Fixing obesity does not improve metabolic health?

Everybody knows that when they gain weight, they are at a higher risk of metabolic diseases and many were lucky enough to reduce their medication for blood pressure or to lower their blood glucose or cholesterol levels when losing some weight. 

Yet Dr Lustig calls this connection a dogma: 

He also said that they (American authorities) have been trying this for 30 years and it did not work, because the number of obese children has tripled since 2001. 

So, what does not work? Reduction of obesity or reduction of metabolic diseases with the reduced body weight? I am getting confused.

Then the slide adds two more lines: 

I have already written a short article about how the obesity can be fixed even without interfering with the biochemistry by drugs, which is Dr Lustig's field. He is a doctor after all. I am a nutritionist.

He gave an equal sign between the obesity and leptin resistance. He said that within 12 hours in an attempt to lose weight the levels of leptin are 25% lower, which he called leptin deficiency and claimed it makes things worse because on top of the leptin resistance, there is also this leptin deficiency and the brain sees it as starvation. How flawed this very simplistic picture is you can realize after reading a short article here. 

Then two more lines were added to the slide: 

Dr Lustig said that if leptin was working people would not be obese. Really? Is it the only reason for obesity? Not the palatable and caloric food that makes people eat more than they normally would? It was well documented that people feel the satiety later when eating palatable food. Other behavioral research also found that people eat more when the food is well presented food while they are socializing. 

I accept that in many diseased people fixing the metabolic dysfunction will improve their obesity. However, does this apply to everybody? Take an individual who has just started to live a comfortable life with abundance of palatable food, which will inevitably lead to increased body weight. Is his metabolism dysfunctional already or not? Yes, there are people who have very strong homeostatic mechanism for maintaining stable body weight, but others do not seem to have it as strong. Is that a metabolic dysfunction? We have evolved on laying the fat deposits when the food was abundant because it was not the case for the whole year and there were periods with reduced access to food when the stored energy was a life saver. The problem is we do not experience a true hunger anymore. But we still have the physiology of our distant ancestors. 

The doctor used to say that it is the trick of the food industry to make people eating (and buying) more of the energy dense and processed food by making it palatable and irresistible. Is that not true anymore? Or, does this apply on those who have not yet developed insulin and leptin resistance, or these were not included in the model of metabolic dysfunction? 

For now we have the official statements of many health bodies that reducing body weight of obese people cuts their risks of disease or even death. In fact, I have just found this study, which compared the metabolically healthy obese and diseased obese people. You know what? They both were at a higher risk of death whether of all causes or due to the cardiovascular disease, in contrast to overweight. How completely different from what Dr Lustig has been presenting to you.  

Nobody can fix the obesity?

You could hear Dr Lustig saying at about 14 minutes of the video that NOBODY can fix the obesity as such, but then he offered a solution: fixing the leptin resistance by fixing the insulin resistance, the obesity will be fixed also. But he did not believe in lifestyle changes, such as exercise, because in his eyes (selectively supported by some research) it does not work. 

I know from my own experience how my extra kilograms secretly kept piling up over a few years but, to my knowledge, I have never been insulin or leptin resistant. My blood tests and fasting sugar were perfectly normal, although they did not test the leptin and insulin levels. And then I have managed to come from the BMI 27+ to my current 24 and counting. The weight gain period was simply a result of having an abundance of palatable and fattening food, which, however, was not too sugar rich, and I did not have to walk miles every day. Partly it was due to the shift pattern job, which stimulates appetite and makes people gain weight. But at that time I have already been avoiding sugary drinks and used sucralose to sweeten my tea or coffee. After I have had enough of myself being overweight, I started to watch my diet and walk more. One summer I even did some regular jogging. Should I not have halted my slow and creepy weight gain, I could end up like some members of my family - obese and sick. I have managed all this without a help of a doctor or some private consultations and more importantly - without any medications!

However, I understand that the individual cases are different from the task for the government to tackle the obesity on the population level. 

Here is the trend of childhood obesity and overweight in England. Can you see the drop after 2004?

That was the time the UK government started to apply robust intervention campaigns against childhood obesity. These campaigns involved dietary changes, behavioral consultations and also increased physical activity. I guess that only few children were receiving some medicines to manage their extra weight. The achieved results are still not perfect and more can be done, but tell me again that nobody can fix the obesity.

Similarly for the U.S. I have already written a brief article with data about the trends in obesity int he U.S. for the adults and that the same is predicted for children. The article clearly shows that while sugar consumption was decreasing after 2000, the obesity has been still increasing, until it started to level off from 2010. What in the American diet has caused this change? 

I will wait for the statistics to see whether this had some effect on metabolic health of the population, too.