I nearly forgot that experience I had with Phen-Fen in the early 1990's. Holey mother of God, I could have given myself a wholly different kind of heart problem just to get my weight down 20#. That kind of tore it with me and the pharma route to weight control....

Thanks for posting this. My husband and I are both overweight people. My case is something that could be managed if I did exercise a bit more -- I've seen it work in the past. My husband's weight issues, though, are likely more genetically influenced. We just don't know, since he's adopted and has no information on his birth mother or family. In a way, I find it comforting to know that science is finding that these issues aren't exactly "beyond our control" (some of them surely are), but that they are a lot more complicated than they seem on the surface. Hopefully, we'll start realizing equating weight with some kind of character flaw is just an extremely simplistic way of looking at the issue.

Genetics seems to play a big role in body size. My sister's dad was of German extraction. He was big, his mother is big and his sister is big. My sister constantly struggles with her weight. She tries to eat right and she is on the go, working and caring for two children. Our mother is skinny. My dad is thin and I'm thin. Our brother's dad is thin and he's thin. It seems in our family that the father's genetic make-up as far as physical build or metabolism prevails over our mother's.

My husband struggles with his weight. His mother and father are/were both large people. His uncle is large and his aunt has to watch her weight, especially since menopause. My husband goes to the gym and eats right (mostly) but still carries extra weight. My husband's father began exercising in his 50s and lost a significant amount of weight but died of a heart attack before 60. That scared my husband very much so he's trying to slim down.

I think the genetic component figures greatly into how a person is built. With much effort, the weight can be lost, but I've noticed that there can be a plateau to overcome for people with internal biology working against them.

There's nothing wrong with you. You're not lazy or deficient in any way. It seems like sometimes we're just given the bodies we need to get our job in life done. Everyone gets a genetic soup of "gifts". For instance, I'm skinny but alcoholism runs in my family. I could live a long time, but end up making everyone miserable around me. Some people spend hours in the gym sculpting themselves to perceived perfection. Other people go there to maintain health and hope for increased longevity. There's no telling how long each of us has, so it's hard to worry about it. The skinny person genetically favored to live a long time can easily fall victim to a non-cardiovascular illness, like cancer. If your quality of life is good and you have satisfaction in your endeavors, then don't beat yourself up about your body. When it's all said and done, people will remember you for the love you gave and not what shape you were.

One of the funny things about genes is that you might have a gene for thinness (or obesity) and never know it, because you're always overweight. That's because genes are expressed only under certain environmental or behavioral conditions. They can be effectively "turned on" or "turned off" by your lifestyle. I always talk in my classes about the example of a male gene that strongly predicts criminal aggression. It turns out that that gene codes for certain developments in the brain's circuitry and that it only gets "turned on" if the child is put under extreme stress or abuse in childhood. In other words, the environment interacts with the genes.

The same is probably true of our "obesity" genes. In our ancestral past, genes that controlled weight were probably very adapted to the low-food or cycles of scarcity and abundance that characterized our species' life. The American lifestyle is notably unhealthy for most people. Our food is full of soybean oil (omega 6 fatty acids) and corn (high sugar). That's true of most store-bought products. Also, our vegetables are less nutritious than they were a century ago, because we've been breeding them for color, shape, and shelf life instead of flavor. We get little exercise and don't walk anywhere. We work a lot, which means we eat a lot more in the evening than during the day, and sometimes skip meals. If we travel, airport junk food is the worst. And generally when we eat out, they serve us enough food for a family of six, which sets a standard for how large a meal is supposed to be.

So in answer to your question, genes play a role, but remember that genes are expressed in a certain environment. It's the American lifestyle that controls which of those genes are expressed, and it's stacked against us. Your farmers' market shopping is a good start in taking on the entire American culture.

Wow, apparently this is a better topic than some others I have blogged about! It's great to see such openness in the responses. Like Hillbilly Aunt's husband, I don't know much at all about my father's family. My mother told me that I resemble his mother in some ways, but I think she meant my height more than anything else, because if I was just looking at pictures, I can see my maternal geneology's evidence stamped in the shape of my limbs, the bone structure of my face, the color of my eyes, and my faintly freckly skin. My roundness is a differently shaped than either my mother or maternal grandmother. And I still don't have high blood pressure, and I don't have that diabetes that they developed late in life, so in some ways, I think I'm good.

Scruffus, I don't believe there is something W R O N G with me. I think that is something that is inflicted upon me culturally, particularly by magazines, and that cultural condition may very well have its impact on us. I just think there is something to understand in the way that I am about being 1) overweight, & 2) my feelings & thoughts about it necessarily have some impact, and finally, 3) if the result remains, it appears there is something left to understand even though I have inquired into this challenge like a dark abyss my entire adult life.

I don't know that I am any more obsessed about my weight than some of the triathletes that I met through my husband. Some of them seemed like they had found a 'legal' avenue for the expression of anorexia, but I didn't get to know them well enough to know if that was true.

inchkachka, thanks for your comments. The stuff that I was reading seemed to indicate that stress had a great deal with turning on some genes. I've had a lot of stress in my life, but I have managed that as well as I can by moving to this beautiful little mountain near a lake. By working from home and just not answering the phone until I am ready to answer it.

I think reading that 25% of the genome helps to determine a person's weight really struck me as the final nail in the coffin of the idea that I was at fault in any way, and that what I am left with is responsibility for the quality of my own life & body. I can accept that easily enough now.

Thanks for your explanations containing really, really clear and helpful information.

I usually think of genes as creating a set of boundaries, and environment determining where you'll fall within those boundaries.

A healthy weight is within everyone's boundaries of possibility (barring very rare examples like leptin deficiencies), but some people will be at healthy-weight only in a small number of possible environments, whereas others will be at healthy-weight in almost all of the possible environments.

The Pima Indians are an instructive example. Until very recently they had a subsistence diet with frequent famines. They developed a very 'frugal' metabolism, and in their subsistence environment they maintained a healthy weight.

Then came the modern diet of plenitude, and now 80% of them are obese and diabetic. It's pretty much impossible for a typical Pima to maintain a healthy weight on a modern diet. They'd have to go back to their subsistence-starvation cycle. But realistically, who is going to do that??

Susanne, thank you for your vulnerable and beautifully expressed post. While weight is not something I struggle with (I was 20 pounds overweight, but that was due to the daily Chardonnay habit I gave up 2.5 years ago), I resonate with the glass ceiling of mortality you face with your family.

I never met my grandparents on either side because they were dead. My father died from a malignant brain tumor at 65 and my mother developed Alzheimer's in her early 60's and is no longer living.

You are right to bring up the triathletes. A good friend of mine, Diane Israel, a former top world triathlete has produced a documentary (Beauty Mark) on bulemia and anorexia that afflicts so many athletes, men and women.

We live in a world obsessed with image and it is so damaging to the psyche.

Currently, my step-daughter's mother is in the hospital for at least a year because of life threatening complications from a gastric bypass surgery, a terribly risky surgery and her last desperate attempt to lose weight.

This has been a devastating time for my step-daughter who is now living with us full time. She is misplaced from her home, her friends and started her freshman year in high school without her mother, who is still fighting for her life. She herself is not a petite girl and I worry about her self-esteem and self-image as she sees the painful struggles her mother is going through, and experiences the cruel and judgmental nature of our culture.

Again, thank you so much for sharing.

Susanne, I'm not professional like pontificatrix, but I think that she is right in that it is a combo effect. My family is a classic example. I have 2 older half sisters (different mother) who have for years been on the heavy side. I am probably a bit below average weight as my mother. However, both my mother and I tended to take care of ourselves better and avoid the average American diet. I always notice when I travel abroad how the obesity factor seems to be absent, and I doubt very much if all those people are genetically predisposed to be smaller!

I can't say that I've ever dieted, but I also don't have any desire to eat more then my tummy grumbles for and I rarely eat anything unhealthy. I've always practiced some form of fitness, while my sisters have not.

Interestingly a few years back I went vegetarian and my body weight, which never fluctuates, dropped about 5 lbs on its own and stayed there. So, I"m guessing that there is some kind of point that is reached by a combination of nature and nurture.

pontificatrix,

I appreciate the framing of the question you have contributed. The context we frame for our questions needs to be as well constructed as possible so that the reasoning that follows has an opportunity to present practical lines of thought and solutions. What you said makes me wonder about how timing affects the interaction between genetics and environment. If food was scarce in childhood, does that have a similar effect as creating a kind of response in the body that becomes harder to overcome?

We were crazy poor most of my childhood, so sometimes we didn't eat as well as we might have wanted. In my Sophmore year in high school there were two months where all I had to eat was USDA corn meal mush with USDA issue margarine and sugar on it. No fruit, no vegetables, no meat. Nothing else. I can remember having cravings during those times, but there was nothing to do but eat more of the same, perhaps more than I should have because I was trying to satisfy my hunger, which was more likely for something else rather than what was available. I was just glad not to be hungry. Another time it was USDA dehydrated mash potatoes made with powdered milk and the same crummy margarine. It practically makes me cry just to remember it, and I can't help but wonder what effect those extreme times had upon me.

Mary,

I hope your stepdaughter gets her mother back soon. I considered bariatric surgery, lap band, etc., but I am reticent for good reason, it turns out. And, while I am a little round, it's certainly not the worst thing I have experienced.

I am all for healthy and happy. There ought to be a lightness around these issues. Our body weight is not who we are, and who we are is the most important thing. If that central sense of being can be happy and fully self-expressed, I feel fairly certain that body weight doesn't have to be an overarching issue, but one of the many things that we manage living a full and happy life.

By the way, I adored your comments from the DNC. I was a Washington State Obama delegate but didn't run for National because there were just so many people who wanted to go. The picture above is from the local Pride Festival where my grandson and I distributed Obama stickers and sold buttons and answered questions. We volunteered in honor of his other grandmother, who was lesbian and died of breast cancer a year ago.

Thanks so much for your comments.

artsfish,

I was vegetarian for about six years. It didn't have any effect on my weight at all, but it was good for me spiritually. I do have a bit of a sweet tooth and have to watch it, since my husband is like you and can eat whatever he wants. When he was running marathons and participating in triathlons he ate about half as much as Michael Phelps 12000 calorie diet. I was amazed at what he could eat.

Susanne:

Yes, definitely. The early environment has programming effects on many systems that last throughout the life of the organism.

Here's an abstract of a review that discusses the myriad of evidence for this phenomenon as it relates to obesity and metabolic syndrome.

http://www.ncbi.nlm.nih.gov/pubmed/15788706

This is an issue I deal with, having been classifed medically as "obese" but in my case I absolutely know it is self-inflicted.

I understand the genome research and I do believe it accounts for some cases, but I have one over-arching thought about it all:

If you simply go to Ellis Island and look at the 1000s' of potographs that are most of our recent ancestors, obesity is limited (on an empirical basis) to far less than our current state of dismay.

Weight is calories in vs calories expended, period. Some fluctuations can be attributed to metabolic rates and age. But we have not evolved to a point where usual things like stress hormones and starvation responses have changed in 200 years. Witness our high level of obsese children.

I was "fat" all through my childhood and then not. Fat again in college, and then not. Fat now, and hoping for the burst of energy I despair of ever finding to be "not" once more before I die. But it's all on me and I would NEVER trust a pharmaceutical to do it for me.

Our ancestors had no choice over calories in or calories out really, they were overwhelmingly too poor to overeat and forced to work hard to get by.

Actually it looks as if this article is available in full-text for free (link button on the upper right of the abstract page) in case you are interested in wading through a lot of very dense medicoscientific jargon.

Another thing I want to say is that everyone is different. Nobody else has your combo of genes, early-environment, appetites, urges, etc. etc. etc. You know your own body better than anyone else. The body-weight thing can be a struggle, and people blessed with a metabolism more appropriate to the age of plenty are often unsympathetic. Nuts to them, and keep up the good work.

Kellylark: It is calories in, calories out; but that equation isn't the same for everyone. Some people 'waste' calories and others are very frugal with them.

Our ancestors lived in eating environments that kept most people at a healthy weight, whether they were frugal or wasteful metabolizers. Our current eating environment (unmodified by individual targeted efforts) yields obesity for all but the most wasteful metabolizers.

Susanne;

Gary Taubes, an occasional writer for the NY Times, has been a major iconoclast in the debate concerning diet and weight control. He published his first article on this issue in the NY Times Magazine several years ago:
http://query.nytimes.com/gst/fullpage.html?res=9F04E2D61F3EF934A35754C0A9649C8B63&sec=&spon=&pagewanted=all .

More recently he has published a book, Good Calories, Bad Calories, which at over 400 pages, is an amazing summary of the literature concerning diet, exercise, weight control, and cardiovascular disease. Taubes is well trained in the scientific method and he provides a withering attack on the weak support for many of the current popular diets. Most interestingly, he provides a wealth of information concerning why most calorie restricted diets don’t work.

Overall, Taubes supports the Atkin’s diet. His book is not an easy read, but the article link above will give you an idea of where he is coming from. He is certainly worth checking out if you are serious about losing weight. Good Luck

Susanne,

Thanks for the response. My step-daughter would rather have her round mother back. After visiting her at the hospital last week, we got in the car. I asked her if she was OK. She started crying. She said, "That's not my mother anymore. I don't even know her."

It was heartbreaking. Her mother will survive, but she is forever changed.

Thanks for the comments about the DNC. How great that you were a local delegate! What a great event to take your son to in support of his grandmother.

pontrificax, I don't think we said any different, just differntly.

Yes, genes are involved in some cases. Just not to the extent people wish them to be . A change from 25% to 75% obesity over 10 generations is not due to evolution of our genes. It is due to changing lifestyles.

That's all I meant.

"I usually think of genes as creating a set of boundaries, and environment determining where you'll fall within those boundaries.

A healthy weight is within everyone's boundaries of possibility (barring very rare examples like leptin deficiencies), but some people will be at healthy-weight only in a small number of possible environments, whereas others will be at healthy-weight in almost all of the possible environments."

That was so well said! Susanne, I have wondered the same thing. Growing up food was fairly restricted in my house and I, the only athlete the in the family, learned to eat very quickly so I could get enough to fuel my activities. It's a habit that I have to actively fight, still - to eat quickly while eyeing what is left on the serving platter, plotting how I'll get any extra pieces.

Kellylark: For sure. Sorry, I guess your previous post reminded me of the "well you just need to eat a little less" contingent. I should have known that wasn't what you were saying.

(I don't particularly struggle with weight myself but my mom has battled hers for her whole life and she really doesn't eat much at all and she does exercise as well.)

Also someone mentioned Gary Taubes and the Atkins diet - from what I know the Atkins diet does seem to work. It's not the healthiest thing in the long term but for short-term weight loss the evidence seems to be behind it.

The same person who gains weight on 1500 calories of carbs can lose weight on 2500 calories of pure protein and fat. It makes biochemical sense (though I won't go into that here) and in my book it completely discredits the calorie-is-a-calorie argument.

This has been all so incredibly helpful to me. Thank you everyone for taking the time to share your experience and your expertise.

pontificatrix

I suspect your are right to a certain extent about the difference in the type of calories we consume.

Are there any clinical studies to back up the claims for such a diet?

I am not being contrary, but the diet you espouse is difficult at best for most Americans, and diametrically opposed to what we have all been taught.

I am a scientist by trade, and I put my stcok in double-blinds. I haven't seen any, most likely because the cost-benefit ratio is not going to return a benefit to the protein-fat diet afficionados.

Kellylark:
Well, it is pretty difficult to blind a subject to the diet he is following. I doubt we will ever see a dietary-habits study that can get over that bar.

But here's an abstract from a recent NEJM article that compared low-fat, Mediterranean, and low-carb diets, with a 2-year followup. For completers of the study, the low-carb diet *with unrestricted calories* came out on top at 5.5 kgs lost on average. The avg wt loss on the Mediterranean diet *with* caloric restriction was 4.7 kg, and on the low-fat *with* caloric restriction it was 3.3 kg.

I thought that was impressive.

http://www.ncbi.nlm.nih.gov/pubmed/18635428

Thanks for the link. I'll check it out and no doubt other readers will too.

You're right, the "correct" body shape presented by our advertising and entertainment is contrary to reality for the most part and creates an ideal that is difficult to meet. It does make people feel like something is wrong with them.

I found your post fascinating because it's a topic so many people struggle with. I've lived with people staring into the "dark abyss" you speak of, I've found the weight loss pills of dubious efficacy in my husband's truck and wondered why he would put something dangerous in his system to lose a few pounds (He was big when I met him. His weight never bothered me). I've seen my sister struggle in her marriage because her husband judges her according to the cultural yardstick. Weight isn't easy to talk about for a lot of people. I know I can't offer much except for personal anecdotes but found your take on weight to be interesting and I wish you all the best.

Thank you for the article. 25 % of the genome. No wonder it is so hard to lose the pounds.

One clarification. I actually don't eat that much - in fact I tend to forget to eat ( I do remember to feed my kids!) until my stomach is talking to me. When I was younger I ate much more and craved more food.

I do love my dark chocolate though.

Ah - found you and your post! Thanks for leading me down the cookie crumb trail. *g*

Here's my take:

Weight is only one indirect indicator of health. And it's not necessarily a primary indicator.

THe marketing of body image and the ag/food INDUSTRIES have perpetuated the processed food products that are presented to us in the psychologically preferred red and gold colored advertising, and fast food heavy on the tantalizing aromas and predictable flavors/mouth feel textures is much more readily available than is fresh fruits, vegetables and nutritiously prepared whole grains, beans, seafood and dairy products.

We treat food as the enemy or as something to conquer instead of as something to embrace, to enjoy, to SAVOR.

We treat exercise as artificial make work instead of as a means to be able to enjoy the world around us.

When I became destitue, I was forced to use dried peas, beans, rice, potatoes and onions for their very low cost, their ability to store and the need to have some protein. Using the herbs and spices I had left from my previously well-stocked pantry, I learned by necessity how to spice, flavor and crank up the aroma, flavor and textures. And somewhere along the way, the foods became desired and enjoyable instead of tedious, boring and a reminder of my life situation.

At the same time, I lost the ability to afford even public transportation, so I walked everywhere. I always enjoyed walking, but it became important to dole out wlaks with how my remaning shoes would hold up, how tired and hungry I would be before being able to eat again, and how much mental energy I would need to expend (I get brain fog when I'm overly hungry and tired).

I no longer eat prepared foods and fast foods. Mostly by force, but also by design, for the rare occasions that I have money to spend on groceries.

I desire fresh fruits and vegetables, and highly sweetened and fat-enriched foods no longer excite me. I happily pass up cheesecake, a former favorite, for an in-season ripe pear, or yogurt with fruit and granola. I enjoy dishes which are flavorful, have interesting textures and have tantalizing aromas.

I don't step on a scale, but my clothes are all sizes too large.

I don't advocate poverty as a means to stimulate radical change, but one could exchange current eating habits by introducing one or two new items into the culinary repertoire - perhaps packing lunches of fresh in-season salads and fruits accompanied with home-baked bread, or instead of watching a video or playing computer games, making a new recipe which incorporates non-meat proteins and experimenting with herbs and spices.

Instead of attending a charity walk, why not volunteer instead for a local program which performs household cleaning, maintenance and gardening for seniors and those unable to do so independently?

Instead of eating at fast food places, why not substitute a weekly visit to a farmer's market and eat fresh, local and in-season?

Wean yourself off what isn't working for you while introducing things which have the biggest bang for the buck: they're enjoyable, they are foods and experiences which are nutritious, in-season, flavorful and which provide opportunities to enjoy preparing them, eating them with other people, and which allow you to learn about other foods, cuisines, cultures, etc.

But most of all, forget about weight. It's counterproductive.

The best way to measure health is by the ability to do the things you want and need to do in your life. Are you able to get to work, to perform the work, to interact with the people you need to without difficulty?

Are you able to do the things with your family and friends that you want and need to?

Are you able to participated in the activities you wish to (within reason - no fantasy lists here)?

If your weight gets in the way of those things, then it's an issue.

If not, it's not.

Wow! Thanks for all the additional insight.