I just watched an episode of House and he diagnosed a girl with Cushing’s – an illness that can cause obesity.
How is that possible? I was under the impression that our bodies use energy we get from food, and if it doesn’t get the food it’ll burn fat resulting in us getting slimmer – how can a disease change that?
How does it not go against some laws of thermodynamics? Maybe I’m just being silly.
In: Biology
The body does not have a calorie counting function – everything is regulated through hormones.
For example, if you give type ii diabetics insulin to help control their blood glucose, they will gain weight. Insulin blocks burning fat and therefore leads to more hunger rather than burning body fat.
People that are obese are that way not because they can’t control their appetite, they are obese because the food they are made them insulin resistant and that makes it very hard for them to burn body fat. If you can’t burn body fat it is very hard to lose weight.
You have a lot more reading/education ahead. You have the very basic formula. But just like cars get varying fuel economy, so do humans.
My brother and I are perfect examples. We grew up together, did the same activities, ate the same meals, went to the same school, etc. He was always heavy/fat and I was always skinny and thin.
Git biome, medical conditions, genetics, etc all play a role in weight.
But yes, basically calories in – calories burned = weight. However, the efficiency of burning calories, how the body stores fat vs burning it, and a myriad of other factors tweak that formula.
I say all of this because I had an ex with a medical condition that kept her heavy. She used it as an excuse to overeat and never exercise. The disease was a factor, but her lifestyle played a bigger part imo. (I managed health clubs for 5 years out of college, I’m very aware of fitness and weight loss science)
We had a horse who lived the last years of her life with Cushing’s disease, kept well under control (with a medicine that was withdrawn from human use but deemed safe for horses).
Yes, fat comes from eating food. But Cushing’s messes with how a horse’s body allocates energy intake. The food energy used for maintaining muscle typically is misdirected into useless functions like building a crest— a big fat-storage hump— on the neck, while precious muscle tissue wastes away. (In horses “Cushings” is actually a slightly different disease than in humans but this is the gist.)
Now as to how a human patient gets fat from illness and/or its meds— well, it’s true that fat comes from food. But our patient might be eating the same amount as ever, but not building/maintaining muscle. Note that this would NOT mean they’re *getting bigger*— if they’re doing that, then they’re obviously overeating.
But it is entirely possible to get weak, flabby and fatty even when you’re small. Desk jockeys everywhere know it!
It doesn’t go against laws of thermodynamics.
Energy in = energy out + accumulation.
Hormone imbalances can result in our body preferring accumulation of fat vs expending energy. E.g. they can make you feel lethargic regardless of how much energy you consume, and tell your body to create more fat cells.
If you’ve ever felt tired before after eating a big meal, it should make sense that the same can happen but worse and over long periods of time.
Hormone imbalances can also speed up your digestive system, triggering your hunger response sooner and more frequently, encouraging to eat more, even if you don’t end up expending the energy.
Hormones can also just trigger cravings. Ask any pregnant woman or her partner.
You’re completely right that weight gain (and loss) is a function of how much energy we intake vs how much we expend. Diseases and the ensuing hormone imbalances are able to impact those factors indirectly.
This is why people shouldn’t assume everyone who is overweight because they eat too much… Thyroid disease, Arthritis, medications and so many other things can cause someone to become overweight.
Everyone’s body deals with health hiccups so differently for example when 2 people who have the same disease one person might gain no weight and the other person gains a lot of weight… we are all different.
In almost all cases it’s something on the lines of causing people to eat more, burn less energy(be less active, etc), or increase in water weight.
Then generally it’s not enough to make someone obese on it’s own.
There is no disease in the world that causes a person to be unable to lose weight by eating less.
The disease only makes it difficult.
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