IFB-Dialog: "There will be no magic pill against adiposity"

More than 200 visitiors followed the discussion of the yearly IFB Dialog.

Morbid obesity is not only a result of an excessive desire to eat and a lack of exercise. It is a sure thing for research that this conclusion would be a too simple one. So how come that more than half of the Germans are overweight by now and about 20 percent are even obese (adipose)? Is overweight fault or destiny? Last week the event "Genes, hormones, psyche - how strongly predetermined is overweight?" of the Integrated Research and Treatment Center (IFB) AdiposityDiseases in Leipzig dealt with exactly this question. More than 200 visitiors followed the discussion of the yearly IFB Dialog moderated by the well-known TV host Dr. Franziska Rubin.

"Adiposity is not only the individual's fault," explained Prof. Michael Stumvoll, the scientific director of the IFB. Also living conditions and the evolution of homo sapiens serve as an explanation for adiposity. For example the brain mass had consistantly grown during the course of incarnation and is now using up more calories. But at the same time, man has simplified the process of procuring food so much due to his higher intelligence that he rarely has to burn any calories for that anymore. Now there are the lands plenty called supermarkets and fast food restaurants in place of hunting and collecting. Additionally, world-wide inquiries have shown that countries with sufficient food also have the happier inhabitants. The persue of happiness thus also means a pursue of calories - and more often than not more than you actually need.

"To make matters worse the genetic configuration of men benefits energy storage. This, in contrast to environmental conditions hasn't change," says Prof. Antje Körner of the University Hospital for children and youths medicine. The optimized calory utilization might protect humans in cases of famine but causes them to get fat in cases of abundance. Studies show that body weight is determined by genetic factors in 40 to 80 percent and a variety of genes influence it. "But there is not the fattening gene," says Körner.

Many people believe that hormones are jointly responsible for excessive weight. "On the other hand less than one in 100 people has a gland disease," knows Prof. Mathias Faßhauer from his daily work with patients at the IFB outpatient clinic. Disfunctions of hormonal production for example in thyroid or pancreas are also quite easily treatable. Using hormones specifically to loose weight, however, is difficult, since hormone-based weight loss pills have so many negative side effects that they had to be taken off the market. Other drugs on the other hand favor weight gain, such as certain anti-depressants.

Neuro scientists have known for quite some time that eating and happiness have a connection. But only recently the scientists around Prof. Arno Villringer of the Max Planck Institute for Human Cognitive and Brain Sciences could show that the brain of overweight people looks different than that of normal weight people. It shows similar changes than the brain of addicts. Therefore adipose people have to eat significantly more than normal weight people to feel the same happiness and sense of reward. "Adiposity thus also is a form of addiction and we have to treat is as such," explains Villringer.

Additionally Villringer was able to see differences between men and women concerning the investigated changes in the brain. In women for example not only the reward areas are different but also areas having to do with learning habits. Also the risk of suffering from demencia is higher for men and even more than doubled for women. It is not yet completely clear why that is the case. But the findings so far are nevertheless important since they can lead to a gender-specific treatment of adiposity.

And last but not least the psyche also has an influence on the human eating habits apart from genes, hormones and brain. "The psyche is also eating," says Prof. Anette Kersting, head of the psychosomatic medicine and psychotherapy at the University Hospital Leipzig. Feelings often play along while we eat - expressions such as "mysery gut" or "stress eating" are proof of that. Psychological diseases such as depression, phobia or post traumatic stress could lead to overweight if the affected person retreats, barely moves and when food becomes a means to influence the mood.

"Physician and patient alone are often powerless. We have to start changing basic social conditions. That means we have to think and work against the current fattening conditions," says Stummvoll. For example against the appealing advertisement in order to not step into the famous calory trap. Faßhauer also emphasizes that the way to lose pounds has to be found by each affected person individually. Rigid diets and exercise programs don't help if you can't keep them up for a long period.

So the main message was: adiposity could be predetermined by psychological, genetic and hormonal disorders to a certain degree. But you are not helpless against this circumstance. The current general conditions that favor overweight and obesity can be fought by simple behavioral changes. "We have to get away from the illusional idea that there will be a magic pill against adiposity," says Prof. Michael Stumvoll. Different and individualised therapies will have to be the future answer to the various causes of adiposity.

Keywords: events, causes of obesity, society & social life