IS OBESITY A CHOICE... What does the science say?

This is a tough one... Some of you may be inclined to answer without giving it it’s due consideration. A lot of people believe that obesity is a direct result of laziness, ill-discipline or lack of self-respect. A result of our decisions alone. That’s part of it, but not entirely how it works. If you gave 100 random people the option of pressing the obese or not obese button, everyone would press the not obese button. People know about the health risks, lower life quality & social stigma that comes with being obese, so who would consciously choose to be obese?

Throughout our lives, each day we have a continuous series of choices to pick certain foods over others, like whether to order fried chicken or grilled chicken, regular coke or diet coke, small fries or large fries. We also decide on certain behaviours over others, like whether to get up & exercise or stay on the couch. Over time, it’s the cumulative effect of these choices that cause someone to become obese. But that's not the only thing at play...

This graph is taken from a 1990 study where 24 participants were overfed by 1000 calories per day for three months. All participants were under 24/7 supervision by the research staff & each bar represents a person & how much weight they gained.

Despite each person eating the same extra calories per day, the person on the left only gained 10lbs, while the person on the right gained an extra 30 lbs. This could be due to a number of factors, but a big one is genetic differences in metabolism. In other words, if none of these people exercised at all, the person on the left would still burn more calories per day than the person on the right.

Going back to the buttons, a small fries from McDonald’s has about 200 calories and a large fries has about 500 calories. That's a 300 calorie difference for the person who goes large... HOWEVER! The person on the left also burns more calories, so they could choose large every time & their net caloric balance would be exactly the same as the other person who chooses the small fries.

Keep in mind that this only considers Resting Energy Expenditure - the number of calories you burn without any activity. People also burn calories through exercise, the thermic effect of eating (TEE), & non-exercise activity thermogenesis (NEAT). The TEE component of metabolism is considered out of our control, & the NEAT component can vary dramatically between individuals. NEAT refers to the calories you burn from daily activities that aren’t actual exercise, including stuff like fidgeting, tapping your feet, typing etc. Even though you can up your NEAT by making an extra effort to move around a bit more throughout the day, a lot of it is subconscious.

Whilst we can all override our genetics with our diet or exercise, we all know someone who can eat whatever they want & remain inexplicably thin. We also all know someone who’s tried every diet book on the shelves yet remains overweight. Most people would be quick to critique the overweight person for lacking willpower or making the wrong choices, not considering the genetic factors that could be making it very easy for the thin person or very hard for the overweight person.

But there’s another big influencing factor; hunger variations. Research shows that in response to dieting, some people simply experience more hunger than others. While many dieters feel like they’re constantly fighting their body’s urge to eat more, others feel more normal hunger. Studies in 2013 also proved the difference between eating high-fat meals & a low-fat meals. They showed significantly higher hunger levels in those eating higher fat diets than lower fat diets, confirming the viscous cycle of the more fatty food you eat, the more fatty food you want! Medication can also either increase or decrease our hunger hormone 'ghrelin', & hunger suppressants which have become all the rage are proven to make maintaining any weight loss much harder than those who lost weight through traditional methods (with some research suggesting over 50% harder).

Of course, this doesn’t mean that a deficit only works for some people. It’s a fact that obesity results from eating more calories than you burn. Tightly controlled metabolic experiments repeatedly confirm that caloric intake is the sole driver of both fat loss & fat gain. This means that anyone who is obese got obese by eating in a sustained caloric surplus over time. It’s means that avoiding that surplus is harder for some people than it is for others. This is why it’s incorrect to reduce all of these factors down to a choice of obese or not obese.

High-calorie foods are also so much more readily available (& cheaper) than a lot of healthier options, making these daily choices harder to be on the right side of. Then there are the lifestyle factors, like how much sleep you get or your job.

So, is obesity a choice? I think the answer is not always. There’s too much influence from genetics & environment to shift the blame entirely on the individual. Of course, that doesn’t mean that you don't have control over your health & body weight. If you want to lose weight, even if there are factors working against you, it’s still possible if you sustain a caloric deficit. I believe that we should shift our effort to understand our bodies & become educated on what we need individually.

Elliot Hutchinson // 04.05.2025

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