Something in the concern

About a quarter of adults in the United Kingdom are overweight, or 25.9%, according to the Health Survey for England 2021. Another survey conducted in 2021 found that roughly 12% of Italian adults are overweight. Increased risk of cardiovascular disease, stroke, type 2 diabetes, and several forms of cancer makes these alarmingly high numbers all the more concerning.

Finding the cause of obesity is a prerequisite for addressing the problem. Speakers argued that focusing on the social and, more specifically, the physiological causes of obesity would give the issue more nuance and help challenge the notion that people who struggle with their weight are simply undisciplined.

The reasons for weight problems

Speaking on a panel at the Italian Embassy in London on Wednesday for the ‘Positive Nutrition’ event, Professor Paul Gately, CEO of the charity Obesity UK, emphasised the difficulty of discussing obesity. He stressed the importance of considering the social setting.

According to Gately, the context-dependent nature of the requirements is what causes the question to shift so frequently. “it’s complicated in a family situation, so for families living in central London, the rates of obesity are very different from families living on the West side of London in the more affluent neighbourhoods, and even within those families you have varying degrees of risk profile of obesity.

You can expand it from the local to the regional to the national and finally to the international level.

Overweight individuals benefit from having easier access to resources like health clubs, recreational activities, and information about how to improve their situation. Overwhelmingly, the 25,000-strong membership of Obesity UK believed they were lacking these resources, which prevented them from managing their weight effectively.

The physiological importance in influencing one’s inclination towards obesity adds another layer of complexity to the problem. Francesco Rubino, professor and chair of metabolic and bariatric surgery at King’s College London’s faculty of life sciences and medicine, argues that the causes of obesity are more intimately linked to physiological characteristics than is commonly believed.

Initially in his cosmetic surgical treatment career, Rubino had no interest in performing bariatric surgery (surgery that alters the digestive system to assist individuals reduce weight) since “I was persuaded that the method the surgical treatment works is by making the stomach smaller sized and requiring individuals to consume less to put it simply requiring a modification in behaviour, and I believed ‘you do not wish to do surg if you do not wish to do surg,'” he stated.

Instead, he found that the surgery had produced an unexpected but significant effect. According to him, the stomach regulates both appetite and sugar metabolism. In light of this, “when you alter the anatomy of that organ you have the most extensive medical effect on… weight problems.” According to Rubino, “the most sustainable weight reduction I’ve ever seen” occurred in patients who underwent this procedure.

Rubino emphasised that obesity is a medical issue, not a choice. The ability to maintain a healthy weight varies from person to person.


The panel discussion took place at the Italian embassy in London. Photograph by Altinosmanaj/Getty Images

Because of our limited understanding of how obesity develops physiologically, we mistakenly feel that we have complete command over our high body weight. Since the hypothalamus, the brain region in charge of regulating body weight, is located far further from the cortex than the cortex itself, you have very little leeway for consciously altering your body weight guideline.

The similar thing takes place during breathing. We breathe normally; you need not give it any thought.

Many other physiological factors contribute to the development of obesity.People who are overweight, according to Rubino’s suggestions, do not get a physical signal to stop eating when this has actually occurred, despite the fact that most people would get this signal after eating, after your gut sees the nutrients. This finding comes from a study that was just published 2 days ago in my field.

Weight problems and preconception

Gately has seen many obese people in his career who blame themselves for being overweight.

He argued that the perception that obesity is a moral failing on the part of the individual who struggles with it has contributed to an unfair stigma.Some of us still believe that those who struggle with obesity made a conscious decision to put on weight and that it is their own fault; we ask, “Why should they get the care of our health care system when they’ve chosen to be that method?”

Gately argued that people are less sympathetic towards obesity than they are towards other disorders that are affected by lifestyle choices.Surprisingly, given that a sizable percentage of malignancies are linked to lifestyle choices, they would never suggest cancer as a possibility.

We know that lifestyle-related factors contribute to cardiovascular disease, so we wouldn’t tell those who are already suffering from it, “well, that’s your choice because of lifestyle-related factors.”

Gately suggested that the causes of cancer and heart disease are similar to the causes of obesity: a combination of genetic predisposition and environmental and physiological factors. People who are overweight rarely receive the same level of sympathy as those who are suffering from cancer or heart disease.

Something about the obesity epidemic seems to capture people’s imaginations in a negative way, and I think that’s a major roadblock. I think this has to do with how we conceptualise obesity and the people who struggle with it.

I think we can make progress if we can overcome the stigma associated with people who are overweight and treat them as equals, deserving of the same high-quality care that patients of Francesco’s and other experts in our profession provide.

According to Gately, the personal experience he’s had in his charitable work has reinforced just how dangerous this misconception may be.People who are overweight or obese, as well as the children and families with whom I talk, often feel shame about the poor decisions they have made.

Why should we be surprised by that given the common narrative holds that the quality of the food available to you is low and your fault?

The same point was emphasised by Rubino. He explained that the widespread belief that it is possible to overcome obesity, no matter how severe, stems from two sources: first, a misunderstanding of the biological rule.

We polled four thousand people in the United Kingdom and found that those with the strongest preconceived notions were those who believed that changing one’s lifestyle would be enough to reverse obesity.

Those who are overweight face double the criticism: first, for gaining weight in the first place, and then for failing to take adequate action to correct the problem.

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