Environmental Factors Trump Genetics in Obesity Epidemic

Key Quotes

"if it's a genetic disease well then she can't do anything right she just has to take the medication but she can sit on the couch and eat all the foods that she wants and there's no solution for that there's nothing that she can actually do because the medication is the first and primary mode of treatment so i'm just going to call bullshit here okay"

Dr. Stephanie argues that framing obesity as a purely genetic disease is problematic because it implies a lack of personal agency. She believes this perspective suggests that individuals have no control over their health and must rely solely on medication, which she finds to be a "bullshit" notion.

"however this idea that obesity is a genetic first disease is not only preposterous it's also insulting all you have to do is look at society 20 years 30 years 50 years ago and you know 100 years ago if you want to put a little bit more time around it and you know that the societies were not generally obese they were typically quite not you might make the argument of fit but like there was it wasn't an obese a obesogenic society people were not obese there"

Dr. Stephanie asserts that the notion of obesity being primarily genetic is both absurd and offensive. She supports this by pointing to historical societal data, indicating that obesity was not as prevalent in the past, suggesting that environmental factors, not genetics, are more likely culprits for the current "obesogenic society."

"what has changed is the epigenetics the environment in which our genes live in right so we live in this like wally that you know the disney movie wally we live in this sort of wally type of world now where everything is available to us at our fingertips right we can order food and it's at our door in 30 minutes we can order whatever we want from amazon or whatever whatever right we go to fast food and we have fast food on our plate within you know minutes"

Dr. Stephanie explains that while genetics are static, epigenetics--the environment influencing gene expression--have changed drastically. She likens our current environment to the world in the movie WALL-E, where convenience and immediate access to food and goods have created an environment that promotes less healthy lifestyles.

"but with obesity it's a little different if we look at obesity as a genetic disease then but we are essentially saying that this can the first line of treatment for it is medication aka glp1s gip1s you know the ozempics the mounjaros the trulicity etc the other problem which is related to a medication first approach is that we are taking power away from the patient to actually affect and control her destiny right"

Dr. Stephanie contends that treating obesity as a genetic disease implies medication is the primary solution, like with conditions such as sickle cell anemia. She argues that this "medication-first" approach strips individuals of their power to influence their health outcomes through their own actions.

"i don't care about i mean i care about feelings but in this case i don't care about feelings this is the truth you can use the pharmacology to help you get out of a bad situation of course you can but you need to develop life skills and lifestyle habits"

Dr. Stephanie states that while she acknowledges feelings, her focus is on the truth regarding obesity. She believes that while medications can be helpful tools to escape difficult health situations, they are not a substitute for developing essential life skills and sustainable lifestyle habits.

"the paradox of life is that right it's like nothing worth having is usually easy and if it you know you've given up something something has been sacrificed in order for it to be easy and this is the hack part of biohacking that just drives me insane you cannot shortcut like ozempic is not going to lift the weights for you ozempic is not going to build your plate for you it's going to make you not want to eat a lot of things on your plate and this is why you absolutely must give your muscles a mechanical stimulus in order to prevent yourself from losing the muscle mass that we that it's been shown shown to do if you're not if you're not weight training and prioritizing protein"

Dr. Stephanie highlights the paradox that valuable achievements are rarely easy, and shortcuts often involve sacrifice. She criticizes the "biohacking" mentality that seeks to bypass effort, emphasizing that medications like Ozempic cannot replace the necessity of physical activity, such as weight training, for muscle maintenance and overall health.