JAMA Viewpoint Discusses Alternative Theory of Obesity
A recent viewpoint article published in The Journal of the American Medical
Association (JAMA) discusses an alternative theory of chronic overeating as
“a manifestation rather than the primary cause of obesity.” David Ludwig and
Mark Friedman, “Increasing Adiposity: Consequence or Cause of Overeating?,”
JAMA, June 2014. Authored by New Balance Foundation Obesity Prevention
Center Boston Children’s Hospital Director David Ludwig and Nutrition
Science Initiative Vice President of Research Mark Friedman, the article
discusses the physiological and genetic mechanisms that may contribute to
obesity, arguing that “a focus on diet composition, not total calories, may best
facilitate weight loss.”
In particular, Ludwig and Friedman not only point to previous studies
claiming that the body adapts its metabolic responses “to defend baseline
body weight,” but argue that insulin disorders “highlight the potential influence
of metabolic fuel concentration on body weight regulation.” They also
note that, contrary to a calorie-centric view of obesity, research has purportedly
shown that genetic and environmental factors can induce “an excessively
anabolic state that favors storage rather than oxidation of ingested calories.”
“If anabolic metabolic defects precede and promote overeating, then
conventional calorie-restricted diets would comprise symptomatic treatment,
destined to fail over the long term for most people in an environment
of unlimited food availability,” report the authors. “Although reduced energy
intake acutely decreases fat mass, predictable physiological and behavioral
adaptations progressively lessen the ability of most people to maintain
voluntary energy restriction.”
Issue 528
