel believes within the next 10 years, there will be medications that will help reduce our collective girths, much like statins have reduced cholesterol.

So does willpower have nothing to do with obesity?

"I'm saying that when you look at something as complicated as body weight, there is a biology. There are basic hormonal and neurologic phenomena that actually dictate this kind of very complex behavior," Leibel says.

As for Hill, "I think for me, I finally decided in order to lose weight and to maintain an ideal weight it's something that I have to be conscious and aware of every single day," she says.

Hill has lost 57 pounds and hopes to lose another 50. While she is relieved to learn that her weight may be, in large part, determined by her genes, she is determined to fight Mother Nature and prove that her behavior can be more powerful than her biology.

---

The American Dietetic Association has more information about nutrition. You can also read more from the American Obesity Association.

[ketemkin]

So I wanted to comment also that I'm now 26 and struggling to drop the weight. I'm 285 pounds and have tried meds, diets, life style changes etc. I want people to know that fat people don't like to be fat. It's an issue they truly struggle with on a daily basis. I was never obese execpt for the last 6 years. I just have a goal to become healthy, be able to fit into nice clothes, and win back my self-image that his deteriorated over the last 6 years.Thank god I didn't have to grow up big.At work they call me cone nipple because of my man boobies.Can you imagine how that hurts self-esteem?To have your boobs grabbed buy *** holes who claim they are just kidding? I hate it.

[ketemkin]

I was never overwieght in my life up till marrage at 20, I was 168 pound 5'9 stud.On a doc visit I told him that I had trouble sleeping.He gave me paxil (pill for depression).Within 8 months I gained something like 60-75 lbs.I read about this pill and it is known to make people gain weight. After about 2 years of work and home I gained more weight.1 day I looked in a mirror.I cant describe the shame I felt at what I did to myself.After my divorse & single, the weight shed it self.Then when I started the next relationship I found myself close to 300 lbs.After that relationship ended I lost the weight and dropped to 240 and I moved to AZ where and lost another 30 pounds.That was last year.I since then moved back to Washington State and I'm back up to 300 pounds again.I wake up at 5am to take my new wife to work, I then sleep for 1.5 hrs then take the kids to day care at 8:30.I come home get ready for work then go to work at 9:30.I have lunch at work (I sit all day at work) then go home at 6:00pm and bed time by 9:30.I also have split days off.I thought I'd start the whole exercise thing.I was very unmodivated but I did anyway. One month later and I've gained more weight. I'm so frustrated &I'm even more unmodivated.I do not want this weight anymore and if I could I would cut these pounds away my self with a knife.So all you skinnies out there that know how its done, tell me the secret to slim.

[sy2502]

Purplebird45 I can't speak for others, but I didn't intend to be cruel or mean, I meant to set the record straight, that's all. I think it is more cruel to tell obese people that obesity is not their fault, because they will give up their personal responsibility in the matter, and that won't make them any thinner.
imadr2 is right, many obese people have no idea of what a healthy lifestyle is, they grew up eating in a certain way, and believe that's how everybody eats, except they are the poor unlucky ones with the bad fat genes. If instead of these defeatist articles we had more instructive ones, that make big people understand that proper nutrition is not a diet you get on or off, but something that should be your normal way of eating, I think it would be of greater help.
Baye13 mentioned that overeating can be the result of emotional issues. Why not taking care of those issues, instead of sitting back and waiting for a pill that will fix your bad genes?

[purplebird45]

Wow! I'm saddened by all the horrible comments about people who are overweight. So far there are more negative comments about the article and obese people than positive ones. This country has an obesity epidemic which in the long run winds up costing EVERYONE (increased health insurance premiums, etc.) I'm shocked that everyone isn't supportive of trying to find a solution. Rather, most people would rather say mean and cruel things. It shouldn't matter why people are obese (genes vs. no self-control). What's important is that the epidemic is stopped or at least under control. I agree 100% with the post from timothyone made on 11-28-06 at 7:59 am.

[siddin-2009]

"I am sorry if the overweight people out there think that the slim people are slim just by their nature, but that is true only for a handful of them. The rest of us watches what we eat constantly and exercises constantly."

Well, that is one of my problems, I can eat all day, do absolutely nothing and still not gain more than 5lbs a month... Most would think this is a good thing, but when you can't maintain what the doctors say would be an ideal weight for height and age, it does get very frustrating.

[Jasonian18]

now a lot of these posts are really wrong alot of obesity is due to genetics but can be helped with dieting and exorcise but there is a portion of obese people who are not genetically set for obesity these are the people of the which is becoming a larger majority regarding obese people as for obese people this also applies to skinny people some of which are genetically fit for skinny bodies and not having a healthy diets i know 4 guys personally that eat literally 3 times as much as i do and 100 times less healthy and they appear unhealthily skinny whereas i am comfortably obese (openly 50 or so pounds over my goal for healthy life)

[imadr2]

Dr. Liebel is wrong. He just tells obese people what they want to hear, and thus attracts more patients that will support his practice. He is giving them excuses to fail.

Obese people generally have absolutely no concept of what a healthy lifestyle is. Most have been stuck in their nonhealthy lifestyle since early childhood. They have to be reconditioned and taught to change their entire lifestyle wrt eating, activity and exercise. It is a major makeover and usually not done alone.

Obesity is NOT genetic (only very very rarely). Watch the show "The Biggest Loser." By changing old habits people lose weight - A LOT. If obesity were truly genetic this simply could not happen.

[jmann27273]

'As for Hill, "I think for me, I finally decided in order to lose weight and to maintain an ideal weight it's something that I have to be conscious and aware of every single day," she says.'
OK Miss Hill, now THAT is what is called self-discipline! Congratulations! The rest of you who are obese, and refuse to admit it is because you are undisciplined, you have yet one more excuse to blame it on...your genes. Yeah, right.

[baye13]

I also had issues with this story. While I was growing up I was thin. When I hit high school I was for a short time 15 to 20 lbs. over my normal weight. I have lost then gained. Now that I am over 30 it seems harder to loose. I wouldn't say I was lazy but for some it is tougher for some to loose then others. I agree once you are 100 to 400 lbs over your proper weight then there is a problem you yourself have created.
I don't think "scientist" should use the "It's no use you were born fat" excuse why this country is overweight.

Granted there are people with emotional problems like depression. Food is seen as a drug.
But that's another problem.

[sy2502]

I am sorry if the overweight people out there think that the slim people are slim just by their nature, but that is true only for a handful of them. The rest of us watches what we eat constantly and exercises constantly. We stop eating while we are still hungry, we don't snack as often as we wish, we pass on tasty foods, and we drag ourselves to the gym even when we would love to sit on the couch instead. I have friends that are seriously overweight, and they eat twice as much as me! Honestly, try to be around slim people more often and compare their lifestyle with yours! Compare what you eat with what they eat. Compare their level of activity with theirs. You'll see there is no magic in staying slim, just a lot of hard work and self-control. The problem is that many think that you can eat everything you want and then be on a diet for a bit and everything will be ok. Slim people don't go on diets, they stay on what you call a diet for life. They don't call it diet, they call it healthy lifestyle, and it is hard, and requires a lot of work.
I personally think this kind of articles are very negative, because they relieve people from the burden of taking responsibility for themselves. You may not be genetically wired to weight 90lbs, but when you get to 200 or 300lbs, you need to acknowledge that you brought it onto yourself.

[lonestartnow]

Maybe it's about willpower, wiring--and the food industry. There are always exceptions, but for the most part, the obesity epidemic ties closely to the introduction of high fructose corn syrup (HFCS) roughly 30 years ago. So does the 1000 percent increase in Type 2 diabetes over the last 30 years. consider that HFCS is produced from genetically modified corn. Instead of going through the normal digestive process, it goes directly to your liver. It's cheaper to produce, is sweeter than sugar, and higher in calories. It tricks your body into metabolizing food more slowly, leading to weight gain because it doesn't send the "fullness signal" to the brain that natural foods and real sugars do. And it's in more foods than one would expect: baby food, soda, fruit juice, sport drinks, yogurt, bread, cereal, syrup, honey blends, some chips, ketchup, salad dressing, steak sauce, tomato sauce, soup, cottage cheese, sour cream, mayonnaise--and that's just for starters.

[nictsiz]

Cytos Biotechnology stopped a Phase I/IIa clinical trial of an anti-ghrelin vaccine due to negative efficacy results on primary endpoints concerning weight loss. Seems that the panacea of biopharmaceuticals isn't here yet.

[jetlizhan]

Sorry folks, but what you put in your pie hole makes you look the way you do - too much food = fat; too little food = thin

Eat, drink & be merry - 'tis the season. America is going to anyway, right?

[timothyone-2009]

If it were simply a matter of self-control 98% of Americans would weight 400 lbs. We spend too much, smoke too much, sit too much, sleep too much, (when possible) drive too much, (and too fast) we want *** too much, we simply overdo everything we enjoy. It is for biological reasons that only some of us get fat from satisfying our hunger for food.
People who blame fat people are the one's with the real problem. These folks have a (sick?) need to find reason to feel superior to others, usually to compensate for feelings of inferiority and self-hate. To them I say, please feel free to hate yourselves folks, and leave those of us with this fat problem alone.

[alaskalady-2009]

Like many things, obesity is complicated. Just anecdotal evidence, but I know from experience that for over 50 of my 64 years, my appetite has been out of control, despite some times of serious effort. Attempts at dieting, while successful for a time, seemed to trigger emotions and hungers which almost guaranteed a relapse. Because of that, I can identify with the idea of the effect of leptin.

HOWEVER, I believe that appetite can be trained. In the past year, I have lost 50 pounds. I am eating differently, drinking water, taking supplements, doing more physical activity, and am part of several support groups. The difference this time is that I am not focused on the point that "I am off my diet so I can eat again." I have begun to recognize "full" and also to know the difference between hunger and thirst. I do think this will be permanent this time.

IN SPITE of the fact that I have done it without medications, the possibility of leptin therapy is very exciting. It would have helped me get started much sooner. I think it would benefit many people who have struggled with appetite and control.

[little lions]

i have to say, this is not exactly good news. i am overweight, have been since i was two, but to hear that weight might be uncontrollale...it think it would be better for scientists to find a type of behavior modifacation that has lasting results.

[butterflync]

Oh boy...here we go. Yes, we love to sensationalize stories that make everyone out there feel better about how fat they are. Because, of course, it couldn't POSSIBLY be that maybe we are eating the wrong things, making bad food choices, not exercizing enough. How fortunate for us that these scientists how found "genes" that are not only fat genes, but also give us a lack of willpower. Hmmm....maybe the next time I feel a slight lack of motivation of the job, I'll let me boss know that it isn't my lack of willpower...I've got a lazy gene that is keeping me from making my deadline!

[butterflync]

Oh boy...here we go. Yes, we love to sensationalize stories that make everyone out there feel better about how fat they are. Because, of course, it couldn't POSSIBLY be that maybe we are eating the wrong things, making bad food choices, not exercizing enough. How fortunate for us that these scientists how found "genes" that are not only fat genes, but also give us a lack of willpower. Hmmm....maybe the next time I feel a slight lack of motivation of the job, I'll let me boss know that it isn't my lack of willpower...I've got a lazy gene that is keeping me from making my deadline!