Why do some countries have more obese people than others?

Everyone’s problem is that the objective of food companies is not to maximize the health of their consumers, but rather the profit of their shareholders, and to achieve this they exploit our bioevolutionary vulnerabilities.

Which are?

Our ancestors often went hungry and if there was food they gorged. That’s why we still get pleasure from eating concentrated sugars and fats in ultra-processed foods, which are also manufactured cheaply and sold everywhere, leaving huge margins for the manufacturer.

Which country, then, has less voracious food companies and consumers?

Japan is an example of nutritional culture. That’s why only 5% of Japanese women are obese compared to 43% of those in the US…

Aren’t the Japanese and Spaniards the humans who live the longest?

But obesity in Spain is also skyrocketing. However, in Japan, no.


Because since childhood, the Japanese are taught not to eat until they are full, but only to stop being hungry. And that attitude allows them to live on average up to six years longer than Americans. Have you heard about the French paradox?

Of course: they drink wine and eat pâté and butter and they are not particularly obese.

The key is not whether they eat this or that, but rather that they pay enormous attention to what they eat: quantities, situations, company…

Do France and Japan make eating a ritual?

If you look at an authentic Japanese tray of food or go to their restaurants, you will see a ritual, and in France, they somehow maintain it. Nothing to do with Americans eating anything on the way to work.

Why don’t you copy them?

I want that and I send my doctoral students to investigate the French Ministry of Health.

What is your starting hypothesis?

That the key to their dietary health is to educate children about nutrition at school and in school cafeterias. In my country, they just stuff them.

Aren’t you very hard on your country?

In the US, parents allow sugary drink and ultra-processed food companies to exploit their children in schools, thus inoculating the seeds of obesity and diabetes into their habits.

Do you never itch or sin?

Obesity begins when you look to food to compensate for other deficiencies and I snacked when I was preparing my first textbook: I gained three kilos. And the worst thing is that it is much more difficult to win them than to lose them.

Weren’t you an expert in nutrition?

I made the same mistake that we usually make with patients and that is not taking care of the extra pounds until they cause a health problem, and then it is more difficult to solve it than when you can prevent it. The pleasure of going to the refrigerator a lot was much less than the sacrifice I had to make to lose weight.

How to blame are genes and how much are memes (inherited cultural values)?

Genes play an important role, but they are clearly not responsible for the obesity epidemic, because they are the same as 70 years ago, when there were more hungry humans than obese ones.

How many humans are born genetically predisposed to obesity?

Today we can measure the genetic diversity that 30 years ago we believed was due only to one or two genes. We now know that the predisposition to obesity is due to dozens of genetic variants that add up to also increase the risk of diabetes…

Does it depend on genes that one person eats junk food and doesn’t gain weight and another does?

In fact, with the same unhealthy diet, some people’s genes cause them to gain more weight than others with less predisposed genes. So let’s not stigmatize the obese: they are not obese because of a lack of will…

And do semaglutide injections to lose weight help or cause addiction?

They are another resource for those patients with genetic weakness, but nothing replaces a good diet and nutritional culture.

Are the years friends of obesity?

After 40 our levels of androgens, testosterone and insulin decrease, which makes it more difficult to gain and maintain our muscle mass, which burns calories all the time, so either eat less than you did at 20 or you will gain weight. You have to look for other pleasures and other compensations.

What if I take testosterone?

You will gain more muscle with less exercise, but it will increase your risk of cancer…

Let’s leave it, then.

The paradox is that we exercise more at 20 than after 40, which is when we need it most. So the older you get, the more muscular you are and the less you eat.