What causes obesity? Is it genetic? Is it lifestyle. And what about choices? You've probably heard that weight gain occurs when someone ingest more calories than they burn, but that's certainly not the whole story.

Genetic factors contribute to the risk of obesity. But, many people who carry obesity genes do not become overweight and healthy lifestyles can counteract these genetic effects. It's hard for some individuals who have addiction to sugar. Dopamine levels are involved and it's just hard because of the way our society is wired. But let's look at recent upward trends of obesity. Our genes really haven't changed enough to explain that. So what has changed? Our food, which is a subject for another day, but also our activity level and our social eating patterns. Since the 1970s, the average caloric intake has increased by 500 kilocalories per day. Tracking rod, along with the increase in obesity. The standard American diet contains more fat, more sugar, more protein, more grains, and less fruits and vegetables. We've replaced nutrient packed foods with fast convenient food. And sweetened drinks.

There's a big study called the nurses health study. And for every two hours women in this study watched TV, the risk of obesity was increased by 25%. Now do the math. If you watch four hours of TV a day, your chances of being obese are increased by 50%.

You will never reach a place where you can slack up and eat whatever you want and not gain weight. It's not going to happen. So here are some practical tips. Replace your couch time with something you enjoy that's active. Get up and march or dance or do squats. And eat more fiber. It fills you up, keeps your gut healthy and suppresses your appetite. Eliminate ultra processed foods from your diet as much as possible. They're loaded with fat and sugar to bring you back for more. Lastly, eat at home. Portions at restaurants are out of control and healthy choices are harder to make.

You got a prescription for the shot and now you've replenished your wardrobe with smaller clothes then comes the bad news. Either your insurance no longer wants to cover your medication for weight loss. Or you have side effects that make it intolerable. Without making changes, you will gain all that weight back. You lost weight with the shot, now what?

Lifestyle modifications with healthy diet and exercise are important. It even says so on the package inserts. There are differing opinions about what constitutes a healthy diet. The bottom line is avoid ultra-processed foods and eat whole food. Low fat diets are not associated with weight gain and are healthier for your heart and lower the incidence of breast cancer.

Everyone is different. Some people can lose weight with lifestyle changes, others need help from surgery or medications. The GLP - 1 agonist generally help people lose 5-22% of their BMI. They aren't without side effects and they are expensive. Obesity is a chronic disease that puts your health at risk. Lifelong treatment is required. Healthy Looks Great on You, lifestyle medicine podcast tackles this tough issue.

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How Not to Die by Michael Gregor

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Often these illnesses are invisible, but the symptoms are real. On this podcast episode, we will look at what happens when your immune system turns on you. I know from experience how it feels to struggle with autoimmune disease.

Those shopping cart memes that paint people who don’t return them as jerks, still hits a sore spot with people who have invisible illnesses.

Do you have a bunch of weird symptoms and no one can figure out what is causing them? Maybe your own immune system is attacking you. It’s designed to protect you, but can also try to kill you. Be your own advocate and be specific when discussing symptoms with your doctor. Eight million Americans are affected by autoimmune diseases. The symptoms range from annoying to debilitating. The gut microbiome is thought to be a big contributor, as well as stress, exposure to toxins, infections and sleep.

Invisible illnesses can be isolating. Many of us fake being well. Awareness campaigns help spread the word.