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– Let me
introduce you to Amanda. You’re just meeting her for the first timebut chances are you’re
already making assumptionsabout how much she eats and
how little she exercisesbecause she’s obese. But I’m about to show youthat there’s much more than meets the eyeswhen it comes to obesity. There are lots of Amanda’s out thereand they need treatment. Maybe you’re one of them or
maybe you know an Amanda. It’s time to act on obesity. But in order to do so effectively,we need to understand obesity. It’s generally accepted that body weightis determined by a pretty simple formula. We call it the energy balance equationand it works like this. If the number of calories that you consumeequals the number of
calories that you burn,your weight remains the same. If you consume more than you burn,you gain weight. And if you burn more than you consume,you lose weight. Most people think that those of uswho properly manage our
energy balance remain lean. Whereas those of us like Amandawho eat too much and exercise too littlebecome obese. We view obesity as a lifestyle choiceand the cure for it is simple,eat less and exercise more. This may sound logicalbut it’s wrong. Let me explain. First, let’s talk about set point. No, I’m not talking about
the point in a tennis matchwhen one player is
about to beat the other. I’m talking about a theory that saysthat no matter what you consciously wantyour weight to be, your
brain has its own senseof how much body fat it
should have on board. And it has a complex system in placethat very precisely regulatesyour energy intake and expenditureto keep you within a so-calledset point range for body fat. So that whole energy balance equation,it’s not something that
you control voluntarily. Your brain regulates your calories into your calories out for you. For your brain to do this,it needs to know how much energyyou have on board at all times,and it knows this by listeningto hormones like leptin,which is made in your body fat. You can think of it like a car. Leptin is the gas gauge
that tells your brainhow much gas is in your tank. But leptin is just one
piece of the puzzle. You’ve got a whole bunchof other hormonal signals and sensesthat are involved too. Your bones, muscles, pancreas,liver, GI tract and sensory organs,they all play a role,communicating with your brainto give it the informationit needs to do its job. But that’s more detailed than we needfor this conversion. The point is that you havea complex system in
place that regulates youto within a set point range for body fat. So what happens if Amanda decidesto lose weight by going on a diet. After all, people with obesityshould eat less, right?Here’s what happens. She loses weight but her
hormone levels change. Her brain hears this, and it starts actingto restore whatever body fat she’s lost. She feels hungrier,and although she doesn’t know it,she is also burning fewer
calories than before. You see set point is usuallya one-way street. Once it’s been elevatedthe brain works to defend it,just as vigorously as it woulda lower set point. Amanda’s brain doesn’t knowthat she needs to lose weight. It only knows to defend
her current set point. Back to our car analogy. Amanda can’t help but look
for a gas station to refuelwhen she sees that her gas gauge is low. At the same time she
becomes more fuel-efficientburning less energy than before. This might explain why treating obesitywith diet and exerciseso often fails to produce
the desired results. It’s sort of like telling Amandathat she needs to be a more careful driverwhen the real problem is that she needsa mechanic to fix her car. Okay. So if we’ve all got this
complicated system in placethat prevents us from losing weight,why doesn’t it also protect usfrom gaining weightand developing obesity in the first place?How can we explain the obesity epidemic?Getting back to Amanda,why did she develop obesity?The answer is that it
takes a perfect stormto cause an obesity epidemiclike the one we’re seeing now,and it’s our modern environmentthat places us and Amandadirectly in the path of that storm. Well, there’s no single causefor the rising rate of obesity. Changes to the chemical
and nutrient contentof our food, the so-called western diet,a decrease in physical activity,increased levels of stress,inadequate and disrupted sleep,and more widespread use of medicationsthat promote weight gain, all play a role. Our unique genetics and
developmental historiescause each of us to respond differentlyto these elements of
the modern environment,and some of us, like Amanda,respond by sending hormonal signalsthat elevate our set point for body fat. It’s not that Amanda’s
system has stopped working. It’s just that it’s
working to regulate herto a set point that’s too high. So you can think of obesityas a biological responseto the modern environment,a disease where the body dis-regulatesto a body fat set point that is too high. Back to our car analogy. The size of Amanda’s gas tank has expandedso she carries around too much fuel. It’s time to stop blaming
Amanda for her obesity. It’s time to recognize that obesityis a disease, not a lifestyle choice,and those who suffer from
it deserve treatment,not snap judgment. It’s time to act on obesityand now that you’ve been educatedhere’s a simple way for you to act. Share this video.

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