Evolution of Obesity: Historical Trends, Genetic Factors, Health Impacts

Body weight 8:00 0
“I think it's clear that we're much fatter today on average with a much higher percentage of obesity and a thousand years ago there was obesity... but certainly the prevalence was much lower.”

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Body weight 9:19 0
“if you compare to the same demographic so middle-aged white men today, you see that there was almost no obesity back then and today the obesity rate is something like for probably 45 for that same demographic.”

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Body weight 10:42 0
“the first really good data we have starts in the 1960s for the United States that's when the NHES surveys started which later became NHANES.”

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Body weight 13:27 0
“so you see very very little very very few people had bmis over 35 in the earliest measures and then now it's like it's something like nine or ten percent today of adults.”

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Body weight 18:05 0
“there's all this evidence that excess body fat contributes to all kinds of diseases type 2 diabetes cardiovascular disease certain cancers and so how could it be productive for mortality when it's driving all these diseases that are the leading causes of mortality.”

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Body weight 19:58 0
“i've lost nine pounds... i probably went from bmi of 26 to bmi of 24.”

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Body weight 20:38 0
“bmi is a crude measure... it's useful for population level studies, it can be useful for screening but it's a crude measure.”

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Body weight 21:16 0
“the maximum attained weight method... you say what's the heaviest you've ever been and how does that correlate with your health outcomes.”

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Body weight 24:33 0
“if you look at studies that have measured the impact of intentional weight loss on mortality... you see a reduction in all-cause mortality.”

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Body weight 26:25 0
“nearly half of the u.s adult population could have a bmi above 30.”

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Body weight 28:58 0
“sometime around between the late 70s and the early 80s we see an uptick an apparent uptick in the obesity rate so the rate starts to increase it goes up and up and up and then there's a couple of places where it slightly goes down for a year or two and then it keeps going up.”

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Body weight 29:31 0
“we went from something like 15 percent of obesity to 43 of us adults and i want to point out something else too that i think is relevant one way i like to think about this is the lifetime risk so that's just the population prevalence that includes people who are 20 years old yeah that's includes people who may be growing into it.”

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Nutrition 32:22 0
“places that are really challenged with food security where the diet is very limited like subsistence farmers in sub-saharan africa you're still going to see that there's a low prevalence of obesity in those places.”

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Body weight 33:27 0
“my overall feeling though is that there is no demographic in the united states that has not gotten a lot fatter over the last few decades even though i think if you look at certain demographics particularly with regard to education you're going to see gradients emerge.”

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Nutrition 35:45 0
“I think most people would agree that food intake quantity and quality is pretty important there.”

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Body weight 38:49 0
“with people with tumors or other damage to the hypothalamus it often causes extreme obesity”

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Body weight 40:22 0
“if you restrict their calorie the first experiments that were done on this showed that if you restrict them to a normal level of calorie intake so that of a non-lesioned animal, it prevents the fat gain suggesting that it's primarily a phenotype of hyperphagia”

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Body weight 40:54 0
“later experiments that were more precise found that it doesn't completely eliminate the weight gain, it only eliminates about 80 percent of it”

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Body weight 43:01 0
“your hypothalamus has a certain idea of how much fat it wants you to have on your body and if you deviate from that it starts to engage a coordinated series of physiological and behavioral responses to restore the previous level of body fat”

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Body weight 46:05 0
“so over the long run the amount of leptin in the bloodstream is strongly correlated with fat mass”

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Body weight 46:22 0
“if you cut your calories by 25% for a couple of days you're going to see a drop in leptin that is disproportionate to your amount of fat mass”

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Body weight 50:48 0
“leptin resistance... is a hormone that regulates body fatness why is it that people with obesity have so much of it and it's not suppressing their excess body fat mass”

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Genetics 52:47 0
“if you look at leptin signaling there's there were some early studies done in animal models suggesting that if you're just looking bro if you mash up the hypothalamus and you look at what's going on in it broadly on average you find that the amount of leptin response the intracellular signaling cascade that's activated by leptin is not really impaired in animals with obesity it's like they're getting the same leptin signal from a much higher level of leptin”

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Genetics 53:24 0
“i looked at some twin concordant and discordant studies, identical twin and i was surprised to see maybe i shouldn't have been surprised but i was surprised at how heritable obesity was it was about 0.7”

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Genetics 54:31 0
“the meta-analysis of twin studies that i like to cite these days suggests an average heritability of 75 percent”

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Genetics 56:59 0
“so far these studies have identified i think like 900 variants that differ so what this suggests is that differences in body mass index between individuals are very complex that genetically very complex are determined by a lot of different genes with very small effect sizes”

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Genetics 59:35 0
“the strength of what ultimately makes genetic analyses like mendelian randomization so powerful is the genes are randomly distributed so that's what cleans out some of those biases is when you are looking at a million people for whom the genes are randomly spread across them”

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Genetics 1:00:13 0
“a thousand years ago to all intents and purposes none of us were obese but that still means directionally 50 of us at least had the genes that would allow us to become obese in an obesogenic environment”

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Genetics 1:01:14 0
“we have this incredible methodology for looking at the underlying biology and that's been done and there are a couple different ways you can do it one is you can say what are the genes that are that seem to be associated with these genomic differences and where are those expressed what tissues are those expressed in”

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Genetics 1:02:28 0
“body mass index looks like psychiatric diseases and educational attainment so all of those are heavily enriched for brain related genes to a similar degree”

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Nutrition 1:06:07 0
“but food and energy are one of our top priorities”

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Genetics 1:07:39 0
“what do we know about the genetics the efficiency with which we store energy”

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Body weight 1:08:34 0
“there are good reasons to have a certain amount of body fat”

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Disease prevention 1:11:17 0
“if you don't have those energy stores you can't defend yourself against infections”

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Genetics 1:12:30 0
“where there were different amounts of food scarcity and seeing if there's an inverse relationship between the food scarcity that that population emanated from whether it's this part of Africa versus that part of Europe and how that translates into the genetic predisposition to obesity in their modern kin today.”

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Nutrition 1:13:40 0
“we have five tastes right we can taste sweet, sour, bitter, salty and umami those are the things the five things we taste.”

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Nutrition 1:14:42 0
“if you look at what hunter gatherers actually eat let's say we're looking at contemporary and historical hunter-gatherers where data have been collected and using that as a proxy for the types of food that our ancestors would have eaten, it is radically different than what we eat today.”

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Nutrition 1:18:59 0
“mice normally they eat these unrefined food pellets that would be like the default diet but they much prefer these calorie dense refined high fat pellets and if you give that to them they will very much preferentially eat that over the healthier unrefined pellets”

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Nutrition 1:19:47 0
“if you have somebody like you or i who's been raised in a context where we have tasty calorie dense easy to eat food and that's how we were raised then going back to eat food more like how our ancestors would eat is really difficult”

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Nutrition 1:20:26 0
“i actually think table sugar is disgusting like i truly do like if you put a bowl of that white crap in front of me and said dip your finger in and eat it i could maybe do it once but that's about it”

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Nutrition 1:21:06 0
“i freaking love ice cream right like i think ice cream is about one of the most beautiful tastes in the world”

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Nutrition 1:25:16 0
“generally the foods that are cited are combinations of carbohydrate and fat usually there's other stuff involved there's flavorings there's salt in in the savory items like pizza or french fries”

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Nutrition 1:25:50 0
“what you see in modern foods that have been crafted to maximally stimulate our enjoyment and motivation either they've been crafted by food industry or by grandma you know passed down through the generations of recipes”

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Nutrition 1:29:00 0
“our ancestors would have needed to prioritize to maximize the reproductive success the currency of natural selection so essentially we have these motivational systems that were selected to seek certain types of nutrients in the environment”

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Nutrition 1:30:36 0
“they discovered these cells that they named neuropod cells in the small intestine primarily that have receptors for specific nutrients that are directly hooked up to vagal neurons”

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Nutrition 1:32:01 0
“stand like shouldn't i be wired to eat ribeye until the point of vomiting given how high it is in sodium fat and protein and total calories like the only thing it's missing is sugar and fiber and you know carbohydrates and things like that but it's easier for me to over eat baked potatoes than it is to overeat a ribeye”

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Nutrition 1:33:15 0
“the foods that people cite as the most typically associated with strong cravings and loss of control over eating behavior meat does not usually come up high on that list”

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Nutrition 1:33:53 0
“meat is about 75 water so the calorie density of is actually it's not low but it's not especially high unless you're eating a really fatty piece of meat”

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Nutrition 1:34:20 0
“it doesn't have any carbohydrates so it doesn't have that fat carbohydrate combination that is most closely associated with foods that people lose control around”

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Nutrition 1:34:55 0
“protein doesn't work the same as carbohydrate and fat and i think we recognize that that's the case protein seems to it's something that our bodies really want to get enough of but don't want to get too much of so there's really a not only there's a drive to acquire it but there's a drive to keep it within a certain range and not eat too much”

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Nutrition 1:38:51 0
“the thesis is basically everything is toxic except grass-fed animal foods.”

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Nutrition 1:39:37 0
“if you eat a lot of spinach you can get kidney stones from all the oxalate.”

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Nutrition 1:39:46 0
“there are studies suggesting that the glucosinolates in cabbage family plants might contribute to type 2 diabetes.”

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Nutrition 1:39:58 0
“kidney beans if you don't cook them enough they can be really toxic because the lectins.”

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Nutrition 1:40:15 0
“the way to think about how healthy a food is is not to say does it contain toxins is to say what's the cost benefit analysis on this food and most importantly what are the empirical outcomes that we can see when its impacts on health are directly studied.”

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Metabolic health 1:45:14 0
“it's improving my insulin sensitivity i feel better i have fewer energy swings but this one thing isn't so good”

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Disease prevention 1:47:28 0
“cardiovascular disease is a huge big deal even if it doesn't kill you it can do really bad things to you physically and cognitively”

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Nutrition 1:48:26 0
“we see these patients that'll go on these incredibly restrictive plant-based diets and it's usually some combination of micronutrient deficiency and or protein deficiency that's going to be the death of them”

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Nutrition 1:51:48 0
“the two models are the carbohydrate insulin model and the energy balance model and the carbohydrate insulin model i just want to get a little more specific with that because there are different versions of this and so this is the one that has been promoted by david ludwig and particularly in a recent review paper that he published with along with some other researchers”

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Nutrition 1:52:35 0
“carbohydrate insulin model and its most recent incarnation is a lot more complex than previous inclination so i'm going to do my best to kind of summarize it and and hit the key points but essentially it's the idea that there are things in the diet and in the environment that impact insulin signaling and insulin signaling impacts body fatness”

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Nutrition 1:56:34 0
“the energy balance model in contrast is acknowledging all this brain regulation of body fat brain regulation of appetite and saying actually body fat is a regulated process however it's regulated by the energy intake and expenditure via the brain”

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Nutrition 1:58:29 0
“yeah i believe rick johnson described an experiment like that on my recent podcast with him which was an iso caloric swap to a very high fructose diet where the animals didn't gain weight but they fueled partitioned differently they got fatter.”

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Body weight 1:59:26 0
“you have a person who weighs 200 pounds person who weighs 160 pounds through the same height 100 the 200 pound person loses 40 pounds they're now 160 pounds the other person's always been 160 pounds on the surface they look identical in fact let's pretend they're siblings but one was obese and he's now post obese the other was never obese.”

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Nutrition 2:00:55 0
“if people go if you take someone on a typical diet and put them on a low carb diet you don't have to tell them to reduce their calorie intake that will occur spontaneously and they will lose loose fat and end up in the typical person comfortably being at a lower weight they're not experiencing the starvation response.”

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Body weight 2:05:20 0
“the children of the woman who had the surgery and had previously lost weight before getting pregnant will have a lower risk of obesity and again I wouldn't call the evidence strong.”

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Nutrition 2:05:35 0
“what if she achieved that weight loss without gastric bypass so what if you had two women who were overweight and one of them lost weight through diet and nutrition and then they got pregnant.”

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Body weight 2:06:16 0
“gastric bypass is a unique situation where provided a person doesn't take in liquid calories, it's quite durable.”

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Body weight 2:09:02 0
“the tools that we have now are just way better than what they used to be.”

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Nutrition 2:11:06 0
“controlling these signals that your brain is receiving is really important and there are different ways to do that one of them is to control your food environment so the sensory cues in your environment that your brain is exposed to whether there is food in your immediate vicinity how tempting that food is.”

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Nutrition 2:11:56 0
“there's a wide variation in the number of calories that it takes to feel satisfied at a meal depending on what foods you're eating”

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Nutrition 2:13:50 0
“calorie density which is an important determinant of the satiating and satiety promoting properties of food”

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Hormone balance 2:18:07 0
“so he's responding to growth hormone and all these other things”

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Hormone balance 2:18:19 0
“whether it be sleep disturbances that increase or decrease insulin signaling or foods that stimulate insulin, they're driving that hormonal environment that is driving the increase in food intake.”

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Body weight 2:20:51 0
“we have a drug, ouigo v aka semaglutide, that is safe and effective and was developed for this purpose based on mechanism from the bottom up.”

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Body weight 1:45:03 0
“the distribution of fat on the body seems very related to insulin signaling; the total amount of fat on the body seems more related to energy intake”

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Body weight 1:45:29 0
“if you consider this idea of energy partitioning which the carbohydrate insulin model is all about, there could be some of that flying under the radar of body mass index”

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Body weight 1:46:55 0
“the more you restrict carbohydrate or the more you restrict fat typically the more weight you're going to lose”

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Body weight 2:28:10 0
“if you start with animals that are on a low fat high carbohydrate diet and you start replacing that carb with fat they get fatter and fatter and fatter and fatter until you hit about 60 percent and then you if you keep increasing the fat and decreasing the carbohydrate they get slimmer again”

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Metabolic health 2:32:16 0
“their energy intake declines by hundreds of calories a day right away, automatically.”

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Nutrition 2:33:00 0
“it's a pretty easy diet to adhere to especially today, harder ten years ago when there were fewer sort of food choices geared towards it.”

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Nutrition 2:35:29 0
“i think it would be very difficult to get that low when you look at um studies that test low fat diets, some of the lowest fat diets i've seen were in the kind of ten percent fat range.”

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Nutrition 2:38:02 0
“the most recent one we did was the volumetrics diet ultimate volumetrics diet by barbara rolls”

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Nutrition 2:38:11 0
“before that we did the carnivore code”

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Nutrition 2:41:02 0
“i might read a book and it seems compelling i'll tell you the carnivore code it did worse than i expected”

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Nutrition 2:39:17 0
“his book grain brain got the lowest scientific accuracy score of any book we've reviewed”

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Overview

The compendium of data points and quotes reflects a comprehensive discussion on body weight, obesity trends, and the genetic and environmental factors influencing them. Throughout history, obesity rates have seen a stark increase, particularly in modern times due to changes in diet, lifestyle, and possibly genetic predispositions.

Historical Perspective on Body Weight

Obesity has always existed, yet its prevalence was significantly lower in the past, as evidenced by data on middle-aged white men from the late 1800s compared to today. The first reliable obesity data began with the NHES surveys in the 1960s, leading into the NHANES, which gave a clearer picture of obesity’s escalation. Current figures suggest that severe obesity (BMI over 35) affects about 9-10% of adults today, a noticeable increase from earlier measures.

Health Impacts and Treatment

Obesity is linked to numerous health issues, including type 2 diabetes, cardiovascular diseases, and certain cancers, leading to a complex relationship with mortality. Despite these risks, significant weight reduction is associated with lowered all-cause mortality. Among the contemporary methods for treating obesity, gastric bypass and drugs like Semaglutide have shown effectiveness. However, the issue is multifaceted, involving hormonal balances like leptin resistance, where individuals with obesity show high leptin levels without the expected regulatory response.

Genetics and Environmental Factors

The heritability of obesity is notably high, suggesting a robust genetic predisposition. Studies, including on twins and genetic variants, support the significant role of genetics in body mass index and obesity tendencies. Environmentally, high fructose diets in controlled studies have shown that quality of calories influences weight gain and fat distribution differently from merely calorie count.

Changing Diets and Their Implications

Modern diets differ greatly from historical diets, with today’s foods being richer in fats and refined sugars, very different from the natural diets of ancestral hunter-gatherers or the limited diets in food-scarce areas like sub-Saharan Africa. The content and composition of food not only influence obesity rates but also our bodily functions and metabolic health.

Problems with Current Weight Metrics and Future Directions

The reliance on BMI as a health measure is criticized for not accounting for muscle mass and body composition accurately. Alternative measures like the maximum attained weight method provide deeper insights into weight-related health risks. As dietary habits evolve and medical understanding of obesity improves, targeted interventions become more viable, moving away from generic diet plans to more personalized approaches based on genetic predispositions and individual health requirements.