Obesity and Overweight Conditions

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

In many parts of the United States in 2010, rates of obesity for the general population exceeded 30 percent, and only 2 states had rates below 20 percent. By 2014, the rate of obesity for the entire population was 34.9 percent (JAMA Feb.26, 2014; 311(8). The simple overweight condition is a separate factor, and is now seen in an additional 30 percent of the population in most states. This means that over half of the population in the United States has a physiological problem with weight gain and related health problems and health risks. While a simple overweight condition may lead to obesity, there are many factors in our modern society that are more serious contributors to obesity syndromes, and the need to better understand this complex syndrome of dysfunction in order to reverse it is obvious. We cannot pretend for more decades that just following standard dieting with fix the functional homeostatic problems, or that we need to resort to drugs that simply depress the appetite, or surgeries that force an immediate weight loss by making the stomach very small for a while. A comprehensive and holistic approach to this systemic dysfunction, and a better preventive system is sorely needed as obesity becomes a public health crisis. Complementary and Integrative Medicine and the specialty of Traditional Chinese Medicine (CIM/TCM) do not provide a quick fix for obesity or a miraculous claim of weight loss, but do provide a sensible and holistic medical care that is comprehensive and addresses the many issues in obesity. By resolving these underlying health issues, you will be able to lose weight and regain health.

Obesity is now considered the number one health threat by the U.S. NIH (National Institutes of Health), and is highly associated with cardiovascular disease, stroke, heart attack, metabolic syndrome, diabetes, and a host of other common diseases, especially subclinical hypothyroidism and hyperparathyroidism, as well as other hormonal imbalances, including postmenopausal and postpartum hormonal imbalances. Besides this great association with serious disease, making it perhaps secondary to another disease state, obesity is a primary health problem as well, that is difficult to correct and severely degrades quality of life. The term obesity is thus complex, but America still refuses to come to grips with even the meaning of obesity. We still cling to a set of ideas from 50 years ago, equating obesity with being fat, or overweight. While obesity does create excess fatty storage, and does result in being overweight, this is not the definition of obesity in a physiological sense, and for those afflicted with obesity, these definitions are not helpful. The defining of obesity according to the 50 year old definition that included the term "simple obesity", which is actually just now correctly termed an overweight condition, or 'out of shape', only obscures a serious health concern. To truly treat obesity, one has to understand what it is, and gradually work to correct the underlying health imbalances. While most patients afflicted with obesity are just looking for a simple solution, they must come to grips with the complex set of dysfunctions that often occur in obesity, and adopt a more persistent and comprehensive holistic strategy to reverse this disease.

It is important to distinguish an overweight condition from obesity. This is not to say that everyone with just a little extra accumulation of fat around the midsection is not experiencing an obesity syndrome. One doesn't need to be excessively large to be obese, and many large individuals may not be obese. Obesity is a complex syndrome of dysfunction that doesn't just start when the weight gain is dramatic, and should be diagnosed and corrected before it gets out of control. Obesity should be distinguished from Metabolic Syndrome (many cases incorrectly termed Diabetes Type 2). Obesity is not defined by the amount of body weight, but rather by the percentage of body fat, and since it is a multifactorial disease, a number of diagnostic tests are needed to clarify the individual diagnosis. Blood tests and urinalysis will look for metabolic dysfunction or abnormality. Body Mass Index (BMI) should not be the sole consideration in diagnosis, and the A1C index (an advanced glycation endproduct), urine ketones, and a glucose challenge test may clarify, as well as a Bioelectrical impedance analysis (BIA). Often the standard blood tests are not dramatic, but a sometimes fluctuating high circulating triglyceride level is commonly seen.

In 2016, experts at the University of California Los Angeles (UCLA) released the findings of a new study that found that the common practice of oversimplifying the term obesity to a simple measure of BMI (ratio of a person's height and weight) has incorrectly labeled more than 54 million Americans as "unhealthy" and obese, leading to higher insurance premiums and workplace discrimination. Dr. A. Janet Tomiyama, a psychology professor at UCLA, and the lead author of the study, noted that this oversimplified diagnosis of obesity is now seen as a gauge of ill health, but that much evidence points to the fact that tens of millions of Americans who are overweight are perfectly healthy, and this is causing a deleterious amount of stress that is more of a health problem than being overweight. The study found that using broader measures of metabolic health that close to half of Americans with a high BMI are healthy, and that almost 20 million Americans labeled obese are also healthy individuals as measured by typical metabolic and cardiovascular parameters. We see that there is a strong need to explore a more intelligent definition of health in overweight and obese conditions, and for the patients with these conditions to take a broader and more proactive approach to their healthcare, not just a focus on weight loss by any means, as standard medicine has pushed. Dr. Tomiyama, who directs the UCLA Dieting, Stress and Health Laboratory (DISH) has found in her research that there is no clear and direct connection between weight loss and health improvement related to hypertension, diabetes, glucose metabolism and cholesterol lipid balance, as is widely assumed. This means that we should not resort to risky pharmaceutical and surgical approaches for everyone who is diagnosed as obese or is overweight, but that we should take a more holistic approach to their health. Complementary and Integrative Medicine and the specialty of Traditional Chinese Medicine (CIM/TCM) offers patients many protocols to improve health and prevent disease when faced with an overweight or obese condition. Weight loss itself is often difficult, and will often occur only after underlying health and metabolic problems are addressed.

How should we accurately assess and diagnosis patients with suspected obesity syndrome? It is clear that we should not just take a BMI test, which is a very simple and crude analysis that would only point to a need for a more detailed analysis. We should not just take a BMI test and be arbitrarily lumped together with everyone that does not meet the one-size-fits-all analysis, or requirement for the 'ideal' body, and then subjected to harsh therapies with many adverse health effects, and arbitrarily labeled obese on our health records. An accurate, informative and individualized assessment is important when trying to tackle health problems and risks associated with an obese or overweight condition. Some newer diagnostic tests utilize markers such as Insulin EIA (enzyme immunoassay), C-Peptide EIA, and Insulin Ultrasensitive EIA. An ultrasound to assess fatty liver accumulation (hepatic steatosis) is sometimes used, and is shown to have a high correlation with the liver enzyme GPT (glutamate pyruvate transaminase). Serum adiponectin and resistin are now being tested as well, and testing for circulating cytokines TNF-alpha, IL-6, and cytokeratin CK-18 are being considered. The World Health Organization (WHO) has set a diagnostic criteria for differentiation between metabolic syndromes and obesity syndromes, with use of BMI, waist circumference, fasting and 2-hour oral glucose tolerance test and plasma glucose, fasting plasma triglycerides and HDL cholesterol, blood pressure, 24-hour albumin excretion, and fasting insulin tests recommended as guidelines, with an addition of AGTT in nondiabetic patients recommended as well (International Journal of Obesity (2005) 29, 668–674). More advanced diagnostic tests are being created and should be utilized when appropriate, such as multiplex ELISA adipokine assays. These tests may assess leptin, insulin-like growth factor-1 (IGF-1), insulin, resistin, and various key pro-inflammatory cytokines and the chemokines that regulate them, such as mononcyte chemoattractant protein-1 (MCP-1). We see from this recommendation that that the assessment should be complete and that treatment protocols for obesity and Metabolic Syndrome should be distinguished and refined. Both of these conditions, an overweight condition and obesity, which often overlap, require a broader treatment strategy and will require integration of Complementary and Integrative Medicine (CIM/TCM) to treat holistically. At present, it is clear that the standard protocols have failed. An insistence that this epidemic of obesity is still just a matter of weight loss is not sensible, and has led to this amazing incidence and failure to adequately address the health problem.

A Serious Look at the Causes of Obesity is Needed to Reverse this Disease

By 2014, scientists were finding evidence that rates of obesity and non-alcoholic fatty liver, or hepatic steatosis, were similar between the adult and child demographics in the overweight population in the United States and Europe. Such findings point to the environment, diet, and particularly the food industry, as primary causes of this disease mechanism, or there would not be a uniform rate of obesity and fatty liver in both young and old. Insulin resistance, or Metabolic Syndrome, was highly correlated with elevated liver enzyme glutamate pyruvate transaminase (GPT), but not with other liver enzymes, and with HGNA, or mercury accumulation (PMID: 24768200), as well as circulating GGT (glutamyltransferase) and ferritin (iron storage). By looking at the mechanisms of fatty accumulation in the liver and metabolic dysfunction, we are finally seeing the real underlying causes of obesity. To really tackle this complex health problem we need to both correct the environmental and dietary concerns, and to take a broader approach to therapy. This means that an intelligent, proactive and persistent complex protocol is needed to really reverse obesity, not just one particular treatment. Most patients that consider CIM/TCM therapy come to the Licensed Acupuncturist and herbalist and just ask: "Does acupuncture cure obesity?" The answer is that the short courses of frequent acupuncture stimulation will help, and a realistic approach is to actually formulate a realistic and thorough protocol, a holistic design that is individualized, and which requires patient understanding of the goals of therapy and the need for a step-by-step approach. Treatment, dietary changes and daily lifestyle routines must be integrated.

The modern diet and environmental toxins are clearly linked to these health problems that lead to obesity. Studies as far back as 1976 have shown that obesity may be induced with excess food additives called glutamates, such as monosodium glutamate (MSG), and hundreds of such molecules have been invented to stimulate increased desire for a food, yet are still unregulated (British Journal of Nutrition; Jan 1976; 35(1): 25-39). Mercury toxicity has increased dramatically in the environment and food, mostly from airborne organic mercury emitted from dirty coal-fired power plants. In addition, research by 2014 has demonstrated that there is a strong correlation between rising prescription of antibiotics for children and rates of obesity. The link between overuse of antibiotics and obesity concerns both the widely known use of antibiotics to stimulate more rapid growth in animals produced for food, as well as the destruction of the important symbiotic biota, or microbial cell colony, which accounts for a majority of cells in the human organism and is essential to producing nutrients for us, as well as providing immune protection. Such scientific evidence points to the dramatic need to take a more holistic approach to stopping the obvious epidemic of obesity. Avoiding processed and fast food, eating whole, fresh, organic local foods, finding joy in cooking, improving the health of the intestinal Biome, and avoiding environmental chemicals and toxins that lead to metabolic and hormonal dysfunction is the first step in healing from and obesity syndrome.

A dramatic percentage of America's children are now afflicted with obesity, which will stay with them their entire life, and contribute to devastating health problems, if it is not reversed. This requires much more education of both the patient population and the physicians. In 2011, standard medicine still has no effective treatment for obesity, and a number of drugs designed in the last decade have been denied FDA approval, both because they are ineffective, and because the side effects of these specific chemical blocks to physiological processes come with alarming side effects for a high percentage, if not all, patients. On the other hand, a number of current medications are being reviewed and limited in use by the FDA, with strong warnings attached, because they also appear to cause obesity, or at least contribute highly to it. The enormous rise in prescription of atypical antipsychotic medications to control behavior in children, especially children already prescribed amphetamine drugs to control ADHD, is especially problematic, with a large risk of metabolic disorder and obesity linked to these psyche drugs and polypharmacy. A study in 2016 showed that prevention of childhood obesity may begin in the womb, with women with the highest level of folates, derived from folic acid in the diet, showing a 43 percent lowered risk that the child will later develop obesity and insulin resistance. Other studies have shown considerably increased risk of childhood obesity related to harm to the Biome from unnecessary use of antibiotics, as well as Caesarian section delivery, and a large 1999 population study showed that prolonged breastfeeding was correlated with decreased risk of obesity later in life. A 2014 meta-analysis of studies of the link between lack of breastfeeding duration and childhood obesity confirmed that proper duration of breastfeeding is a significant protective factor (BMC Public Health 12/13/2014; Jing Yan et al). Clearly, a more holistic outlook and importance of nutritional and lifestyle habits is the key to preventing, and even reversing obesity.

The treatment of choice for obesity in standard medicine appears to be gastric banding, which has increased in use dramatically, and for want of any other effective treatment, has been granted expanded use by the FDA. This type of surgical correction, though, comes with poor long-term outcomes, and unhealthy changes in the short-term, as the body is literally starved of nutrients and forced into sudden hormonal, metabolic and immunological changes. These treatments of obesity are now being questioned due to recent research revealing the obesity paradox today, as the increased fat is found to decrease mortality risk in diabetes and cardiovascular disease, not increase it, and simply forcing weight loss may not be the correct approach to resolving health risks (see more below on this subject). A holistic approach to resolving the underlying causes of obesity may be more important. Integration of Complementary Medicine in the treatment of obesity should be adopted immediately as a part of standard treatment protocol, but a competitive business model has kept this from happening.

The Surgeon General in 2001 stated that "Overweight (conditions) and obesity are among the most pressing new health challenges we face today. Overweight (conditions) and obesity may soon cause as much preventable disease and death as cigarette smoking. Approximately 300,000 U.S. deaths a year are associated with obesity and overweight (conditions). The total direct and indirect costs attributed to overweight (conditions) and obesity amounted to $117 billion in the year 2000." The problem has dramatically increased by 2012, and this statement from 2001 is clearly an understatement of this important public health issue. By 2014, the U.S. CDC estimate of the cost of obesity annually rose from $117 billion to $147 billion, and the annual medical costs for obese individuals was $1,429.00 per year higher than for normal weight individuals. This complex disease syndrome takes a very dramatic toll on the population from all perspectives, and oversimplification of the health problem has not led to a satisfactory outcome.

Obesity is defined as an abnormal increase in fat in subcutaneous and organ tissues, and is generally associated as a disease state with poor hormonal balance or hypothalamic function. It is also often associated with subclinical hypothyroidism and metabolic syndrome, and in most cases the underlying health dysfunctions are multifactorial. Obesity cannot always be equated with "being fat", as many patients with measurable obesity are only about 10 percent heavier than the so-called normal. So-called simple obesity, or the overweight condition, is not a disease state, but is simply a matter of excess food intake with deficient exercise. While many persons are afflicted with a habitual lifestyle that is too sedentary, often with habits acquired at a young age, this does not define those persons with a disease state. For patients that are just overweight due to a lack of good habits, changing the diet and increasing daily activity will correct the problem. For patients with an inability to lose weight, we must look farther than "simple obesity", and discover the underlying health problems that need to be corrected. A patient that is unable to lose weight is often made to feel guilty for their weight rather than finding help and empathy, even though we now know that food additives, environmental toxins, and even pharmaceutical medications may be responsible. For these individuals, a simple program of dieting and exercise will not be enough, and the options presented by standard medicine often involve harsh pharmaceutical approaches and surgical options that damage the health in dramatic fashion. The patient afflicted with obesity can find help and empathy in Integrative and Complementary Medicine, with numerous treatment options, patient education, and help to counter the harsh side effects of medications and surgery, if these options are chosen.

In my clinical practice, I have seen an almost universal lack of empathy for patients suffering from true obesity. Society has ingrained an attitude that looks down on and blames the obese for their problem, but the truth is that our modern society is the cause of their obesity. There is a societal tendency to group all overweight persons into a single entity, and a feeling that they chose bad habits that caused their obesity, and now suffer the consequences. The fact is that there is a complex variety of underlying problems that cause obesity, not just a lack of exercise and a decision to eat an unhealthy diet. Thankfully, there is finally a call to arms to counter the rates of obesity in the United States, supported and pushed by the first lady, Michelle Obama, but this movement, so far, is addressing the food industry, our educational system, and the individual choices of eating and exercise routines. It is still not properly addressing those individuals that have a true obesity, or inability to lose weight, and it is not addressing physicians, who should adopt a comprehensive integrated protocol to treat this widespread health problem. The 35 percent of our population that may be experiencing obesity must have more support to understand and deal with this serious health problem. Obesity affects the entire population, in health care costs that affect all of our insurance policies and taxes, as well as productivity and economic consequences. The environmental and industrial chemicals that have gotten worse and contribute heavily to the rise in rates of obesity also may affect anyone"s child. A change in society's attitude is in order. Greater utilization of appropriate integrated medical care that addresses the whole physiology of the patient is also needed. Patient education and understanding, coupled with greater use of Complementary Medicine, is the ticket for success and avoidance of adverse effects of treatment.

There is no better place to turn for this help than Complementary and Integrative Medicine (CIM) in the form of a knowledgeable Licensed Acupuncturist and herbalist, or the Naturopathic Doctor. A physician must be able to assess the health holistically and thoroughly, and must have a variety of tools to treat the systemic health problems underlying obesity. Modern medicine does not have the tools or the time to help the patient sufficiently, and should incorporate Complementary Medicine into the treatment strategy for obesity. Patients that resort to the quick fix, taking stimulant medications and surgical banding to inhibit food intake and assimilation, will often find themselves with more health problems than when they started. Newer medications being developed and marketed for weight loss are having a difficult time even getting past even the industry friendly FDA, and when side effects and risks are great enough to warrant non-approval by the FDA today, the patient needs to worry. The U.S. FDA has responded weakly, placing a moratorium on fast-tracking obesity medications until they can show definitively that they will not cause cardiovascular damage with prolonged use, but much pressure has led to reversals of non-approval of obesity medications still banned in Europe and it is widely acknowledged that standard medicine does not comply with the guidelines of short-term use only for these medications. In 2015, experts have found that over 80 percent of anti-obesity and weight loss prescriptions still consist of phentermine, an amphetamine-derivative drug that was part of the banned Fen-Phen medication that resulted in over 50,000 cardiovascular injuries and deaths with enormous sums awarded to patients. Phentermine now is marketed with a wide array of happy names that create confusion for the patient population, and possibly the prescribing doctors and clinical nurses.

Many standard clinics specializing in obesity and weight loss now utilize CIM in the treatment protocol, but with no medical school instruction in nutritional and herbal medicine in standard University medical schools, these M.D. experts may not have the expertise to design an effective and individualized treatment protocol. A stubborn refusal to integrate Licensed Acupuncturists and herbalists, and Naturopathic Doctors, into this standard clinical practice to achieve a higher level of trained expertise has led to the adoption of often useless protocols with herbal and nutrient medicine designed by the pharmaceutical industry, which has a monetary incentive to discourage the effectiveness of these medicines that compete with profitable pharmaceuticals. Complementary and Integrative Medicine (CIM) can help the patient understand the puzzle of physiology that creates the state of disease obesity, and a wealth of research has been performed in the last few decades to help with this task, some of which is documented by the final section of this article with summaries and links to scientific studies. No matter what treatment strategy you choose, integrating the Complementary Medicine physician, such as the Licensed Acupuncturist and herbalist, or the Naturopathic Doctor, into your persistent treatment plan, will greatly help you to achieve the outcomes that you deserve. Many studies of weight loss programs have consistently shown that standard quick fix protocols do not achieve long-term weight reductions, do not benefit overall metabolic health, and often leave the patient with increased weight and other health problems at the 2-year mark. How long we will ignore these studies is the question.

A Problematic Treatment Strategy in Standard Medicine and New insights into a More Holistic Approach to Treatment of Obesity and Weight Loss

In 2012, an advisory panel to the FDA recommended 17 to 6 that all new obesity drugs undergo rigorous human clinical trials to assess cardiovascular risks even if the initial trials did not indicate such risk. Dr. Sanjay Kaul, an advisory cardiologist at Cedars-Sinai Medical Center in Los Angeles, stated in a New York Times article: "Given the checkered history of the weight-loss drugs, I think it is better to err on the side of caution." Presently, only one drug is approved for long-term use to treat obesity, Xenical, and past drugs, such as Fen-Phen and Meridia, had to be withdrawn from the market due to dramatic numbers of cases of cardiovascular injury and death. Recently developed drugs have also been rejected for cardiovascular risks, such as Contrave, and the most popular European weight loss drug, Mediator, has been withdrawn from the market as well due to cardiovascular deaths and injury. Health authorities see little hope for a safe and effective allopathic pharmaceutical treatment for obesity or weight loss in the near future. The spin in standard medicine is quite different from this reality, though, trying to convince patients that all is well. The need for a comprehensive approach has prompted a keen interest in Integrative and Complementary Medicine (CIM/TCM) worldwide, and research is discovering an array of effective therapies that may be combined into a holistic treatment protocol. Some of this valuable research is available in the section of this article entitled Additional Information and Links to Studies.

The vast majority of prescriptions for weight loss since 1979 have involved the amphetamine derivative Phentermine, and the anti-seizure and anti-migraine medication Topiramate (Topomax), which is now combined in a weight-loss medication with approval for short-term use only. A 2014 retrospective audit of use of this popular drug, Qsymia, which will soon go generic and be marketed with many names, by the hospitals of Austin Health, a renowned research and tertiary care company centered in Melbourne, Australia, reviewing all patient records form 2010 to 2012 who were prescribed this drug, found that: "Phentermine-topiramate therapy was not well tolerated; more than half of the patients in our (restrospective) study stopped taking it because of adverse effects, and more than half of the adverse events reported were ascribed to topiramate" (PMID: 25164851). Documented adverse effects with topiramate seen in more than 10 percent of the select groups in the manufacturer short-term clinical trials included fatigue, somnolence, depression, dizziness, paresthesia (numbness and tingling or pins and needles sensation of the extremities), increased allergic congestion of the sinus, diarrhea, nausea, and of course, weight loss. While short-term weight loss of 5-10 percent of total body weight is achieved with current pharmaceuticals, the strategy of negatively effecting overall health to achieve weight loss is clearly a bad strategy, and integration of healthy holistic treatment protocols is sorely needed in the field of obesity and weight loss. CIM/TCM can provide this. These treatment protocols in Complementary and Integrative Medicine (CIM) involve no adverse health effects, and are proven to work if combined in a symbiotic protocol that should be individualized and used in a step-by-step manner. To utilize pharmaceuticals that have weight loss as an adverse health effect, or side effect of the medication, is obviously not a sound strategy, and the public should question this.

With the widely acknowledged failure of standard pharmaceutical protocols to achieve meaningful long-term outcomes in obesity and weight loss, the medical industry has seen resurgence in problematic surgical solutions as well, which have also been shown in many studies to incur many adverse health effects and poor overall long-term outcomes, but generate enormous profits. The use of gastric banding surgery, that temporarily restricts the volume of the stomach to force less nutrient intake, works temporarily to reduce morbid obesity mainly by starving the body, relying on the assumption that these obese individuals have no will power or intelligence to achieve this simplistic strategy on their own. In 2013, researchers at Harvard Medical School and Massachusetts General Hospital studied the effects of the now popular gastric banding surgery for treatment of obesity, and discovered that at least 20 percent of the short-term weight loss benefit could be attributed to the effects of the gastric banding on the intestinal microbiota, though (see study link below in Additional Information). These researchers, Peter Tumbaugh and Lee Kaplan, studied the effects of gastric banding on laboratory animals to see just what long-term physiological changes occurred that could explain the weight loss post-surgery, other than the obvious decrease in nutritional calories by drastically decreasing the size of the stomach. Gastric banding, while usually very successful in the short-term, often results in a regaining of the weight when the body adapts to the banding, and by 2015 many clinics have adopted gastric bypass as a more effective surgical technique. These researchers at Harvard now hope that this research study leads to new utilization of restoration of the homeostatic microbiota to achieve a significant weight loss in obesity in a more healthy manner, and with long-term effects of more normalized weight. Studies at Washington University, in St. Louis, Missouri, U.S.A. have shown amazing potential in advanced probiotic therapy, with new total Biome pills in development, and even today, integration of healthy holistic protocols with gastric banding or bypass is sure to improve the long term outcomes.

In September of 2013, the journal Nature reported on important research at Washington University in St. Louis, Missouri, confirming the importance of the symbiotic Biota to metabolic energy regulation and obesity. The lead researcher, Dr. Jeffrey Gordon, designed a study that took microbiota from the guts of 4 sets of twins that had developed in early childhood with one suffering from obesity and one lean, and infused these biotas into laboratory mice to see if there was a result. The outcomes were dramatic, with the obese mice quickly losing weight despite eating the same amount of food as the lean mice. This study proves that there is great potential in simple biotic transfers to reset the metabolism in early life to cure obesity. This research was a follow-up to prior articles in 2012 that showed the amazing importance of gut microbiota and energy metabolism printed in The American Journal of Gastroenterology Supplements and headed by Dr. John K. Dibaise of the Mayo Clinic in Scottsdale, Arizona, and Daniel N. Frank and Dr. Ruchi Mathur of the University of Colorado and Cedars-Sinai Medical Center in Los Angeles (see links below for this research). The implications of this research are that there may be simple treatments to reverse obesity, as well as the importance of gut health and probiotic health in the overall treatment protocol.

Skeptics of the idea that their intestinal microbrial biome has much to do with weight gain and obesity need only look at scientific studies of this subject, as well as the obvious fact that massive amounts of antibiotics have been used by the feed animal industry to increase profits by stimulating extremely fast weight gain with antibiotics. Dr. Martin J. Blaser, director of the Human Microbiome Program, and a professor of medicine and biology, at New York University, has been exploring the question of antibiotics and weight gain for decades. His experiments showed that when taking laboratory animals and feeding them all a high calorie high carbohydrate diet to stimulate obesity, but then dividing them into a group fed antibiotics, and a group taking no antibiotics, that the rate of weight gain was doubled with antibiotic use. This is no surprise, since scientists have conducted experiments on targeted populations, especially children in third world countries, and mentally handicapped children, since the 1950s, and consistently have found that those fed daily antibiotics had twice the weight gain than those that did not.

The proof here in these new studies, though, showed that our belief that the sugary diets were wholly responsible for the obesity is wrong. Today, the average child in the United States is given an average of more than one course of antibiotic per year. It is no wonder we have an epidemic. Studies in recent years have also shown that besides altering the metabolic and hormonal health of the patient, these antibiotic courses also sometimes completely destroy some of the most important symbiotic bacteria in the gut, perhaps permanently. The way to restore and protect this homeostatic biome is to utilize professional Complementary and Integrative Medicine to repeatedly clear excess pathogenic growth of microbes, and use professional probiotic formulas to reestablish growth as much as possible. Of course, the U.S. FDA has to allow more types of biotic bacteria to be used as well, instead of succumbing to industry lobbying and preventing the use of more proven beneficial gut bacteria, that are safely and effectively used in countries like Japan. In addition, using Complementary Medicine to restore neurohormonal immune function is also sensible, as well as utilizing herbal medicine when possible to avoid overuse of antibiotics, and of course, using such methods as topical antibiotics for ear infections, which are proven to be more effective than oral dosing, as well as shorter courses of antibiotics, and choosing the best antibiotic when it is needed by always culturing a sample of the infected bodily fluid. A thorough, thoughtful and holistic approach to the problem is needed. Continuing with the same misguided course in treatment is outrageous. Especially for patients afflicted with excess fatty weight and obesity, this course of treatment, and these new guidelines, should be incorporated into the overall treatment protocol.

While the concept that the human intestinal microbiota, or colony of symbiotic bacteria, may be integral to the pathology of obesity, is still controversial, nevertheless, experts around the world are seeing the evidence that this may be true, in a complex way. Research in 2009 at the Catholic University of Louvain, Brussels, Belgium, noted that it was definite that the gut microbiota has been demonstrated as being different in the lean and obese child, and between those that are healthy and those with diabetes type 2, or Metabolic Syndrome. The mechanisms associated with the gut biota included energy, or nutrient harvest, as well as the synthesis of key nutrient molecules, by this biota that helped regulate the energy metabolism. The wrong gut microbiotic balance produces a metabolism that contributes highly to fatty liver disease, inhibiting phosphatidylcholine and excessively breaking down cholines to methylamines that contribute to liver toxicity, as well as increasing free fatty acids and oxidative stress. These researchers also noted, though, that study in recent years has found that mechanisms of obesity that occur due to a high-fat diet, such as inflammation and insulin resistance associated with obesity, also is dependent somewhat on bacterial lipopolysaccharides (LPS), and the free fatty acid activation of toll-like receptors in cell membranes. More and more evidence was mounting that perhaps the health and function of the gut biota could be the unifying key to obesity. Review of this study by the University of Louisville School of Medicine, in 2011, also concluded that the root mechanisms of obesity, such as low-grade endotoxemia and inflammation, gut permeability, fatty liver disease, and the apparent beneficial effects of prebiotics and probiotics on obese subjects, leads them to assume that the human gut biota acts as a metabolic organ to regulate energy homeostasis, and is thus integral to the pathological mechanisms of obesity. While this does not negate the need for a comprehensive strategy to treat obesity and the overweight condition, it does elucidate the cascade of causative effects, and places emphasis on dietary and gastrointestinal health, and epigenetic changes that may be passed to children with this poor diet and unhealthy gut biota.

The pathology of obesity is thus very complex, and not just a problem with overeating and lazy lifestyle, as has been implied for decades. While the root of obesity may lie in the health of the gastrointestinal system and gut microbiota, and the effect of a modern diet with processed fats and sugars on this system and superorganism, the array of ill effects extends to the liver, the brain, the endocrine system, and the immune system. Other articles on this website also provide valuable information concerning obesity: please refer to the articles on Diabetes/Metabolic Syndrome, Weight Loss, and Insulin to gain a more complete understanding of this complex problem. In addition, imbalance of the intestinal symbiotic microbial colony, or Biota, has been found to be integral to weight gain and obesity issues, and an article entitled Probiotics on this website may be very helpful for individuals wanting to gain understanding of their condition, and means to reverse this health problem. In addition, an article entitled Diet and Nutrition may also explain why common dietary habits in the United States have led the country to such an epidemic of obesity. We have come to the realization that creating the imbalances that cause obesity is a much easier task than correcting these imbalances. Weight loss is now an enormous industry with very poor results for long-term health for the customers. The best way to reverse chronic weight gain and obesity is to become more educated to the physiological aspects, gain a holistic perspective, and establish a comprehensive regimen to restore a healthy metabolism and inflammatory regulation in the body. Of course, the best time to work on this problem is before it becomes severe. Countering the path to obesity before it is diagnosed will result in the easiest course of treatment.

Does acupuncture, Traditional Chinese Medicine (TCM) and Complementary and Integrative Medicine (CIM) provide a quick and easy cure for obesity? There is obviously no easy cure in the long run, as much as we want there to be. The sensible approach to this health problem is to work hard, utilize a number of treatment protocols, and address the problem holistically, tackling the entire cycle of dysfunction. With difficult health problems we must stop looking for the "magic bullet" and decide to gain greater understanding of our physiology, and devise a more thorough plan of correction. This is what Complementary and Integrative Medicine can offer, guidance and a variety of coordinated treatments to restore healthy homeostasis and reverse obesity. This is not an alternative treatment, but rather a necessary strategy. This holistic approach may be important not only for you, but for your children, as it is now evident that obesity creates epigenetic changes, related to environmental, dietary and lifestyle effects, that are passed on to your children. These epigenetic changes can be reversed by attention to the root homeostatic mechanisms that contribute to obesity, beneftting not only you, but your children as well.