One thing has been clear to me for a long time: obesity and super-obesity have many different causes, and there is no one-size-fits-all solution that will “fix” those who suffer from these conditions (and I do mean suffer – except for Sumo wrestlers and the occasional actor preparing for a role, no-one genuinely chooses to be super-obese).
One of those causes has, for me, been self-evident. It’s an abnormally low normal body temperature. Finally, it looks as though research is beginning to provide evidence-based support for that idea.
The investigation has been undertaken using dogs for now, but a comparison between weight and body temperature has shown (among other things) an inverse correlation between the two (i.e., the lower the body temperature, the higher the weight).
Science Digest shows a summary here:
and the International Journal of Obesity published the paper here:
It amazes me that this aspect hasn’t been investigated long ago. One of the things you learn when studying clinical chemistry is that temperature can control the direction in which metabolic processes take place; conduct the process at one temperature and A→B, but conduct it at another (usually lower) temperature and the process is driven in the opposite direction (A←B).
This also gives the lie to the idea that a calorie is a calorie is a calorie and that obesity results solely from taking in more calories than you need. If your metabolism is out of whack because your body temperature is awry, it’s entirely possible for the emphasis to change – from giving highest priority to immediate energy needs and lower priority to fat deposition, to a priority that puts fat deposition as the main priority and immediate energy needs much lower down the list.
That would mean that two individuals with exactly the same lifestyle, the same apparent caloric needs and the same intake would experience totally different results. One would have a “normal” weight while the other would become obese – and not understand why.
Abnormal “normal” clinical values are well-known. For example, the normal resting heart rate is around 70 beats per minute (bpm). I once worked with someone whose normal resting heart rate was 45 bpm. He wasn’t super-fit, it was just the way his system operated. If he exercised vigorously his rate would struggle to reach 70 bpm. For a so-called “normal” person this would result in a diagnosis of bradycardia. How different can the values get? Competitive cyclists can obtain resting heart rates as low as 28 bpm.
I know someone who has been suffering from super-obesity pretty much all their life. Their normal body temperature, instead of being around 98.6° Fahrenheit, lies between 94.6° F and 96.4° F.
A lower temperature implies a different metabolism, whether it’s in a dog or a human being.
Once the pattern is identified, the next step is to try to discover why the body temperature is so low. One possible cause is a genetic difference. Another is a mitochondrial defect. Yet another might be an environmental factor (a toxin of some kind).
And yet another – and in my view, probably one that’s quite prevalent, given the subjective histories I’ve encountered – is the possibility that the individual has contracted an infection earlier in life, one that marked a change in their physiology from that point on.
The infection could have been ostensibly bacterial but the underlying agent might have been viral (the two have been known to travel together, one inside the other), and the virus could have been the key agent, altering either cellular or mitochondrial genetic code in such a way that the human host was afflicted with severe obesity that resisted attempts to control it.
Such a condition could be masked by other factors – even eating disorders on top of emotional issues – making the correct diagnosis difficult to achieve.
I hope I can look forward to the time when the underlying causes of severe obesity (i.e., gaining more than 100 lbs) are properly identified and treated, and the stigma currently experienced by sufferers fades into history.
I say “I hope” simply because the world doesn’t always take on board modern knowledge (look at the farcical situation with regard to the teaching of Evolution, for example; by now it should be accepted as fact and the discussion should center on the discovery of the different mechanisms).
There was a time, centuries ago, when epilepsy was believed to be possession by demons. The treatments were often really bizarre: being thrown into a pig sty was popular at one time (the idea was that demons wouldn’t be able to stand the conditions and would leave the human host).
Luckily for today’s epileptics we’ve learned a great deal since then. Or have we? In Tanzania they still believe epilepsy is caused by demon possession. Maybe it will take an equally long time to accept that severe obesity is not simply caused by stuffing your face…