Weight gain

Description

Weight gain occurs when more energy (as calories from food and beverage consumption) is gained than the energy expended by life activities, including normal physiological processes and physical exercise.

If enough weight is gained due to increased body fat deposits, one may become overweight or obese, generally defined as having more body fat (adipose tissue) than is considered good for health.

Having excess adipose tissue (fat) is a common condition, especially where food supplies are plentiful and lifestyles are sedentary.

A commonly asserted "rule" (the Wishnofsky Rule, aka Wishnofsky's Rule) for weight gain or loss, is based on the research of Max Wishnofsky (December 17, 1899 – August 2, 1965), a Russian-born physician who had a medical practice in Brooklyn, New York. The Wishnofsky Rule states that one pound of human fat tissue contains about 3,500 kilocalories (often simply called calories in the field of nutrition). Wishnofsky conducted a review of previous observations and experiments on weight loss and weight gain, and stated his conclusions in a paper he published in 1958. Thus, according to the Wishnofsky Rule, eating 500 fewer calories than one needs per day should result in a loss of about a pound per week. Similarly, for every 3500 calories consumed above the amount one needs, a pound will be gained.

Wishnofsky noted that previous research suggested that a pound of human adipose tissue is 87% fat, which equals 395 grams of fat. He further assumed that animal fat contains 9.5 calories per gram. Thus one pound of human fat tissue should contain 3750 calories. He then critically analyzed the relevant literature and applied a number of additional assumptions, including that the diet contains sufficient protein and that the person is in glycogen and nitrogen (protein) equilibrium, leading to most weight loss stemming from the catabolism of fat. He concluded that a 3500 calorie excess or deficit for a person meeting his assumptions, would lead to the gain or loss, respectively, of one pound of body weight. He noted that if the assumptions he made are not met, a deficit of 3500 calories would not necessarily equate to a pound of weight loss.

Wishnofsky did not take into account numerous aspects of human physiology and biochemistry which were unknown at the time. The claim has achieved the status of a rule of thumb and is repeated in numerous sources, used for diet planning by dietitians and misapplied at the population level as well.

Causes

In regard to adipose tissue increases, a person generally gains weight by increasing food consumption, becoming physically inactive, or both. When energy intake exceeds energy expenditure (when the body is in positive energy balance), the body can store the excess energy as fat. However, the physiology of weight gain and loss is complex involving numerous hormones, body systems and environmental factors. Other factors besides energy balance that may contribute to gaining weight include:

Social factors

A study, involving more than 12,000 people tracked over 32 years, found that social networks play a surprisingly powerful role in determining an individual's chances of gaining weight, transmitting an increased risk of becoming obese from wives to husbands, from brothers to brothers and from friends to friends.{{cite news

The human microbiota facilitates fermentation of indigestible carbohydrates to short-chain fatty acids, SCFAs, contributing to weight gain. A change in the proportion of Bacteroidetes and Firmicutes may determine host's risk of obesity.

Sleep and stress

Lack of sufficient sleep has been suggested as a cause for weight gain or the difficulty in maintaining a healthy weight. Two hormones responsible for regulating hunger and metabolism are leptin, which inhibits appetite and increases energy expenditure, and ghrelin, which increases appetite and reduces energy expenditure. Studies have shown that chronic sleep deprivation is associated with reduced levels of leptin and elevated levels of ghrelin, which together result in increased appetite, especially for high fat and high carbohydrate foods. As a result, sleep deprivation over time may contribute to increased caloric intake and decreased self-control over food cravings, leading to weight gain.

Hormone and neurotransmitter imbalances

Weight gain is a common side-effect of certain psychiatric medications.

Pathologies

Pathological causes of weight gain include Cushing's syndrome, hypothyroidism, insulinoma, and craniopharyngioma. Genetic reasons can relate to Prader–Willi syndrome, Bardet–Biedl syndrome, Alström syndrome, Cohen syndrome, and Carpenter syndrome.

Effects

Excess adipose tissue can lead to medical problems; however, a round or large figure does not necessarily imply a medical problem, and is sometimes not primarily caused by adipose tissue. If too much weight is gained, serious health side effects may follow. A large number of medical conditions have been associated with obesity. Health consequences are categorised as being the result of either increased fat mass (osteoarthritis, obstructive sleep apnea, social stigma) or increased number of fat cells (diabetes, some forms of cancer, cardiovascular disease, non-alcoholic fatty liver disease).{{cite journal|vauthors=Haslam D, James WP | journal=The Lancet| title=Obesity| volume=366| issue=9492| pages=1197–1209| year=2005| doi=10.1016/S0140-6736(05)67483-1 s2cid=208791491}} There are alterations in the body's response to insulin (insulin resistance), a proinflammatory state and an increased tendency to thrombosis (prothrombotic state).

References

References

1. (2020). "Aim for a healthy weight". National Heart, Lung, and Blood Institute, US National Institutes of Health.
2. (2020). "Health risks of being overweight". National Institute of Diabetes and Digestive and Kidney Diseases, US National Institutes of Health.
3. (16 February 2018). "Obesity and overweight". World Health Organization.
4. (1958). "Caloric equivalents of gained or lost weight". Am J Clin Nutr.
5. (June 18, 2013). "Why is the 3500 kcal per pound weight loss rule wrong?". International Journal of Obesity.
6. (2011). "Quantification of the effect of energy imbalance on bodyweight". Lancet.
7. Nicholas A. Christakis, M.D., M.P.H., and James H. Fowler. (2007-07-26). "The Spread of Obesity in a Large Social Network over 32 Years". [[New England Journal of Medicine.
8. (2011). "Fermentation Potential Of The Gut Microbiome: Implications For Energy Homeostasis And Weight Management". Nutrition Reviews.
9. (2005-01-10). "Overweight and Obese Patients in a Primary Care Population Report Less Sleep Than Patients With a Normal Body Mass Index". Archives of Internal Medicine.
10. (January 17, 2008). "Short sleep duration and weight gain: a systematic review". Obesity (Silver Spring).
11. Newcomer JW. (2005). "Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review". CNS Drugs.
12. Bray GA. (2004). "Medical consequences of obesity". J. Clin. Endocrinol. Metab..