The following article was written by Dr H. Rensburg, leading bariatric physician and hormone specialist. KEY Nutrition works in conjunction with Dr Rensburg and it is a great asset to our practice to have a medical specialist on board with our weight loss views.
This article contains some higher medical terms but it is well worth the read to understand the truth of what obesity actually is.
It is always recommended, when taking medical advice, to first consult your own doctor to see if this medical advice is suitable to you.
‘To be or not to be, that is the question’
We all know what Obesity is, don’t we? Often the term ‘Obesity’ is associated with having a BMI of exceeding a certain amount, being too heavy for your age and height, etc. However, in individual cases, the definition outlined above is far from reality. The concept of a BMI was developed over 170 years ago and over 2,000 years ago the Romans used the word Obesity (Obesitas).
To fully comprehend what ‘Obesity’ is, we have to consider the following:
1. Define what Obesity is in the first place.
2. What causes this condition?
3. The need to design or coin a new name that would be more suitable for this condition, since “Obesity” is an outmoded, outdated and incorrect term to describe this dangerous and horrible disorder. The fact that it is still in use by the medical profession today is actually quite surprising.
# 1. What is “Obesity”? Well, according to the medical profession it is being over-weight in relation to a person’s height, weight and age. They have designed a lighter version of it, namely “overweight” before a person actually becomes “Obese” at some magical point and at another equally magical pinpointed point “Morbidly Obese”.
I guess “overweight” is a form of “pre obesity”. It may even be designed not to let patients feel embarrassed, because “Obesity” carries with it the stigma of mental problems, a lack of self-discipline, laziness and the burden of diseases of affluence. It may even be seen as derogatory. But, then at a certain cut-off point let’s make them feel embarrassed anyway by calling it “Obese or Morbidly Obese”
In Medical practice is it common for a disease to develop whereby an essential substance in the body becomes either over (hyper) or under (hypo) produced. As an example, and there are many, if you produce too much thyroid hormone you may develop hyper thyroidism like in Grave’s disease. An underproduction (hypo-) of the thyroid may lead to Hashimoto’s disease…and the list goes on…
We all have fat and fat is essential to our existence. If we make too little (hypo-fat) we become sick or if we produce too much
(hyper-fat), we also become ill. The latter is
really what “Obesity” is – a condition, for whatever reason, overproduce fat leading to a disease called “Obesity” (hyper-fat).
There are only degrees or levels of “Obesity”. If you suffer from very mild asthma you suffer from asthma. Full stop. If you suffer from severe asthma you suffer from the same disease, just to a greater more severe degree.
To play semantics by calling a smaller amount of over-fat (hyper-fat) as “overweight” serves no purpose at all and can lead to confusion and a false sense of security. A mild degree of Grave’s disease is still called Grave’s disease. A mild cancer is still called cancer.
Summary: Obesity is simply a disease that causes an over production of fat for whatever reason(s) leading to hyper-fat. That’s all it is. There should be no mystique about it. Actually, it’s quite simple.
# 2. What causes Obesity?
The primary cause is purely genetic in by far the majority of cases. You cannot be held responsible for not choosing your parents properly.
Just mentioning this will certainly raise the eyebrows of some psychologists, sociologists and a few other “-ologists”. According to them, a person suffering from any degree of “Obesity” has some psychological hang-ups, as a result overeat for comfort, thereby taking in too much calories leading to “Obesity”. Let’s just treat their hang-ups and they will be fine (hopefully).
Well, it does not work and in the last 50 years of this theory, and the extensions of it, we have become fatter than ever before and developed all sorts of fancy psychological theories as to explain this. These theories are not based on facts, but rather on a hunch and lots of guess work.
What they did not point out to us is that thin folks have their own fair share of hung-ups, overeat and stay lean. You guessed it; it’s due to their genetic differences responding differently to the same environment. There is no place for any guilt feelings and psychological theories – the tendency for “Obesity” is primarily a survival issue. It is physiological, survival orientated and absolutely normal.
The Genetics load the gun and the Environment pulls the trigger. If you are Hyper-fat, it’s because you were born in the wrong place and the wrong time. 100 years ago, you would probably have been thin – like most folks would have been, even the genetically predisposed folks with the tendency to develop Over-Fat were leaner.
We are all genetically programmed to over-eat, because under-eating is incompatible with survival.
In primitive times if you see food, you better devour it, because tomorrow it may be gone. Now we can overeat on cheap abundant calorie-flavour-enhanced foods 25 hours a day, 8 days a week in our present
environment. It depends on your genetics how you will respond to this nonstop over supply of high-energy foods.
If you have the Genetic gun for Obesity the Environment (food supply) will squeeze the trigger. If you don’t have the Genetic gun the Environment cannot tickle the trigger so you will stay lean, in-spite of the fact that both parties overeat and live in the same Environment, which is a Calorie and quantity augmented never ending food supply.
In general, “Obese” folks do not eat more than genetically thin folks. Just their metabolisms are responding differently to the same environment.
(Hyper-Fat folks are metabolically more efficient in storing fat)
# 3. Why a new name for “Obesity”? Translating from Latin Obesity (or Obesitas) means gluttony and greed. What is wrong with this name? (Seriously wrong?)
In the first place it is not a descriptive name, namely an over production of fat (adipose tissue or adiposity). It only alludes to a possible cause, namely over-eating and gluttony, which is not even a cause by itself. It says nothing about the Environment (food supply) and the Genetics. A fair number of lean people are gluttons and stay thin. Why? Genetics.
So, what can we call a disease, which is primarily caused by the interaction of the Environment and Genetics, which results in an over production of fat, which in turn cause the development over 60 different diseases? (Yes, a ‘big’ question)
Adiposis in Latin means an over production and accumulation of fat. Therefore, we can call it the Hyper-fat Syndrome, the Hyper-Adiposis Syndrome or Hyper Adiposity Syndrome. But yet again, it’s only descriptive and does not allude to the cause at all, neither its resultant pathology (disease). Megaly or ‘megalos’, meaning big in ancient Greek is used in Medicine like cardiomegaly, 3
which means an enlarged heart. Fat is basically an endocrine organ in the body producing its own hormones. Thus, Adipomegaly Syndrome (AMS) could also be a contender meaning an enlarged fat organ. However, as with the Hyper-Adiposity Syndrome (HAS), it is only descriptive and does not take any cause into account.
However, HAS and AMS are descriptive enough to be used as a blanket term for all the different types and causes of over-fat replacing Obesity” Therefore we will use it as the umbrella word for “Obesity”, but in specific cases it has its limitations and we have to dig
deeper… For simplicity we had to pick one and we decided on HAS.
This situation often occurs with medical terminology and in most cases the term is solved with an acronym meaning an abbreviation formed from the initial letters of other words and pronounced as a word. Like AIDS, which stands for the Acquired Immune Deficiency Syndrome, etc.
There is no other way to describe “Obesity” or HAS in a broader sense as just one word. Another acronym is the answer. In this acronym we should include Genetics, Environment, Over-Fat and Syndrome. The latter meaning a group of symptoms, which consistently occur together, or a condition characterised by a set of associated symptoms and disease.
What we also have to take into account is that certain folks who were not born with the Genetics for “Obesity” can accumulate excess fat (HAS) under certain circumstances. In this case we have to include Pathology in the acronym.
Additionally, it would be nice if we can pronounce the acronym as sounding like a word like AIDS for instance, and not like something that needs to be spelled out like KHRWG.
So let us give it a try.
The Genetic Hyper Fat Syndrome (GHFS) is fine, but saying it is difficult. The Genetic Excess-Fat Syndrome GEFES is easier to say, but I thought to keep a remnant of “Obesity in the acronym like “O” for sentimental reasons.
In the end I settled on GOFES (The Genetic Over-Fat-Environmental-Syndrome) as the “day to day” word as it were. With acronyms we can use a bit of poetic license.
It is very easy to pronounce – initially a bit awkward, but very workable. You will soon get used to it. However, to be more scientific sounding, we could call it GHASE (The Genetic Environmental Hyper-Adiposity Syndrome). The E was just put at the back of the acronym so it sounds and pronounces like a word. Yet again we decided on GOFES s the day-to-day acronym.
This describes exactly what “Obesity” is: the Environment interacting with the Genetics leading to an Over-Fat (HAS) situation, which in turn leads to a Syndrome (disease, pathology – the latest count about 65 of them).
GOFES includes: Description, Cause and resultant Pathology (Syndrome). Thus, a comprehensive name, which makes it spot on.
However, in certain situations GOFES has some limitations like in the case of a person who does not have the Genetics to become Over-Fat (HAS), but still do so due to some other disease process. Then G (Genetics) cannot be part of the name.
If a Genetic lean person develops an adrenal tumour, which produces too much cortisol and as a result develops Cushing’s disease, which amongst things produce too much fat (HAS), then in this case Pathology cause the Over-Fat (HAS) and not Genetics. Thus, we need to add a P for Pathology.
PHAS would be appropriate describing these patients. In some cases, existing GOFES can be further aggravated, when a person additionally develops Pathology on top of their GOFES. In this case the G and P should both be in the acronym like PGHAS (pronounced “PG-HAS”). Pathology causes HAS in addition to the Pathology (Syndrome) that HAS itself causes in the first place.
By far the majority of the population, who suffer from the HAS2, is due to GOFES. Some have additional medical causes further aggravating their GOFES, which then becomes PGHAS. PHAS is relatively rare, but a doctor would not like to miss the diagnosis.
An important consideration: The tendency to become over-fat is not a disease at all. In fact, it’s a clever survival advantage. However, the consequences, namely the Over-Fat (HAS), are the disease (syndrome)
In the end the only measure to control the HAS (“Obesity”) epidemic is to legislate against the food supply, or an economic collapse, war, tsunami, etc. Politicians will not legislate against the food supply in any meaningful way. If you want to be successful, you need to manage your own food supply (Environment) to control your Genetic tendency to develop HAS, in this case GOFES.
Controlling this will be your challenge. You will have to be a Pit Bull to fight a Pitt Bull, due to the ruthless nature of survival instincts like the PS (Phagic System).
This is our dilemma living in our modern toxic environment we created, playing up to our natural physiological (not psychological) tendencies to over-eat and shun exercise by producing labour saving devices for survival reasons. (Very normal behaviour indeed – no psychological problems here at all. Thus, no quilt, no shame…this behaviour is natural.)
The 3 specific diagnosed causes of HAS2 are:
GOFES = Genetics + triggered by Environment, (as in a Polar bear)
PHAS = Pathology causing a HAS situation (as in a Humming bird + Pathology)
PGHAS = Pathology aggravating the Genetics (as in a Polar bear + Pathology)
Once GOFES has been diagnosed a further search should be undertaken to exclude PGHAS. Always. These terminology distinctions become very important in management and treatment options.
For example, we have 2 types of Diabetes. Type 1 (under production (hypo-) of Insulin) and type 2 (an overproduction (hyper-) of Insulin), there also 2 types of HAS namely:
HAS1= Hypo Adiposis Syndrome1 (Thus having too low fat %)
HAS2 = Hyper Adiposity Syndrome2 (Thus producing too much fat)
Summary illustration:
Practical outcomes:
Apart from making scientific and treatment sense by better reflecting what “Obesity” really is, my patients who have learned the new word and concepts for “Obesity” and understand what is involved, have dramatically improved their success in controlling their HAS2 due to either, GOFES, PHAS and or PGHAS.
They did not buy all sorts of iffy wishy-washy theories about their condition and concentrated on the real issues of dealing with it, namely controlling their own Environment and Food Supply. Not through guilt and shame, but through the facts of the situation. They took the mystique out of it and got on with the job with excellent results.
(They were also less susceptible to fraudulent advertising and dubious information even from so called experts)
GOFES (As in most HAS2 sufferers)
Dr. Hendrik in Rensburg
MA. MB.Bch. BAO. (TCD) M.R.C.S. (Eng) L.R.C.P. (Lond) Faculty Member of the international Hormone Society (IHS) The Rensburg Medical Clinic, Perth WA
