While some of medical fraternity insist that obesity needs to be classed as a disease, others are convinced it’s perpetuated by brain chemicals, some adamant that surgically altering our digestive system (bariatric surgery) is the only option, while others are still suggesting we reduce calories, despite a solid 95% failure rate, so it’s no wonder the public find this topic confusing!

I have been working in this field for over 30 years now and, for what it’s worth, I’d like to share my thoughts and experience. Having been on the ‘frontline’ for three decades, starting out as an overweight individual and working with countless overweight and obese individuals and witnessing thousands of triumphs and disappointments along the way, here are some of my insights.

Obesity is a complex issue with a myriad of contributing factors. Some individuals may have been exposed to one or more of the most common factors below, most of which need addressing as individual issues. While obesity is the common symptom, it is only the visible symptom of many underlying issues at play. Let’s start to unravel the complexity:

• Emotional/mental health issues

I have worked, and continue to work with many individuals with a vast range of mental health issues, ranging from ADHD and depression to anxiety and Asperger’s – all of which can impact our relationship with food.

• History of abuse (physical/emotional)

Associated chronic stress and commonly a sub-conscious need to feel ‘invisible’.

• Chronic stress, low self-confidence, grief, heightened emotions

Using food as a coping mechanism as have not yet learned other more effective methods of managing emotions.

• Insomnia, poor lifestyle habits, poor sleep

All elevating cortisol – resulting in insulin resistance, triggering excessive hunger, cravings and uncontrolled weight gain.

• Microbiome / food sensitivities

Our microbiome environment can have a significant impact on our ability to regulate weight and our physical and mental health.

• Inflammation

Systemic inflammation can initiate many biological conditions that impact weight.

• Mindlessness

Not being ‘present’, mindless behaviour around food.

• Poor education around food

Poor awareness and knowledge of the impact of foods on health and weight.

• Inactivity

Sedentary job, general inactivity, injuries or illness

• Poor time management

Lacking skills to make time for activity and food preparation, eating at the wrong times, eating out/take away food options, etc.

• Poor cooking skills

Boredom with lack of food variety, reliance on fast foods

• Nutrient deficiencies

Several nutrient deficiencies can impact our behaviour and energy levels, decreasing motivation and physical activity.

• Lack of support/peer pressure

Unsupportive environment, peer pressure amongst work, social groups and/or family. Being emersed in a culture of poor habits.

• Sarcopenia

Loss of lean muscle tissue (inactivity and aging), reducing metabolic function and exacerbating insulin resistance.

• Hormone imbalances

Stored body fat is part of our endocrine (hormone) system, so has an influence on other hormones, such as estrogen, testosterone, insulin and thyroid.

• Medications

Some medications can exacerbate insulin resistance and perpetuate weight gain, including cortisone-based drugs, statins, some anti-depressants and HRT.

• Disordered eating

Often in combination with one or more of the above

As you can now understand, with so many contributing factors, one size does not fit all. It’s imperative to first identify the underlying issues, emotional and biological, and work on a structured, progressive, supportive, and long-term approach. Note that none of the above list a stomach being too large, a pharmaceutical deficiency or an issue of consuming too much dietary fat as the primary cause!

I have always found that educating people on the underlying issues is not only a great relief for many, it’s also empowering, as it removes the stigma and judgement they may have endured.

In my experience, it’s too simplistic to label obesity itself as a disease – it’s one of many symptoms of other, often seemingly unrelated, and unidentified issues. Once a person is provided with the opportunity to understand their condition, it’s the first step to finding the right path for a permanent solution.