Although in small proportions, obesity has always existed in almost all societies. Now, however, the huge increase in the number of overweight or obese people has led to one of the most important health problems in the world.
But why does this happen, and what are the causes that lead people to eat far in excess of their needs?
There are multiple influencing factors, classified as genetic, personal and environmental. Of these, the hereditary factor is partly attributed to non-hereditary personal factors and social aspects.
From the 60s and 70s of the last century, and in relation to the rapid increase in cases of overweight and obesity, the first medical explanations were the obvious ones, i.e., if these situations are caused by an increase in body fat, this is the consequence of eating more than necessary to maintain energy reserves.
Then, the solution is to restrict the access of calories in the diet and, at the same time, to increase caloric expenditure through physical activity.
The explanation is true, but it leaves out other factors, those related to genetics and personal and social lifestyle. Since then, in countries such as Spain, the spread of “balanced hypocaloric diets” of 1000 kc, 1200 kc, 1500 kc or more began, and this approach, with small variations, is still maintained.
But instead of improving, the situation has not stopped getting worse and there are no signs of change. Heredity plays a role in favoring the distribution and accumulation of fat but also in transmitting to the children the paternal eating habits and their own behavior patterns.
Other personal endocrine-metabolic factors may have a small influence on its appearance, menopause, etc.
Advances have been made in genetic studies but we are far from determining most of the genes that cause obesity; it is quite possible that obesity is the result of genetic and non-genetic interactions, the latter being determinant.
Neuroendocrine causes have been evaluated since the discovery at the end of the last century of substances such as leptins, ghrelins, adiponectins and others produced in the adipose tissue that act as mediators in the appetite regulation system.
Nor have good results been achieved in reducing appetite in obese people. Social aspects are fundamental to understanding the progression of obesity. The lower the educational and economic levels, the greater the dependence of obese people on fast and cheap food.
For example, the economic cost of sweets, corn and soy is low and these are important sources of sugar and fat in processed foods, being cheaper than vegetables and fish.
Intense advertising of sweet and fast foods has also determined many bad dietary habits. The increase in less active lifestyles while commuting and working is another important aspect.
Long hours in front of a computer occupy the working hours of millions of people, whereas previously more physical work was performed. The great expansion of the megacities produces a parallel growth in the obesity rate.
As can be seen, the causes of fatness are very complex and are largely due to environmental, social and cultural aspects.
And all these factors ultimately influence what is known as food addiction.
The current way of life generates intense stressful situations that produce many alterations in the organism. In the case of obesity, anxiety is reduced by eating, deriving to a severe form of drug addiction as similar and powerful as those of tobacco, alcohol and other more or less prohibited drugs.
For this reason, reducing to a conventional hypocaloric diet in such conflictive situations rarely has a good result. This is also why, for many years, these diets have been combined with appetite suppressants at brain level with irregular results, because they reduced “emotional hunger” but also produced other clinical problems.
Today, protein vegetable diets are used, which have good results and in recent years have had a great increase.
But, as we can see, the situation is very complex and affects the whole society; a general change of habits and trends is needed.