Why do people struggle to lose weight? Why are obesity rates increasing and why can’t any diet seem to stop this trend? In this article I debate the obesity pandemic and how this has been reinforced by scientific misinformation and I suggest solutions to promote fitness and health among the public.
In today’s world, obesity is normality. Yet, we are living through a silent pandemic. Just a few decades ago, obesity rates were virtually non-existent when compared with today’s numbers. The pandemic may be silent – as there is not enough discussion on this topic – but it is also visible. There is no “asymptomatic” obesity, as can be the case for COVID-19. Being overweight, and particularly being obese, has tremendous health consequences with huge costs for national health systems.
Most people think that being skinny, overweight, or obese is written in our genes. “How can you eat so much and stay skinny?”, “I eat very little but can’t lose weight”. We keep hearing this. The fact is that despite what most people think, being skinny, overweight, or obese has relatively little to do with our genetics.
Let’s be clear on this point: our genes do play a relevant role (as well as many other factors). Many aspects of obesity have not yet been clarified, but it is clear that genetics determines how much a person is prone to gaining muscle or fat (1), where fat tends to be stored (2), or the susceptibility to obesity (3). Though what matters the most is how many calories are consumed and over what timeframe. Ultimately, genetic differences are associated with our food habits and preferences (4), which implicitly suggests these can generally be overridden with willpower. Even though you may have more appetite, you can still choose not to overeat.
Calories in versus calories out. If you consume more calories than you require, you gain weight. If you burn more calories than you consume, you lose weight. The quality of this weight – be it fat or muscle, depends on several factors: your genetics, the distribution of macronutrients in your diet, how much you move and your training regime. Despite this, weight is for the most part the net result of eating and lifestyle habits.
The concept of calorie balance is simple to understand. Why, then, does it seem so complicated for people to understand?
The answer is scientific misinformation. As the World Health Organization’s (WHO) Director-General Tedros Adhanom Ghebreyesus defined it last year, we are living through an “infodemic”. The modern era is characterized by the overwhelming spread of scientific information online, much of which is imprecise, incorrect, or completely manipulated. People find it hard to distinguish real from fake information. I discussed this problem in the context of vaccine misinformation, but this also applies to obesity and diets.
Given the growing numbers of overweight and obese individuals, the fitness industry is literally exploding. In addition to the myriad websites talking about diets and fitness, most of which are not reputable, fitness gurus are now gathering on social media, such as Instagram, Facebook, Twitter and Tik Tok. These fitness “influencers” and models (see video below), with often unattainable physiques, dispense “knowledge” about training and diets, while selling their dubious supplements and programs.
Most of these people have no degree or qualification to operate in this sector, but they have something many other people value: many followers, and a muscular or bikini physique. It doesn’t matter that drugs such as steroids are often unnaturally inflating the biceps or butts of male and female influencers, while also reducing their body fat to naturally unattainable levels. These people often suggest their followers to eat junk food and deny that they take steroids. The “fake-natty” infodemic is a real thing. Most people do not realize the truth and think these physiques are what they should strive for. They think these bodies are the paragon of health, instead they are often rotten cages waiting for injuries and diseases.
In order to make more money, these gurus need the average person, slightly overweight and with smaller muscles, to try a new diet, buy their program, lose some weight, and bounce back, only to start a new one a couple of months later. This strategy, which I call the “strategy of repeated failure” is in fact extremely profitable for them.
Unsurprisingly a large number of diets exist: intermittent fasting, the keto diet, the carnivore diet. Take away the carbs, pump up the “healthy” fats, go without sugars, etc. Many different strategies that, most of the times, culminate in a common result: failure. And they ultimately fail for the same reason: at some point, calories in outcompetes calories out. Even when these diets are initially successful, they often require people to undergo extreme changes in their lifestyle, which are not sustainable in the long-term. For those wondering, evidence says a long-term approach, with a small (sustainable) daily calorie deficit (5) is all a person needs to successfully lose weight, regardless of the type of diet one follows.
The social media jokers (or influencers) know the truth too well. And they keep selling you something new. People go for what seems easiest for them – such as taking a weight loss supplement and following false promises. Luckily, there are also informed professionals out there, but for many people it is difficult to understand who’s the cheat and who’s the expert.
Scientific misinformation on these topics is dramatic and needs to be immediately considered a global health emergency, alongside COVID-19. People should be given the chance to discern the experts from the charlatans.
Instead of using click-bait titles to articles describing revolutionary new diets, well-established and considered news media outlets should begin hiring scientific journalists that can successfully explain basic concepts of dieting and fitness to a broad public, even if those concepts are not sexy.
And beauty and fashion magazines, which have for decades promoted unhealthy images of anorexic, cocaine-addicted models, or steroid-boosted alpha males, should not begin to spread the opposite message just to avoid mainstream social critiques and favor their businesses.
Putting an obese model on the front page of a fitness or fashion magazine claiming “this is healthy” does not undo the damage that was done for years at the societal level. Rather, it causes more.
Finding strategies to halt the spread of misinformation is extremely challenging, and everybody should make an effort: scientists – even those working on the genetics of obesity – should remind people of what is at the bottom of the pyramid (the calorie balance); social media should find ways to limit the reach of influencers with no proper education in health and fitness; magazines and news media outlets should promote healthy lifestyles. But first and foremost, we should all recognize the dangers posed by the “infodemic”, highlighting the sensitive and moral role information providers have in shaping global health.
- Bouchard, C., “Current understanding of the etiology of obesity: genetic and nongenetic factors”, The American Journal of Clinical Nutrition, 1991.
- Schleinitz, D., “The genetics of fat distribution”, Diabetologia, 2014.
- den Hoed, M., et al. “Genetic Susceptibility to Obesity and Related Traits in Childhood and Adolescence”, Diabetes, 2010.
- Loos R.J.F., “The bigger picture of FTO – the first GWAS-identified obesity gene”, Nature Reviews Endocrinology, 2013.
- Aragon A.A., et al. “International society of sports nutrition position stand: diets and body composition”, J Int Soc Sports Nutr., 2017.