When we think of obesity, the excessive accumulation of body fat, some tend to think of an individual who lacks the willpower and discipline to eat well and exercise. However, researchers are now saying that the science is revealing “a much more complex story.” As such, experts at Santé Québec – Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-UL) say they’re working to better understand obesity as a chronic medical condition. READ MORE: “The biggest myth is really to move more and eat less [to] eradicate obesity and weight problems,” said Marianne Legault, a dietician with IUCPQ-ULaval. “It’s really more difficult than that. There are multiple physiological responses [from] the body when you try to lose weight.” Researchers stress that treating obesity involves much more than simply questioning a person’s emotional willpower or mental discipline. “Multiple genes will affect how you gain weight or how you maintain your weight,” said Legault. “It can really be in the brain. How you like certain foods and don’t like some; you don’t control that.” Part of the difficulty in treating obesity has been uncovering its biological components. “When we think about the biology of obesity, one thing we need to understand is that hunger itself is a biological signal, just like thirst,” Dr. Alexandre Caron, a researcher with IUCPQ-ULaval, tells CTV News. “We don’t really decide how hungry we feel as much as we don’t choose how thirsty we are.” He gives the example of someone who misses lunch. “Food starts taking up more space in our talks, and we can obviously decide to wait before we eat something, but we cannot decide to stop feeling hungry,” Caron said. “Some people experience that drive much more strongly than others.” An epidemic Caron notes that obesity has long been considered an epidemic, adding that it’s been encouraging to see drugs approved to tackle the issue. “Now, as a society, we’ve made the decision that everyone can take it quite easily,” Caron said. “My biased opinion is that this should benefit mostly the people that need it the most, which we haven’t socially really identified.” The people most in need, according to the doctor, are those who have obesity associated with metabolic risks, like hypertension or diabetes. READ MORE: In his years of studying the disease, Caron says he’s analyzed a number of reasons why a person may put on weight. “Some people are living with obesity because there could be issues with the way they feel hunger, others have larger appetites, others have issues with emotions driving food intake,” he lists, pointing out that mental health also plays a role. “Now that we appreciate more the complexity of this biology, I think we’re getting better at predicting the reason why someone lives with obesity and eventually trying to help them better.” Quality of life For Legault, addressing obesity isn’t about “losing weight” but rather “getting healthy.” “The first thing is to really try to change the focus [from] weight and more on the quality of life,” she said. “It really changes your focus to have smart objectives.” Some of those realistic goals, the dietician points out, can include committing to eating dessert two or three times a week instead of every day. “‘I will never eat desert’ isn’t realistic,” she said. “You have to try small steps to lead to a greater [behaviour] change than can be sustained over time.” She acknowledges that it can be hard to overcome prioritizing the physical benefits of weight loss, but insists it shouldn’t be a person’s main focus. “A big problem [is] that people really see the number on the scale as the biggest goal or aim,” she tells CTV News. “But, as we know well, the science really shows what we want is to have a better quality of life and to be able to move more with your kids or your grandkids and to be able to grow old with a healthy body.” ‘Going up and up’ Despite all the research in recent years, and the help of medicine and other therapies, Caron points out that obesity numbers do not seem to be declining. “The prevalence of obesity has been going up and up, and there isn’t any hint that it’s getting better,” he said. “We’re getting good at making people lose weight, but we’re not good yet at keeping them in this state.” READ MORE: The researchers say their ultimate goal is to distance the conversation from “blame and judgment” toward understanding obesity as a “complex disease, while addressing the stigma that people living with obesity can face.” Conversations around the science, realities and treatment advances for obesity are set to be part of the 2026 Denis Richard Symposium on Nov. 10 in Quebec City, “where experts will bring together science, clinical expertise and lived experience in a format designed to make these issues accessible to the public.”