Stigma and shame do not change the body, but they do harm the mind.

Measuring Tape Wrapped Around Fork

Scientists have determined that obesity, for most obese people, is a birth defect.

Why do we not discriminate against short people? Why do we accept them and not give them unsolicited advice – e.g. wear padding in your shoes, sleep on your back, do daily stretching exercises? We understand that height is a function of  genetic makeup. Your genes determine how tall you will grow.

Yet, we don’t yet accept that obesity is a function of genetic makeup, even though scientists have proven that a genetic defect causes obesity. We continue to discriminate against obese people, telling them to try harder, use willpower, count calories, push away from the table.

When identical twins who were separated at birth reunited for the first time as adults they tended to be within a few pounds of each other. Some pairs of twins were slim, others moderately overweight, and some obese, yet they were raised in different parts of the world by parents who had no knowledge of their inherited factors.

Food intake is controlled by our appetite and our appetite is controlled by leptin, a particular hormone. Most people produce the right amount of leptin to keep their weight within a narrow range, so even if they overeat they will soon lose those pounds with modest effort.

Leptin regulates the intensity of appetite. People with leptin deficiency are always extremely hungry, even after eating a large meal. Extreme hunger hurts and the drive to extinguish that severe pain is as strong as the drive for air when gasping for breath.

Yes, some people do lose weight and maintain their new weight. Usually those people were not obese to begin with but gained moderate weight later in life, not because they were constantly feeling hunger pangs, but because they were exposed to large portions of delicious food many times each day. Habit control works for those people. With effort they will lose ten, twenty, thirty or more pounds.

A small percentage of people who were born with the genes for obesity may lose 50, 75, 100 pounds with extreme effort and they will be forced to struggle every day to fight their biology. We should applaud them, and at the same time we should not condemn those who are unable to overcome their genetic destiny. They have a very hard time fighting their body’s urges, they should not have to fight society, as well.

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