If you are one of the 6.8 million Americans who meet the criteria for a diagnosis of morbid obesity then you are probably aware of the stereotypes that accompany the diagnosis. I know this well. I used to be morbidly obese before my bariatric surgery in 2003.

Too many assume that the morbidly obese are people who always make poor food choices and eat nothing other than a calorically-dense diet that is high in saturated fats, trans fats and sugar but low in fiber and nutrients. The belief that morbidly obese people constantly make poor food choices is complimented by the belief that the morbidly obese also eat excessively. While this might be true for many, it is not true for all. The fact is that there are many factors which contribute to morbid obesity.

Obesity and morbid obesity are chronic conditions. Studies have shown that once the problem has taken root, exercise and diet are limited as long term solutions.

As for me, I have become educated on what are healthy and what are not healthy food choices. I realize how uninformed I once was. Nowadays, I eat far differently than I did prior to my weight-loss surgery. For a few quick guidelines on making healthy food choices, read Bariatric Diet: Build a Healthy Plate.

Genetic Factors for Obesity

Genetics seem to play an important role in weight gain. Adopted children often do not have the same body weight as the adoptive parents who instilled in them their eating habits. There is an 80% chance the adopted children will be of similar weight to the biological parents they never met. My father's family, which is the side of the family that I take after, is virtually all obese.

Identical twins who have the same genes have more similar body weights than fraternal twins who have different genes.

Lifestyle Factors for Obesity

Researchers have determined that excessive nutrient intake combined with
a sedentary lifestyle are the main causes for obesity in Western civilization in the last quarter of the 20th century. We have become able to move from place to place faster than we once did while expending less energy in doing so.

Metabolism

It has long been believed that if a person takes in more calories than they burn they will gain weight. If more calories are burned than ingested, weight will be lost.

We now have the theory of set point where a mechanism in the brain makes people resistant to either weight gain or weight loss. If a person dramatically cuts her calorie intake, the brain will lower metabolism and slow activity. The result is regaining weight that has been lost.

The Pima Paradox

The Pima Indians are among the heaviest people in the world with some of the adults weighing in excess of 500 hundred pounds. Many of the teenagers have diabetes, an illness that often accompanies obesity.

A group of Pima Indians living in Mexico does not have this problem and many began asking why not.

Generation of Pima had lived in the desert and often went without food. Those Pima with genes that allowed them to store as much fat as possible when food was available fared best. But now those fat storing genes are having a poor effect in that many Pima have a predisposition for weight gain.