What causes obesity? Overeating or lack of activity?

While we all know both play a role in our obesity, it’s obvious to me that overeating is a lot more significant than lack of exercise.  The following is an email that I sent to a well known research scientist here in Columbia.


Dear Dr. —–

I saw an article on the State about your research into the cause of obesity.  I highly respect your world wide reputation on this topic.  But as a medical practitioner who has seen and treated close to 8000 obese patients, I thought the answer was pretty straightforward: I have never seen an individual who can lose weight by increasing exercise without dietary control.  But I have seen plenty of patients who go on a diet without added exercise and lose lots of weight.
I felt the US academic on obesity research has been missing the key point.  One other topic that receives lots of research is the genetic contribution to obesity.  I don’t think genetics plays any significant role in American obesity.  The reasons are clear:
  1. The obesity rate among the Americans is ~30% and that of the Europeans, 10-12%.
  2. Most, if not all, American caucasians immigrated to the US within the last 500 years.
  3. 500 years, in genetic evolution, like a drop of water in a bucket, are too short to cause a genetic mutation to spread to a significant proportion of a population.
  4. Moreover, if a genetic mutation(s) caused our obesity, why does it happen only the the Americans?
The conclusion from the above public domain info is clear: genetics doesn’t play much of a role in our obesity.
The causes of American obesity are well known and are multiple: overeating, slowed metabolism, lack of physical activity and imbalance of homeostasis.  The treatment should also be of a multi pronged approach.  That’s the approach that I have taken for the last couple of years and that’s why it’s EASY for me to help my patients to lose 20 lbs in a month and 50 lbs in 3 months (see a few examples here:http://www.drwlc.com/blog/?cat=14).  In my opinion, obesity treatment or the lack thereof, highlights the urgency why modern medicine needs to change how we think about disease and how we treat them.  Modern medicine has been quite successful in dealing with simple and single factor diseases such as infections.  But when it comes to multi-factor conditions such as obesity, hypertension, or diabetes, modern medicine has not made much advance in the past couple of decades.  Why?  The answer, in my view, is our approach is wrong.
For acadmic curiosity, I’d like to meet with you to exchange our experiences in this field.




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