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Over one-third of U.S. adults have obesity. Worldwide, more than one billion people are obese. This global epidemic has led to a significant increase in harmful health conditions such as Diabetes 2, cancer, obstructive sleep apnea, high blood pressure, joint and muscular disorders, strokes, and heart attacks. Additionally, the prevalence of childhood obesity in 2‐ to 17‐year‐olds in the United States has risen from 14.6 percent in 1999–2000 to 17.4 percent in 2013–2014. Childhood obesity generally leads to the early onset of comorbidities, and the increased likelihood of children with obesity going on to become obese adults (50 percent risk vs. 10 percent for children without obesity).

Even modest weight reduction may help obese individuals reduce their risk for ill health. A relatively small and simple reduction in weight, for example, of around 5 percent, can improve outcomes and may act as a catalyst for further change. There are psychological and biological factors that have been identified as contributing to obesity, and there are some proven ways to improve your relationship with food.

Emotional Eating

Obesity is a complex phenomenon influenced by various psychological factors. The concept of obesity refers to a pattern of compulsive, excessive, and uncontrolled consumption of certain foods. The psychological roots can be understood through several key factors.

Many individuals turn to food as a coping mechanism for dealing with negative emotions such as stress, sadness, or boredom. Eating certain foods can temporarily alleviate these emotional states by providing comfort and distraction. This association between food and emotional regulation can become deeply ingrained, leading to a reliance on food as a means of emotional coping.

Over time, individuals can develop conditioned responses to certain foods through associations formed between the food and environmental cues. Often, this kind of conditioning harks back to our childhood when motherly love was associated with food. When we feel unloved, lonely, or anxious, instead of turning to mother (who is absent) we turn to food, something that is easily available.

Individuals who have experienced emotional, physical, or sexual abuse, neglect, or other traumatic events may turn to food as a way to self-soothe or regain control. The consumption of fast foods high in calories, and low in nutritional values, can provide a temporary escape from distressing memories or emotions associated with trauma.

Chronic stress coupled with a high-calorie diet leads to overeating and increased cravings for sweet, palatable food, contributing to weight gain.

Additionally, factors such as personality traits, impulse control, and low self-esteem can contribute to the development and maintenance of overeating.

The Neurobiology of the Problem

Certain foods, particularly those high in sugar, fat, and salt activate the brain's reward system, releasing neurotransmitters like dopamine that create pleasurable sensations. Over time, repeated consumption of these foods leads to desensitization of the reward system, requiring larger quantities to achieve the same level of satisfaction.

Genetic Roots

Research suggests that some individuals may have a genetic predisposition that makes them more vulnerable to developing addictive-like patterns around food. If your parents or grandparents were overweight, your risk of following in their footsteps increases.

Weight Management Strategies

1. Drugs and Surgery

New weight loss drugs like Ozempic, Wegovy, and Moujaro are having their moment. A highly public ad campaign from one start-up, Ro, banks on the drug’s simple premise: “A weekly shot to lose weight.”

It is a fact that these drugs work, for as long as you take them. Apart from having to mortgage your home to afford them, they can cause serious side effects. The pharma company that manufactures Ozempic and Wegovy, lists their common side effects as nausea, vomiting, diarrhea, and constipation. More worrisome but less frequent are pancreatitis, vision changes, low blood sugar, kidney problems, allergic reactions, cholecystitis, thyroid tumors, and cancer.

2. Bariatric surgery

Essentially, this is gastric bypass surgery that shrinks the stomach to the size of a walnut. This and similar operations minimize the area in the gastrointestinal tract where calories can be absorbed and also provide a feeling of fullness.

Bariatric surgery costs about $15,000 to $25,000—not cheap, but still cheaper than forking out in excess of $1,000 indefinitely on the new weight loss drugs. Unfortunately, about one out of five people regain a significant amount of weight—15 percent or more—two to five years after surgery. According to the University of Pittsburgh Medical Center, the most common side effects associated with bariatric surgery include acid reflux, chronic nausea, vomiting, dilation of the esophagus, inability to eat certain foods, infection, obstruction of the stomach, and most surprisingly, weight gain or failure to lose weight. Long-term risks are dumping syndrome, a condition that can lead to symptoms like nausea and dizziness, low blood sugar, malnutrition, vomiting, ulcers, bowel obstruction, and hernias.

3. Shifting Your Mindset

• Engage in introspection. Think of the possible reasons you overeat, as described under emotional eating above.
• Embrace a positive body image. Focus on appreciating and respecting your body for what it can do, rather than fixating on perceived flaws.
• Practice self-compassion. Treat yourself with the same kindness and support you would offer to a friend facing similar challenges.
• You do not need to be perfect. No one is.
• Do not buy foods that you know feed the problem.
• Exercise. Walk, swim, garden, bike, whatever, but do it every day. No excuses.
• Focus on sustainable habits: Rather than adopting extreme diets, weight loss drugs, or surgery, concentrate on creating a balanced and reasonable approach to nutrition and exercise.
• Build a support system: Surround yourself with caring friends and family who share similar health goals.