Understanding Why Obesity is a Chronic Disease

Dr. Alexandro Zarruk, MD, MSc., FACP, FRCPC, Internal Medicine, explains what body systems break down when a person has obesity.

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Dr. Alexandro Zarruk, MD, MSc., FACP, FRCPC, Internal Medicine, explains what body systems break down when a person has obesity.
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Featuring Dr. Alexandro Zarruk, MD, MSc., FACP, FRCPC, Internal Medicine

Duration: 3 minutes, 58 seconds

Obesity is a chronic disease. 2015 was the year where the Canadian Medical Association recognized obesity as a chronic disease. For decades, obesity was recognized as a risk factor to develop other complications such as diabetes and hypertension.

It is an entity on its own, and it’s a chronic disease, because we all know—and everybody that’s tried dieting or losing weight does know that the battle is lifelong. Once we suffer from obesity, we have dis-regulation of several hormones, or even the neurobiology is modified.

For a long time obesity was regarded as being a lack of motivation. We now know that there are genetic factors involved, there is neurobiology involved, and there are hormonal factors that are implicated in weight management. Let me explain. Our adipose tissue actually secretes a hormone called lectin. Lectin goes to our brain to tell our brain we have enough storage.

Well, when we suffer from obesity, and we live with obesity, that signaling is lost. There’s a hormone secreted by our gut called the GLP-1, secreted after we eat, to tell our brain we just ate, we just had a caloric intake, so you can stop eating. It’s called satiety, satiety signaling. Well when we suffer from obesity, that signaling is also dampened. So now imagine: you’re trying to lose weight. You’re trying to control your caloric intake. And the two main signaling are dampened in your brain.

This being said, there is a concept of setpoint that I wanted to bring up. The concept of setpoint is important because it finally explains the weight rebound. Everybody that loses weight on a diet re-gains their weight. Sometimes very quickly, sometimes over years. But the reason is the setpoint theory.

Let me explain. When we lose weight, we also lose muscle mass. And muscle mass is very important for our basal metabolic rate. If we lose muscle mass, we lose basal metabolic rate, which kind of limits our calorie burn at rest. So we tend to re-gain weight.

Not only that, there’s also hormonal adaptation. I told you about a hormone secreted by the gut that is used for signaling in our brain to tell us we just had a caloric intake. Well, when we lose our weight, we lose that signaling. Imagine that? Even less. We’re already resistant to that satiety signaling, okay, that fullness feeling. And now we have less signalization to our brain.

Not only that, there’s a hormone called ghrelin secreted at the level of the stomach, that actually increases appetite. Well, guess what? When we lose weight it increases. So we have our defense mechanism is to make sure that we don’t die from starvation. So if we lose weight, as soon as there’s going to be food around we’re going to be able to re-gain our weight.

If you’re looking for more information on obesity and how to help with weight management, ask your family doctor, ask a specialist. You need a multidisciplinary approach: dietitian, kinesiologist, personal trainer even, to make sure that there are agents, medication to help you also if you suffer and you live with obesity.

Presenter: Dr. Alexandro Zarruk, Family Doctor, Pierrefonds, QC

Local Practitioners: Family Doctor

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.