Obesity—A Disease With Many Aetiologies Disguised in the Same Oversized Phenotype

Has the Overeating Theory Failed?

Peter Stenvinkel


Nephrol Dial Transplant. 2015;30(10):1656-1664. 

In This Article

Has the Overeating Theory Failed?

The attempts by health authorities to control weight gain in obese patients by caloric restriction have not been successful. In fact, in a community-based sample of subjects, only 4.6% lost and maintained weight successfully whereas 53.7% gained weight.[17] The Nutrition Science Initiative (NuSI) is a non-profit organization (http//nusi.org) that addresses the fact that official dietary guidelines are not based on rigorous science and that overconsumption of calories is not the sole answer to the obesity epidemic. Based on a review of nearly 100 relevant studies, NuSI concluded that these studies did not convincingly show that increased carbohydrate consumption increases fat mass independently of calories consumed and the other way around. Many shortcomings of the studies were identified including a failure to control for what the participants actually ate.[8] A recent epidemiological analysis of food from 175 countries showed that although a difference in sucrose availability explains the variation in diabetes prevalence, this effect is not explained by overweight, obesity or physical activity.[18]

Most would agree that eating too little calories is a symptom rather than the cause of disease in anorexia nervosa. However, it is still believed that eating fewer calories will lead to the solution of the obesity problem. Whereas anorexia nervosa patients have heightened brain reward sensitivity to taste stimuli (possibly related to dopamine function), obese patients are less responsive.[11] Thus, eating disorders may be due to altered neurotransmitter system function, and overeating may be a symptom rather than the cause of the obese phenotype.