*head spinning from all the responses*

The thing is, for me, I also tend to forget to eat sometimes. I often don't have an appetite and just don't want to eat more than a couple of snacks a day. Other times I'll eat a full meal, mostly lean meats and steamed veggies.

Before I was diagnosed diabetic, I used to starve myself for days, maybe weeks. Once I looked at the empty refrigerator, decided that now would be a good time to wash it out, bent down to get the crisper, and fainted. Now I know I have to eat to prevent a sugar drop (which is probably what happened then).

Sometimes when I starved like this, it was because I was out of grocery money but was ashamed to ask for help. I was afraid of being told, "Yeah, sure, you really look like you're starving." (I have never actually been told that, but a family friend was, when she applied for food stamps.) Other times, and I still think like this on occasion, I tell myself that with so much world hunger going on, someone as fat as I am has used up her right to eat and deserves to starve.

But I don't lose weight *easily,* no matter how little I eat. I ate (or didn't) like an anorexic, but sure as you-know-what didn't look like one. Whereas others can cut back maybe 100 calories a day and melt like butter.

Also, people tend to judge me if they see me eating, at all. When you're overweight, you're not supposed to put any food at all in your mouth, or else it's evidence that you're a pig and that's why you're so fat. Doesn't matter if it's a plate of lettuce with no dressing, if you eat you're being a pig.

On the other hand, there is a conversation I once had with an ex-in-law, who was the younger sister in her family. As a child she tended to be slim, while her sister tended to be plump. If Betty reached for anything to eat--anything at all--her parents would say, "Betty, you don't need that. Give it to Donna. She needs it worse than you do." So they'd pump Donna full of the food Betty "didn't need." And pretty soon, Donna didn't need it either....

So I understand that "metabolism" doesn't tell the whole story, but we don't all begin at the same starting point. Some of us have more challenges than others.

Now, final point: Why can't different body sizes be beautiful? Why do we all have to be the same size and shape, and have the same proportions? Can a 5'6" woman look good at 180 pounds? I think so, but society says she doesn't look good unless she's 130 or less. Narrow-minded, if you ask me.

Understand I'm not making excuses. I still need to eat healthy and exercise, no matter what challenges I have.

Just because thyroid and PCOS are the only two medical conditions that come to your mind doesn't mean they're the only ones (I can think of at least a dozen - just off the top of my head. Some of them I've run across in my coursework in college and graduate school, and some of them I've run across in my independent study of obesity. Given a week and access to a university library, I bet I could come up with two dozen, maybe even three dozen).

Also, just because you assume that the overwhelmingly large percentage of overweight people you've come across are not affected by these (two or for that matter any) doesn't make it so.

You cannot guess by looking at someone what medical conditions (factors or whatever you want to call them) they may have. Obesity could be 99% physiological - and no one would know that by looking or guessing. You don't see what people eat, and how much - so you can't say whether they're eating more than most people of that size (or any size). You can't tell how they respond to which kinds of diets, either.

There's quite a lot of evidence that many factors affect obesity (social factors, emotional factors, genetic factors, physiological factors).

But our assumptions change how we treat obesity. If we assume it's only one factor, we're going to miss opportunities and ways to help people.

Before I had hypothyroidism, diabetes, and IR (possibly PCOS, possibly obesity-induced), I still may have started with a genetic disposition towards overeating. I definitely had hormonal issues (but fat can contribute to hormonal issues, just as it can be affected by them).

I started menstruating in 4th grade (I don't remember if it was first semester or second, so I might have been 10 or I might have been 9. I think it was 9). I had a heavy, severely painful 8-9 day period on clockwork regular 25 day cycle from the very start. I felt starved, no matter how much I ate during one week every month - and struggled most of my life to lose the weight I gained during that week. No doctor in their right mind at the time (or probably even now) would have put a 9 year old on birth control pills - but I would bet if my doctor had, I would have never exceeded 180 lbs. It's only a theory (an assumption, really), but I do often wonder "what if."

I suspect that genetics/physiology didn't put the weight on, but it "loaded the gun." I'm more and more convinced that physiology (perhaps even genetics) loads the gun, and environment pulled the trigger. If I had been born 200 years ago, unless I was born very, very wealthy, I wouldn't have had access to enough food (and sendentary lifestlye) to pull the obesity trigger.

There's no way to understand how many bullets are in the gun. We can't "see" a person's physiological factors. There's no skin color, there's no tattoo, there's nothing that tells you what your own physiological factors are, you certainly can't see or guess them in others - you can only wonder, guess or assume. I wish more people would wonder, and fewer would assume.

For most of my life, I was ignorant of my own physiological factors (and I'm still ignorant of most of them). There's absolutely no way for anyone to accurately guesstimate how much a role physiology actually plays - for any individual or on average.

You can assume it's "rarely physiological" just as you can assume it's "usually physiological," but the fact is either way you're guessing.

All of that is fine and dandy Kaplods (or not so fine and dandy as the case may be), but I still believe that most, not all, but MOST, cases of obesity are NOT caused by an underlying medical condition. Could I be wrong - well surely, without a doubt ,but I don't think so. I really, really, really don't. And I'm sorry if that bothers you and you feel the need to try to convince me otherwise.

Quite frankly, there are times that I disagree with lots that people say here - certainly when opinions are stated as FACTS, and I'm sure lots highly disagree with what I say - and that's perfectly okay. We can't all always agree or even *like* what someone else is saying. There are many threads that I will take a peek in, maybe even respond to and than not return to it, because I find what I deem as the mis-information too *annoying*. We're not doctors, we're not experts, we are just regular folks speaking about what each of us has come across in our own lives.

Okay, wow, this is a super fun discussion, and clearly hits quite close to home for many of us given the fieriness (is that a word?) of replies!

Kaploids, I would be interested to hear your top-of-the-head dozen medical conditions causing obesity. I don't doubt there are, but I do wonder about the prevalence. In my experience, most of the obesity I see related to medical conditions is iatragenic (neuroleptics, steroids, the list goes on...). And overall, most obesity that can be *related* to medical conditions is not one of cause and effect but rather one piece in a multifactorial process.

One condition not mentioned here that contributes towards having a lowered metabolism is one of the most obvious...

DIETING!!!

Yo-Yo dieting, especially.

Now, I'm stepping away from the thread!

It neither bothers me, nor do I feel the need to convince you otherwise. I know your opinion on the matter, and I know it is not one that you will ever change, unless you experience some of these issues yourself (and maybe not even then).

I am just (as you justifiably felt the right to) disagreeing and stating my opinion - for no less valid reasons than you.

I still believe that MANY, perhaps even most, not all, but perhaps even MOST, cases of obesity ARE caused by an underlying medical condition or more often as a result of the interaction of a COMPLEX and NUMEROUS set of related, unrelated, and interrelated factors. Could I be wrong - well surely, without a doubt, but I don't think so. I really, really, really, really don't. And I'm sorry if that bothers you and you feel the need to try to convince me otherwise.

I am not arguing cause and effect. Even with PCOS and thryoid and other endocrine disorders. I too am arguing that obesity is a multifactorial process - one that can not easily be quantified. Which factors are present (genetic, physiological, environmental, cultural, social, socio-economical...), how important and to what degree the factors play a role, cannot be easily determined for any individual. Especially since we're not sure we've even identified them all, and we certainly don't understand the complex relationships between all of the factors.

The state of the research does not allow much more than theory at this point. Even the experts who have made obesity research their life's work cannot agree on the role and importance (and even the existence) of some of these factors. Assuming that we can draw conclusions when the scientific community cannot, is arrogance in the extreme.

We are guessing, and that's ok, but we need to acknowledge that we are guessing.

I strongly believe this is one of the most common, and one of the best documented and supported in the research.

Some of the most interesting research is on high school and college wrestlers as well as adolescent and young adult gymnasts and some military conditions (where yoyo dieting generally is initiated at a healthy, and even underweight condition).

When you put thin folks on restrictive diets (especially repeatedly) the begin to exhibit behaviors much like overweight and ED patient, experiencing cravings, food obsessions, food hoarding behavior, binge disorders and often eventually weight problems. (Wrestlers who have never dieted are less likely to become overweight than wrestlers who dieted to be able to compete in a lower weight class). Because there is a weight advantage, wrestlers who are at the low end of a weight class are often encouraged by the coaches to lose weight so they can fight at the top of a lower weight class. The more often, and longer a wrestler has yoyo dieted, the higher the risk of eating disorders, and obesity.

Could be a huge contributor in my case. I matured early, was wearing a bra (A-cup, not a "trainer,") to the third grade, had underarm hair, and was at least a full head taller than any of my classmates. Naturally I weighed more too, which led me and others to the conclusion that I was "fat." I wasn't medically overweight until I started high school, but I was dieting since age 8, because I weighed 70 pounds when other kids my age weighed 60 or 65. Nobody took the other factors into consideration. Nobody told me that because I was taller and more physically mature, I was *supposed* to weigh more.

And when I was 12, pretty much my present adult height, had the body of a grown woman, and was still at the taller end of the spectrum, I thought I was fat because I weighed in the 120 to 130 range. Exactly what I should have weighed. My classmates still had prepubescent bodies and were less than five feet tall, and they weighed anywhere from 70 to 90 pounds. Did anyone take that into consideration? No. I weighed more, so I was "fat."

I now think I programmed myself to be fat by thinking I was fat, seeing myself as fat, believing other kids when they called me fat, and (not) eating accordingly.

So, I think it's possible that yoyo dieting from a young age contributed to lowering my metabolism, making it extremely difficult for me to lose weight. An excuse to go wild? No. All my fault? No. Not that either.

(I think I got lost somewhere in this thread....)

I've read that there excluding people with a lot of muscle mass (like body builders) or say with metabolic disorders, that the difference in metabolism really is no more than about 100 cals a day, when you are talking about two people of the same height and activity level. That's really not much. I don't know how true that is though.
I saw someone posted how their 5'8" mother could eat more and stay slim, but the poster was listed as 5'2". Someone taller will be able to eat more and not gain as easily. Also, they have more "space" so spread out their weight.

I think the people that talked about those with "high" metabolism actually being more active are right. We don't follow them daily, and we may not see that they naturally chose the more active choices, like stairs over the elevator or stay active long after a heavier person has stopped moving.
Someone had said that they see people on this board listing much higher cal diets and losing weight, but again, its important to take in to consideration height, current weight (someone at 300 lbs will burn more than someone at 150 lbs), gender, age, and even workout.

My cousin used to say that when I dieted I was able to eat more than her and just lose weight, but when I diet I really put a lot into working out. I would (before kids) spends 2 - 3 hours at the gym. I'd jog, do the eliptical, step and spin classes and then about an hour of weights, and really bust my butt. One time we met at the gym together, and I saw why. Aside from the fact that she went only 2 -3 tims per week, she was there for about 30 minutes. She walked on the treadmill, read a magazine, didn't break a sweat, and left (while I stayed behind to finish my workout).
Since we can't go with other members of the board to their workouts, we can't see how hard someone's working out. Someone that seems to be eating more, mght be working out longer or harder than we are.

As far as dieting causing lowered metabolism, that's what we discussed - that metabolisms change throughout the course of our lives - for whatever reason, for many reasons. The rate at which we burn calories - that's all that a metabolism is, our set of circumstances, the way you live your life, either by choice or by chance is what it is. And it's up to US to adjust as the metabolism, that rate at which we burn calories, changes. We have to be on top of it and change along with it.

And as far as medical - well I have a daughter with a fairly bad chronic stomach condition. She can eat practically no fresh fruits (a nibble every now and then and often pays for it) and vegetables and slightly more (from time to time) cooked veggies. I feel for her beyond belief. It's so not easy for her maintaining a healthy weight AND eating nutritiously. It is quite the challenge! And my heart breaks for her. So is this a medical condition that *causes* her to be overweight? No, I don't think it is. She knows what she's up against, her circumstances suck and she has to adjust to meet her own specific needs. Just. like. we. all. do.

I am sorry for this.

Lovebirds... I'm sorry you feel like you got lost. But it IS an interesting discussion.

Really, if you want to boil the discussion down to its bare bones, the essence of the question is this: if you are "naturally thin" or "tend to run fat" is that volitional or not....

Is your body weight the result of your personal choices that ultimately you control?

Or is your body weight the result of complex genetic, environmental, and medical factors, most of which you DON'T control?

And the truth, like most things, probably runs somewhere in the middle....

There ARE a complicated set of factors influencing our weight-- obviously many factors are combining right now to lead to an increase in global obesity. Obviously, a lot of those factors are NOT in our control.

On the other hand, clearly an individual CAN influence his or her own weight by controlling the CONTROLLABLE factors. Rockin Robin is a prime example of someone who has done so.

I know in my own case, I developed early, started dieting young, and by the time I got out of college, I was overweight. But when I moved overseas for several years and lived in a more or less "native" style in a country where the obesity rate was very low, I also became very thin-- the only time in my life I've maintained a BMI of around 22-- and I did so for almost 4 years with what I perceived as virtually no effort on my part...

I was very active because the only way to eat was to walk two miles to a village and walk home carrying a heavy basket. Food preparation was arduous-- if I wanted bread, I had to knead the dough. If I wanted chicken, I had to cut off its head, boil it and pluck it (I DID NOT WANT chicken very often) During that time I "ate whatever I wanted" and was rail thin.

When I came back to the US, I think I gained back 30lbs I had lost in the blink of an eye. A few weeks of driving everywhere and eating American food was enough to do it.

Environment? Genetics? Personal choice? I guess all of the above....

But the beauty of weight loss is that I still have that choice. I can find the combination of factors that will allow me to lose weight, and I can choose to do those things....

I can't choose to be taller, or more beautiful. But I CAN control my weight, to a reasonable degree.

Nobody needs to apologize.

Of course we all have to adjust to our own circumstances. I'm not sure anyone was ever really disputing that. Having a low metabolism doesn't give me license to eat like crazy and stop exercising, and then blame my body for the fact that I'm not losing weight. In that sense, "It's my metabolism" is no excuse. However, one can say correctly that his/her metabolism makes it more difficult to lose weight, and it's not just an excuse but a fact.

I think the ones saying that the higher-metabolism people are more active are right too, but the point I am making is that they seem to have more energy in the first place. My grandchildren's father hardly ever slows down, and his three older children, not biologically related to me or my daughter, are just plain hyper. However, none of them are making a conscious decision to get exercise. They don't follow any program. Besides obviously not caring what they eat or how much, they also don't think to themselves, "OK, I need some exercise, so I'm going to do this specific action for this amount of time." They simply have a lot of energy. While I have to watch everything that goes in my mouth, and deliberately set aside times to move my body in ways I carefully plan, this man and his children aren't even thinking about it.

Regardless of any physical factors, I think it's the "having to think about it" as opposed to "it comes naturally" that makes the most difference.

And it could be that the habits are formed so early in childhood that we aren't aware of them. I was my mother's first baby, and she was young. She fed me every time I cried, thinking I was hungry (when I probably had a tummy ache from being overstuffed) to the point that I was on two junior-sized jars of baby food *all three meals* by the time I was five months old. I've seen pictures of myself then. I looked like a little Buddha. Exercise? Nah. Our parents didn't encourage us running around and making noise. They preferred for us to stay in our rooms and be quiet. Maybe the bad habits were formed then, before I have any conscious memory?

One thing: If I was a fat baby, a fat teen, and a fat adult, how did I miss being a fat child? Especially in light of that old "finish everything on your plate" rule that so many children are raised with? From toddlerhood to about age 8, I don't remember weight ever being an issue.