I’m not a doctor, but as far as I’m aware, the only way to become obese is to take in more calories than one burns off. However, there are some medical conditions which make that more difficult. For instance, if one has an under active thyroid then one may burn off less calories than than a person whose thyroid is working properly. Also, some medicines (like steroids) can cause weight gain.
Do we know what percentage of obese people are obese because of medical conditions or drugs which may affect their metabolism? I’ve heard that the percentage is only about 2% but that seems quite low to me. Cheers.
I was going to guess less than 5%, but I don’t have any statistics to back it up. AFAIK the vast majority of people who are obese are because they consume more calories than they burn, over a long period of time (years or decades). Also, psychological issues (e.g. eating disorders) are more common than you might think. Medical-related obesity exists, but I think it is fairly rare, and can usually be treated with drugs or hormones.
Most obesity is not a result of a “hormonal imbalance”. Even the example you gave of hypothyroidism is not particularly relevant. By and large, hypothyroidism leads to only modest weight gain (or, commonly, difficulty in losing weight). It is not a cause of extreme obesity.
All that said, there are clearly as yet uncharacterized ‘hormonal’ influences on body weight. I am not referring to things like thyroid hormone, insulin, or even ghrelin et al. No, I am thinking of those controllers of metabolism that regulate body weight and caloric intake to within one percent over a person’s lifetime. Think about it - without trying, most people’s weight stays pretty much constant for huge swathes of their lives. For decades. And that’s despite eating different amounts and kinds of food, and with varying activity levels. Again, all without the person caring or trying.
I’ll also note that things like appetite control and satiety signals may, by themselves promote obesity independent of any ‘lack of will’. All people simply don’t feel hungry and don’t have the same urge to eat for the same level of caloric intake. It is a gross oversimplification to consider overweight a ‘character flaw’.
Well as the OP said, the only way to make fat is to consume the excess calories that get stored as fat…
But the thyroid problem can be the cause of feeling the desire to eat… or low on energy… foods that provide lots of energy fast are then favoured, sugar and starch …
Are we counting medications, for depression, psychosis, etc, that either outright cause weight gain, or create an ‘always hungry’ scenario? Just curious.
The thing is, even people with a real medical condition or who need to take medication that really does promote weight gain do not always become obese. I have a sister who has had thyroid problems for decades. For most of that time she has been only mildly overweight, if that (during her divorce she packed on pounds, but after it was finalized she did manage to shed 90 pounds and keep them off). Of course, she watches how much she eats and exercises like a fiend. My other sister is on medication with a double whammy of both making you constantly hungry and promoting weight gain. Again, she did put on some weight, but is not obese.
Even people with Prader-Willi syndrome, which is arguably the worst medical disorder for promoting weight gain, can be kept in or near a normal weight zone although it requires a LOT of help and support to do so (in some cases putting a lock on food storage areas like the refrigerator).
Weight gain always involves more calories in than out. You can not magically gain weight. On the flip side, for some people it really is more difficult to balance that equation. You have people with relatively mild problems who can make minor dietary and activity changes to achieve results. You have people with major problems where great effort and sacrifices are required and as a result most people with those problems are overweight or obese. It’s not just about the medical, mental factors come into play. Obviously, someone self-disciplined and good at delayed gratification is more likely to be successful at weight control than someone with little discipline or ability to defer gratification.
Obesity is always caused by consuming more calories than the body is using. Even for those with hypothyroidism or on Predinose or antidepressants. Problem is, to get to a calorie deficit, calories have to be cut beyond what people find tolerable, and that is the big medical mystery. Why do people who have more calories than they need feel like they need more calories? Fix that, and you’ll cure obesity (but the answer is probably very complex and involves many factors, and probably different factors for each person.)
Just because “it doesn’t hapoen to everbody”, or it didn’t happen to your sister, doesn’t mean it isn’t valid for those whom it did affect. You see that, right?
My sisters avoided obesity on through great effort and self-discipline on their part. That was sort of my point - it’s very hard. My sisters were able to do it not only because they were self-disciplined and committed, but also because they didn’t have additional mental burdens on top of that (such as mental illness, addiction, history of abuse leading to “comfort eating”, or other dysfunction - as I noted, when one of them added the additional burden of divorce proceedings her control slipped) nor did they have family and friends who sabotaged their efforts. Given the vast numbers of people struggling with their weight who have additional burdens on top of that is it really puzzling so many struggle and fail?