I really liked this approach of determining the underlying reasons for why we got fat. I suspect most of us will have multiple reasons and do a "1 from column A, 2 from column B" type of approach, but it helped me think through what underlying behaviors need to be be addressed for different people.

Synopsized from Dr. Sharma's Obesity blog post, food insecurity vs. binge-eating syndrome), may well present with exactly the same amount of excess body fat and identical clinical complications (e.g. diabetes, reflux disease and urinary incontinence).

On the other hand, two individuals, gaining weight for exactly the same reason (e.g. on anti-psychotic medications), may present with quite different complications (e.g. sleep apnea vs. osteoarthritis).

The authors are certainly correct in their statement that,

“Obesity is a heterogeneous and complex disease influenced by exogenous and endogenous exposures. Stratifying obesity into meaningful subtypes could provide a better understanding its causes and enable the design and delivery of more effective prevention and treatment interventions.”

I think this is great. Most of us have different behaviors, different eating triggers, different health issues, and different cultural perspectives surrounding food and eating. There is not one single path to obesity & there's not a single path to overcoming it, either. You always post the most thought-provoking things!

Interesting. I bet that those of us who gained weight primarily for emotional reasons are the ones who have the hardest time taking it off. We also seem to be the primary ones who can't succeed without a big boost like WLS. And we are most successful when we are obsessive about researching and managing ourselves post-WLS. I hope there are more studies and scholarship about these issues in the future now that some of the stigma seems to be easing.