Recent articles and books question the popular wisdom about being overweight, namely that what we need is exercise and the will power to moderate and properly manage our food intake.
What I recall from The Fat Trap (a 9 page NY Times article) is that weight loss programs, even those with clinical support and follow up, do not work. Studies show that our bodies after days of dieting change their metabolism, producing a cocktail of hormones that increase cravings for food. Another way that the body seems to fight weight loss is by altering the way the brain responds to food. Genetic factors are of course also at work. The article links online to a few studies, and summarizes many others.
"Beating Obesity, FAT NATION" The Atlantic Magazine, May 2011, shows that although popular wisdom is wrong (i.e., exercise and will power, to moderate food intake, are not generally successful), that popular wisdom is still the basis for widespread antipathy and prejudice against fat people. Inescapable social factors (food industries, changes in customs, how we live) are the driving forces. The problem is epidemic; 40% in the US will be obese by 2015. Trillions in extra medical costs will be needed. Diabetes, particularly type 2, is closely linked to sugar and fat. Taking care of obesity may become a major occupation, and preoccupation. Politics and a number of government agencies are involved, but their competing priorities and projects are likely to prove ineffectual.
Is Sugar Toxic? (also a 9 page NY Times article) discusses the key role sugar (including high fructose corn syrup in foods and soft drinks) plays in all this. In the US sugar consumption is approaching 100 pounds of sugar per person per year, about 125 grams/day. Some "experts" take the position that sugar is both addictive and toxic. There is a strong correlation between sugar consumption, fat, and diseases such as diabetes (type 2), heart disease, and cancer. The correlation is strongest for sugar intake and obesity, next for sugar intake and diabetes type 2, less so but still proven for sugar intake, heart disease and cancer. (Heart disease is the leading cause of death for both men and women. About half of us will suffer from cancer, and 1 in 4 will die of it. ) This article also summarizes many studies, and has links to others.
The authors of these articles confess to and discuss their own obesity problems, concurrent with their years of researching, professional reporting on, and struggling with fat. Only one author claims to have resolved his problem, and that via his $30,000 bariatric surgery in which he he was lucky, but since the surgery was only a year ago it is too early to tell.
A Mathematical Challenge to Obesity discusses a National Institute of Diabetes and Digestive and Kidney Diseases mathematical model of how one's body works, primarily addressing weight versus food intake. The researchers who devised the model think that the underlying cause for the weight epidemic is simply increasing availability of inexpensive foods over the past decades, due to government subsidies for increased if unneeded added production, to increasing cost effectiveness of processed foods and of manufacturing and distribution. One of their conclusions is quick results are not available or sustainable, the time scales for adapting to changes is diet is on the order of a year.
A number of recent best-selling books address the problem. Mark Hyman MD, in "The Blood Sugar Solution" (about "diabesity") provides both a clearcut diagnosis that most processed foods are deliberately manufactured to include addictive compounds of sugar, salt and fat, and a clearcut prescription to avoid processed foods, eat healthy and balanced real food, and test and supplement for nutrition and health. David B. Angus MD, in "The End of Illness" has a more nuanced and cautious but long range systemic approach. In "The Creative Destruction of Medicine", Eric Topol MD introduces a radical departure from conventional medicine to focus on genetic-related diagnosis and treatments at a molecular level. William Davis MD, in "Wheat Belly", argues that the problem is due to the recently popularized (1970s) hybrid of wheat that is by now the source for 99% of the world's wheat consumption, and advocates completely eliminating this wheat, and most glutin, from one's diet. All authors criticize conventional medicine as it is usually practiced in this country, and all advocate taking responsibility for understanding one's health and alternatives in influencing health, including lifestyle as well as medical consultations, tests and treatments.
We don't really know where we are in all this, and there probably are no short terms fixes particularly for the overweight or obese; only prospects for future research and legislation. One could move to another country; Asia is leaner. Europe although lagging Asia is leaner than the US, possibly due to more attention to food preparation time and socializing around meals. Still, most countries are still heading towards US food practices and problems.
Exercise and proper nutrition, while essential to good health, will not necessarily result in long term weight loss for individuals, and probably will not mitigate the US epidemic of fat and obesity.