I have to admit I've been bad at keeping track of BBC's science documentary show, "Horizon" this year, which is a shame as the previous series was excellent. That said it was on in the background yesterday and I found myself been quite drawn into it.
The show was presented by Gabriel Weston, a surgeon who feels obesity is the biggest health concern in the developed world. Like myself, she went into the documentary with the opinion that obesity was more of a choice than some inescapable "condition". There was quite a bit of evidence in the episode that suggested once obese you had the odds stacked against you. For example obese people have "hungry" and "full" hormones that never seem to peak like in "normal" people meaning they may always feel slightly hungry and never full. I did take slight issue with these findings though as they assumed that obese people always had these unbalanced hormones and that it caused the obesity. Surely a counter argument is that the hormone imbalance could be a result of very unhealthy eating? This seems like something that could be tested relatively easily by looking at people on the path to full on obesity or by seeing whether a Fat person losing a lot of weight can get the hormone balance back to normal.
Another interesting finding was the "identical twin" studies. In most cases identical twins seem to be very similar in weight but it's very hard to separate nature and nurture. However, they had 20 cases of identical twins that had very different weights/eating habits suggesting it's not all genetics. This was quite interesting but again there was a suggestion that life events could actually have an effect. What struck me was that all the polarised twins were female, which could be "random" or could suggest these differences were female specific. I'd be interested to know whether having had children had an effect.
There were several other interesting observations such as the environment in the room has a striking effect on your weight later in life. This seemed to be something that could partly explain the massive upswing in obesity and could potentially help in future.
The final segment was about gastric bypasses. I have to admit I tended to pass them off as pointless because i feel if you're too lazy to diet you probably wouldn't see the benefit. Turns out that was a very small-minded view as the gastric bypass seems to cut off the negative signals to the brain resulting in the patient not only being physically unable to eat as much, but mentally feeling that way too. Now if there was a way to find a drug/injection that could give the same results without an invasive and expensive operation, I think we could be onto something.
So I think the take home message is that obesity is a complicated thing. We probably need to stop thinking of it as just one thing if we want to tackle it properly. The show did a good job at showing this although it really only scratched the surface. For example there was very little on the actual diet itself - I'm sure that many of the foodstuffs may in of themselves lead to these hormone imbalances. The effect of exercise was largely ignored too and was only really mentioned in the sense you couldn't exercise to constantly gain muscle mass alone. There's also the question of whether we should even have the right to tell people not to be obese - in many cases people are simply happy with the size they are. If they want to be that size (and it's stable) then maybe that's more important? That said the show was only an hour in length. Hopefully Gabriel will try and tackle some of these other issues in a follow up some time.
As a personal inspiration for a healthier lifestyle, the show failed as before the end of it, I felt an uncontrollable urge to eat a jam donut (which the show had essentially branded as evil) and I enjoyed every last bit of it - particularly the licking of the sugar off my fingers at the end!