In the past battles against obesity, patients often heard the advice to simply increase exercise.
Now researchers are actually quantifying the amount of exercise needed to prevent (and possibly reverse) the disease according to genetic risk factors.

Thoughts? Comments?

https://news.vumc.org/2024/03/27/higher-genetic-obesity-risk-exercise-harder/

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816822

Problem is, do you have an inherited risk of obesity or how many kids do you see that are thin with overweight parents? Is the problem culture of food eating patterns? Or are we talking some of the Asian populations that do have this problem - and don't have the problem with rice that other cultures do?

They also didn't note anything about the food patterns in the studies. Or I missed it.

Yeah, not buying it. The medical community looks for what it wants to see. I married a statistician. They constantly remind me "Correlation does not equal causation!!"

The medical community wants to believe that more physical activity will miraculously solve obesity issues because it puts the cause and the remedy right back in our laps, instead of admitting that this is a disease that is very complex and no one smoking gun is the cause or the cure. We need holistic approaches.

I was a very active child. So were my siblings. My brother is a normal weight, my sister is often underweight, and I ended up over 300 lbs. My parents are normal weight though they both have siblings with weight issues. I gained a ton of weight while I was still active. Puberty hit and it was like someone switched on a helium tank and I just ballooned up. I've had more doctors than I care to count tell me that if I just got more physical activity and stopped eating McDonalds all would be well, ignoring the fact that I hate McDonalds and until my autoimmune disease got severe I was quite physically active. I know a lot of thin people who are couch potatoes. I know a lot of fat people who are active. These "studies" do nothing but continue to give doctors more ammunition in the shame game that is current obesity management.

My partner is Chinese, was raised on traditional Cantonese food (which is very healthy in general), in a family where everyone is effortlessly thin except their grandmother who was diabetic... Several years ago my partner was diagnosed with diabetes. They've had weight issues all their life, despite being very active for most of it. Is it genetics? Perhaps. Is it current lifestyle? It probably contributed to it. Was it due to a childhood diet based on rice? Not likely, that diet also incorporated a ton of healthy protein options and a healthy variety of vegetables, including plenty of greens. A lack of exercise was certainly not the cause of it and increasing exercise is not going to be the cure for it either...

The problem I see with this, not the study itself but the implications, is that if you have a high genetic risk for obesity, the amount of exercise required to stave it off may be well outside the limit of what most people can tolerate. Finding out you need 4 or 5 hours a day of exercise when most people might only need 30 minutes isn't exactly actionable if you also have to work in a sedentary job to earn a living.

Not jiving in my mind. I was ALWAYS thin and active. Once I got pregnant with my son, my PCOS really kicked in. I gained almost 100 pounds and only lost 35 after I had him. Nothing I did worked, but back then, doctors didn't know much about PCOS (this was April of 1998). I worked out, ate fairly healthy, did a lot of swimming, and still nothing worked.

Because of my PCOS, I then had 10 losses (and gained weight with each pregnancy). I was diagnosed with PCOS in 2005 as well as insulin resistance. I was put on Metformin, which helped me drop down from 322 pounds to 301 pounds. I got pregnant with my daughter and had her in Sept 2006. At that point, I was 355 pounds. I stayed on Metformin, worked out, improved my eating even more than before, and went down to 340 pounds. And never lost another pound. At all. I also was never able to get pregnant again.

Through the years, my weight ballooned up to my highest weight of 421 pounds. I ended up getting type 2 diabetes, high cholesterol, high blood pressure, painful joints, mobility issues (needed a cane to get around), and I was wearing size 28/30 (4x/5x), size 10 rings, 22"-24" necklaces, no bracelets (none fit me).

I exercised so much for so many years, but the PCOS really did a number on me and stopped me from getting healthy. After a while, you start to feel defeated and give up. Why kill myself dieting, working out, doing everything right to, at best not lose weight, or at worst keep gaining?

If you eat less calories than you use then you will always begin to lose weight. With exercise, your body adjusts over time and compensates for the lost calories (saving them elsewhere) meaning that exercise becoems less effective over time.

It's still best to combine both though. Exercise has many offer health benefits.

I’m glad I’m not the only one that feels like this shifts the blame back to the patient’s lack of commitment to exercise!