# Obesity due to medical problems. Rare? Common? **URL:** \ **Category:** Factual Questions\ **Created:** [July 12, 2006, 8:37pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236 "2006-07-12T20:37:33Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Crafter\_Man](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crafter_man/32/458_2.png) [@Crafter\_Man](https://boards.straightdope.com/u/Crafter_Man)\ **Post date:** [July 14, 2006, 1:23am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/41 "2006-07-14T01:23:08Z")
> [@alice\_in\_wonderland](#): > > their are people for whom weight loss is not as easy as “Eat less, exercise more.” Well first of all, it _ **is** _ that simple… if you eat less and exercise more, you _ **will** _ lose weight. But while the “formula” is certainly simple, it takes a _lot_ of discipline to do it. Most fat people don’t have the discipline to lose weight, hence they remain fat. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [July 14, 2006, 1:54am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/42 "2006-07-14T01:54:22Z")
> [@alice\_in\_wonderland](#): > > Even anorexics, who have the mother lode of willpower when it comes to eating, eat more than 300 calories worth of food a day. (On average – yes I know that anorexics can go more than a day without eating.) > > The answer in this sort of situation is not “Eat less, exercise more.” The answer is “Treat the underlying medical condition so that more than 300 calories are burned.” Your refusal to acknowledge this always blows my mind. That and doesn’t your metabolism slow down when you go into “starvation mode?” Sometimes, I understand, the damage is permanent. ---
**Author:** ![Garfield226](https://avatars.discourse-cdn.com/v4/letter/g/9e8a1a/32.png) [@Garfield226](https://boards.straightdope.com/u/Garfield226)\ **Post date:** [July 14, 2006, 1:55am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/43 "2006-07-14T01:55:53Z")
> [@Guinastasia](#): > > That and doesn’t your metabolism slow down when you go into “starvation mode?” Sometimes, I understand, the damage is permanent. Cite? ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [July 14, 2006, 3:07am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/44 "2006-07-14T03:07:01Z")
> [@Garfield226](#): > > Cite? I don’t have one-that’s why I was ASKING. ---
**Author:** ![Garfield226](https://avatars.discourse-cdn.com/v4/letter/g/9e8a1a/32.png) [@Garfield226](https://boards.straightdope.com/u/Garfield226)\ **Post date:** [July 14, 2006, 3:10am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/45 "2006-07-14T03:10:07Z")
> [@Guinastasia](#): > > I don’t have one-that’s why I was ASKING. If you were asking, how is it that you “understand” the damage is permanent? ---
**Author:** ![Ring](https://avatars.discourse-cdn.com/v4/letter/r/6a8cbe/32.png) [@Ring](https://boards.straightdope.com/u/Ring)\ **Post date:** [July 14, 2006, 3:43am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/46 "2006-07-14T03:43:05Z")
> [@](#): > > A simple example, go on a starvation diet and you won’t loose weight that fast, as you body will adjust, your metobilism will slow (or become more efficient). I was about 35 pounds overweight and absolutely could not lose it. I tried mightily for at least 2 years. I developed a bad case of acid reflux and lost 40 pounds in less than three weeks. It can be done, and it can be done very quickly. You just need the right kind of motivation. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [July 14, 2006, 3:49am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/47 "2006-07-14T03:49:31Z")
> [@Garfield226](#): > > If you were asking, how is it that you “understand” the damage is permanent? Sorry, I should have said, “I heard”. ---
**Author:** ![rhiannon777](https://avatars.discourse-cdn.com/v4/letter/r/dfb087/32.png) [@rhiannon777](https://boards.straightdope.com/u/rhiannon777)\ **Post date:** [July 14, 2006, 4:18am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/48 "2006-07-14T04:18:38Z")
> [@Crafter\_Man](#): > > It’s funny… people always want to absolve themselves from responsibility every chance they get. The worst offenders are the people who say, “I’m obese. And it’s not my fault!! Diets don’t work for me!!” :rolleyes: I don’t dispute the fact that a lot of overweight people lie to themselves about how many calories they eat or how much energy they expend. However, I weigh or measure everything I eat and use a computer program to track everything that passes my lips, even a stick of gum. I know I am not lying to myself or to anyone else. There are those few of us who are overweight yet have more discipline in our little fingers than most thin people have in their whole bodies. ---
**Author:** ![rhiannon777](https://avatars.discourse-cdn.com/v4/letter/r/dfb087/32.png) [@rhiannon777](https://boards.straightdope.com/u/rhiannon777)\ **Post date:** [July 14, 2006, 4:22am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/49 "2006-07-14T04:22:04Z")
> [@Epimetheus](#): > > There is the normal 98ish degrees of normal human metabolism. That takes a specific amount of energy dependent on body weight and composition alone. Interestingly enough, my “normal” body temperature is about 96 degrees. I always wonder if that is linked. ---
**Author:** ![rhiannon777](https://avatars.discourse-cdn.com/v4/letter/r/dfb087/32.png) [@rhiannon777](https://boards.straightdope.com/u/rhiannon777)\ **Post date:** [July 14, 2006, 4:27am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/50 "2006-07-14T04:27:18Z")
> [@Bippy the Beardless](#): > > PCOS sounds like the sort of condition that the Atkin’s diet was designed for (ie a condition of compromised carbohydrate use similar to diabetes). Do PCOS sufferers have a specific diet that reduces the carbohydrates that your bodies don’t utalise properly? Yes, various low-carb diets are used by women with PCOS. Personally, I have been able to lose a small amount of weight by eating only meat and a small amount (1-2 cups a day) of lettuce with vinegar. This diet has also reduced my other symptoms of PCOS. There is also a medication, which someone else mentioned, called Metformin, which can help reduce insulin resistance in women with PCOS. I don’t have health insurance and am a student, so I have not been able to try it yet, but I have heard stories of women who begin taking it losing 30-40 pounds without altering a thing about their lifestyles. ---
**Author:** ![Imasquare](https://avatars.discourse-cdn.com/v4/letter/i/5f9b8f/32.png) [@Imasquare](https://boards.straightdope.com/u/Imasquare)\ **Post date:** [July 14, 2006, 4:50am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/51 "2006-07-14T04:50:07Z")
> [@kanicbird](#): > > A simple example, go on a starvation diet and you won’t loose weight that fast, as you body will adjust, your metobilism will slow (or become more efficient). This does not seem right to me. But if our bodies can work more efficiently why would they not always work more efficiently? Also, why would our bodies prefer to consume lean tissue for energy when calorie intake is too low, rather than consume the otherwise useless fat deposits? I thought the reason for fat deposits was to use as energy during times when food is short. ---
**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\ **Post date:** [July 14, 2006, 8:10am UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/52 "2006-07-14T08:10:14Z")
> [@Epimetheus](#): > > (people saying they get by on 800 calories or less) > > This always puzzles me. > > Assuming 1 lb of fat has the exact same calories, with no variation. (could there possibly be variation due to some people creating fat that holds much more water?), there is the normal 98ish degrees of normal human metabolism. That takes a specific amount of energy dependent on body weight and composition alone. This can be measured in individuals by measuring VO2, and has been done so much that there is pretty much an agreed upon average based on height and weight. People vary in numbers, but it is not by significant amounts. It takes me 1800 calories a day just to exist. Of course I am 185lbs and 5’9. Any moving around increases that figure, but assuming you were 5’0 and 100 lbs, that mass has to be heated, your blood has to pumped and your brain needs energy. By measuring the Oxygen used, they can determine EXACTLY how much energy you need. You can subside on less for a period of time due to fat stores and muscle stores. You suffer though because you lose muscle mass, bone density and other problems could arise. > Do I think you need 300 calories to exist? No way! My dog needs more than that or he gets too skinny (and he isn’t’ THAT active), and I guarantee he weighs at least half what you weigh. (unless you are under 90lbs). > > I mean, the body is complex with lots of actions and interactions, but energy in, energy out is still a factor. There is no way one 120lb woman can consume half the calories and survive of another 120lb woman of the same height. (for any length of time of course) > > Now, I don’t know how well people count calories, but most are terrible at it. If you ask around, most people think they are eating around 2k calories, while many are consuming half again as much. That latte you drink may contain 1200 calories alone. I had one friend say he ate 800 calories a day but still gained weight. He is 6’3 and like 240lbs. No way he was surviving on 800 calories a day and gaining weight. So I drilled him and figured out he was really consuming like 3000+ calories per day and just didn’t calculate them. Estimating is bad and if you aren’t careful you can eat a lot more than your goal. > > I agree though, it is more complex than calories in, calories burned. But it insults even my intelligence to suggest that your body “gets more energy out of food than everybody else” (what, is your body performing nuclear fission? Glycolysis only produces a specific amount of “energy”), or that “my medical condition makes me suck fat out of the netherworld, and I am not really eating anything, fat just magically appears.” > > Right. I kind of wonder the same thing. I’ve counted calories (accurately) for decades and I’m pretty familiar with the range of normal metabolic requirements for adults. For 30-40 something adults of sedentary to moderate activity levels it ranges from approx 10-14 calories per lb of body weight per day. It might be more or less at the far end of the standard deviation curve if the body has some metabolic disease or related dysfunction, or if exercise levels are very high, but there are thermodynamic limits to how far that metabolic envelope can be stretched. [Regarding PCOS](http://en.wikipedia.org/wiki/Polycystic_ovary_syndrome) I don’t see how someone is going to gain weight on an incredibly restricted calorie intake. I suppose anything is possible, but let’'s say with PCOS your body can’t process carbs correctly, and turns them (largely) to fat. So you crunch your calories down to 600 or 800 calories per day. If that’s _actually_ the amount of calories you are eating if can’t see how that’s enough energy to live re just keeping your body temperature to normal levels. You’re violating the laws of thermodynamics at that point. Now if you’re starting with a substantial fat reserve you could eat 600-800 calories per day for months (or possibly a year or more) without too many problems as long as you got adequate vitamins and minerals, but the PCOS sufferers claim seems to be that I will _gain_ weight at 1000 calories per day and I just don’t see (biochemically & metabolically) how that leaves you with enough energy to live. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [July 14, 2006, 12:04pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/53 "2006-07-14T12:04:01Z")
> [@Imasquare](#): > > Also, why would our bodies prefer to consume lean tissue for energy when calorie intake is too low, rather than consume the otherwise useless fat deposits? I thought the reason for fat deposits was to use as energy during times when food is short. Lean tissue itself consumes more energy than fat does. By burning lean and defending fat, energy reserves can last a lot longer. ---
**Author:** ![rhiannon777](https://avatars.discourse-cdn.com/v4/letter/r/dfb087/32.png) [@rhiannon777](https://boards.straightdope.com/u/rhiannon777)\ **Post date:** [July 14, 2006, 12:09pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/54 "2006-07-14T12:09:06Z")
> [@astro](#): > > The PCOS sufferers claim seems to be that I will _gain_ weight at 1000 calories per day and I just don’t see (biochemically & metabolically) how that leaves you with enough energy to live. Sorry for the misunderstand. Speaking for myself and what I meant, I do not gain weight at 1200 calories a day. I gained weight when I ate normally, which was between 1800 and 2500 calories a day. At 1200 calories a day, I stay steady. ---
**Author:** ![Crafter\_Man](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crafter_man/32/458_2.png) [@Crafter\_Man](https://boards.straightdope.com/u/Crafter_Man)\ **Post date:** [July 14, 2006, 12:12pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/55 "2006-07-14T12:12:59Z")
> [@rhiannon777](#): > > I don’t dispute the fact that a lot of overweight people lie to themselves about how many calories they eat or how much energy they expend. However, I weigh or measure everything I eat and use a computer program to track everything that passes my lips, even a stick of gum. I know I am not lying to myself or to anyone else. There are those few of us who are overweight yet have more discipline in our little fingers than most thin people have in their whole bodies. Are you obese? If so, you will lose weight if you consume less calories and exercise. You can dream up excuses all day long. But it is a _fact_ is that you will lose weight if you consume less calories and exercise. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [July 14, 2006, 3:17pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/56 "2006-07-14T15:17:20Z")
> [@Crafter\_Man](#): > > Are you obese? If so, you will lose weight if you consume less calories and exercise. > > You can dream up excuses all day long. But it is a _fact_ is that you will lose weight if you consume less calories and exercise. _sigh_ I think the point is that there are some conditions where one’s body does NOT burn calories the way it should, and thus, you have to go on a super low calorie diet, and exercise to extremes before you see results. It’s NOT that people are lazy-some of them may be, of course-but that it’s more difficult for them to lose the weight than others. And they might need medical assistance to try and get the body working properly. Also “less calories and more exercise” is relative. What amount of calories and exercise works for me will not be the same as that works for you. Got it? Just like some people have trouble gaining weight (my mother, for example), some people have more trouble losing it. ---
**Author:** ![Bippy\_the\_Beardless](https://avatars.discourse-cdn.com/v4/letter/b/ac8455/32.png) [@Bippy\_the\_Beardless](https://boards.straightdope.com/u/Bippy_the_Beardless)\ **Post date:** [July 14, 2006, 4:25pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/57 "2006-07-14T16:25:51Z")
> [@Crafter\_Man](#): > > Are you obese? If so, you will lose weight if you consume less calories and exercise. > > You can dream up excuses all day long. But it is a _fact_ is that you will lose weight if you consume less calories and exercise. This is not in dispute, but you must realize by now that some people have medical conditions that means the borderline between: eating too much and gaining weight; eating enough to be able to keep active but also low enough in callories to be able to lose weight; and eating too little, so that being active becomes extremely difficult due to lack of energy due to lack of calorific intake. For most people it is relatively easy to live in that healthy middle ground, for some that middle ground may be very narrow and difficult to achieve, maybe for some the middle ground has no width at all and they are trapped between either gaining weight or starving. So though it is true that everyone will lose weight if they consume less calories and exercise. Doing so may be more dangerous for them than the obesity, or at least have more obvious negative effects (such as lack of energy, increased depression symptoms, feelings of nausia, constant hunger, etc. etc.) I fully expect someone to come back and say that those can all be ignored if they tried hard enough to lose weight. to which I would have to say that you are deluding yourself to think you can resist anything by will power alone. ---
**Author:** ![rhiannon777](https://avatars.discourse-cdn.com/v4/letter/r/dfb087/32.png) [@rhiannon777](https://boards.straightdope.com/u/rhiannon777)\ **Post date:** [July 14, 2006, 7:35pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/58 "2006-07-14T19:35:53Z")
> [@Bippy the Beardless](#): > > This is not in dispute, but you must realize by now that some people have medical conditions that means the borderline between: > eating too much and gaining weight; > eating enough to be able to keep active but also low enough in callories to be able to lose weight; > and eating too little, so that being active becomes extremely difficult due to lack Thank you for eloquently explaining the point I was trying to make. I get so frustrated with the attitude of “well, you’re just not doing enough to lose weight,” as that attitude was the reason my symptoms went undiagnosed for fifteen years, until things got so bad that I started hermorraging and ended up in the ER. I get so angry and upset when people take that attitude that it’s hard for me to make a thorough, logical response. ---
**Author:** ![Harriet\_the\_Spry](https://avatars.discourse-cdn.com/v4/letter/h/e56c9b/32.png) [@Harriet\_the\_Spry](https://boards.straightdope.com/u/Harriet_the_Spry)\ **Post date:** [July 14, 2006, 9:45pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/59 "2006-07-14T21:45:29Z")
I’ve been trying to think through the logic of this w/r/t the laws of thermodynamics. Does the mechanism of various health conditions and medications linked to weight gain go something like this? Person consumes a balanced 2000 calorie diet, which body can convert to fat or burn to give you energy to get through the day. In a healthy person not taking medication, these calories are almost 100% burned to create energy. In a person with certain health problems or taking certain medications, those 2000 calories are now processed differently: some are converted to to fat and stored, leaving fewer to be used as energy throughout the day. I could see how that would be a vicious cycle. Because the person would have less energy, exercise would be harder to do and even normal activity might drop some. Plus, eating less could presumably lead to even less energy. Anyone with a medical background know if this is what happens with some conditions/medications? ---
**Author:** ![istara](https://avatars.discourse-cdn.com/v4/letter/i/e79b87/32.png) [@istara](https://boards.straightdope.com/u/istara)\ **Post date:** [July 15, 2006, 6:02pm UTC](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236/60 "2006-07-15T18:02:47Z")
Firstly the theory that carbohydrates are “better” than fats is so outdated it’s not even worth laughing at. Secondly it is, as mentioned, quite amazing how we underestimate (and sometimes overestimate) food. I recommend anyone - fat, thin or normal - trying out [**Fitday.com**](http://www.fitday.com), which offers a free food diary. You input every single thing you eat, and it spits out your daily/weekly/monthly nutrition information. It’s absolutely eye-opening. It’s also interesting and very important to see what vitamins and minerals you’re not getting. Eg on a lower-carb diet, my thiamin levels are always way too low (around 40% - eating all fresh, unprocessed food). According to [**wiki**](http://en.wikipedia.org/wiki/Thiamine): > [@](#): > > Also known as vitamin B1, thiamine plays an important role in helping the body convert carbohydrates and fat into energy. That certainly sounds like something that could play havoc with energy levels, appetite, weight gain and weight loss if you’re deficient in it. I defy all but professional nutritionists not to be shocked at the amount of sugar, saturated fat and calories they’re likely eating every day. Third comment: aerobic exercise is very good for you, but not always very efficient at making you lose weight. I was suprised to find this out, but apparently it’s quite common knowledge among gym types. For weight loss - or rather fat loss - your best bet is weight training. [Previous page](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236.md?page=2) [Next page](https://boards.straightdope.com/t/obesity-due-to-medical-problems-rare-common/364236.md?page=4)