Causes of Obesity

In scientific terms, obesity occurs when a person's calorie intake exceeds the amount of energy he or she burns. What causes this imbalance between consuming and burning calories is unclear. Evidence suggests that obesity often has more than one cause. Genetic, environmental, psychological, and other factors all may play a part.

Obesity tends to run in families, suggesting that it may have a genetic cause. However, family members share not only genes but also diet and lifestyle habits that may contribute to obesity. Separating these lifestyle factors from genetic ones is often difficult. Still, growing evidence points to heredity as a strong determining factor of obesity. In one study, of adults who were adopted as children, researchers found that the subjects' adult weights were closer to their biological parents' weights than their adoptive parents'. The environment provided by the adoptive family apparently had less influence on the development of obesity than the person's genetic makeup.

Nevertheless, people who feel that their genes have doomed them to a lifetime of obesity should take heart. Many people genetically predisposed to obesity do not become obese or manage to lose weight and keep it off.

Although genes are an important factor in many cases of obesity, a person's environment also plays a significant part. Environment includes lifestyle behaviors such as what a person eats and how active he or she is. Americans tend to have high-fat diets, often putting taste and convenience ahead of nutritional content when choosing meals. Most Americans also don't get enough exercise.

People can't change their genetic makeup, of course, but they can change what they eat and how active they are. Some people have been able to lose weight and keep it off by:

Learning how to choose more nutritious meals that are lower in fat.

Learning to recognize environmental cues (such as enticing smells) that may make them want to eat when they are not hungry.

Becoming more physically active.

Psychological factors also may influence eating habits. Many people eat in response to negative emotions such as boredom, sadness, or anger.

While most overweight people have no more psychological disturbance than normal weight people, about 30 percent of the people who seek treatment for serious weight problems have difficulties with binge eating. During a binge eating episode, people eat large amounts of food while feeling they can't control how much they are eating. Those with the most severe binge eating problems are considered to have binge eating disorder. These people may have more difficulty losing weight and keeping the weight off than people without binge eating problems. Some will need special help, such as counseling or medication, to control their binge eating before they can successfully manage their weight.

Some rare illnesses can cause obesity. These include hypothyroidism, Cushing's syndrome, depression, and certain neurologic problems that can lead to overeating. Certain drugs, such as steroids and some antidepressants, may cause excessive weight gain. A doctor can determine if a patient has any of these conditions, which are believed to be responsible for only about one percent of all cases of obesity.



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