The Five Riddles – Portsmouth Daily Times
It’s time to go through the 5 puzzles. It’s been a long time. The mysteries of obesity can be organized into my 5 riddles. I don’t have the answer to these riddles, but when we do, it will provide an understanding of this problem that may allow us to solve it. All of the fat science columns can each be organized under one of these riddles or the 6th riddle, which is why we continue to emphasize diet and exercise when it has proven to be so useless.
Riddle 1. Weight, like height, is very genetic. It runs in families. So how could there be an obesity epidemic in less than a generation? It takes several generations to modify the genetics of a population. Studies have shown very conclusively that obesity is 80% explained by your genes. But it’s probably 100%. If you are very obese and everyone else in your family is skinny, then you must be a mutant or adopted.
This riddle is about other things. We have also all grown taller than our parents, but it seems that we have grown bigger than taller. There is also an epidemic of asthma and allergies in less than a generation. Intelligence is very genetically endowed, but today’s children turn out to be much smarter than 100 years ago. The answer is therefore that obesity is genetic and conversely environmental. This is not an understandable answer. There’s a thing called epigenetics that can happen to a parent and then be passed on to children that we’ve been discussing, but I don’t think that entirely solves that conundrum either.
2. Why does biology seem to defy the first law of thermodynamics that energy can neither be created nor destroyed? Every calorie you consume has to go somewhere. Studies have shown that mice and humans, especially humans who have dieted to lose weight, become and remain obese with the same number of calories that lean people eat.
3. There is a set point somewhere in your brain that controls your weight. People regain the same weight after becoming ill or pregnant or following a diet…. People stay at the same weight for many years in a row, even very obese people. Yet sometimes people get fat when they weren’t before. The set point is reset. How can you reset something that then resets?
4. Why does bowel obesity surgery work so well? It does not work by preventing you from eating or by preventing you from absorbing the calories you eat. If it worked like that, it wouldn’t work or it would kill you. Still, it causes you to reset your weight by about a third less.
5. Finally, why do we live longer and have fewer heart attacks, if we’re all getting fatter and it’s supposed to be so unhealthy? This question is not as simple as it seems at first sight, because we have also accomplished so much else – treatment of high blood pressure, cholesterol, type 2 diabetes, stents and coronary artery bypass surgery , increased exercise, less smoking – all of which resolved the heart attack. the epidemic to a large extent while the obesity epidemic has gotten much worse.
But perhaps this riddle is less enigmatic.
It should be easier to understand how obesity happens than to understand why the universe exists. There should be a hint here. All puzzle answers should fit together in some way. Are we getting closer?
John DiTraglia MD is a pediatrician in Portsmouth. He can be contacted by [email protected] or by phone-354-6605.