Carrying fat around the waists is linked to increased cardiovascular problems and total mortality. Having the extra fat around the hips and thighs appears to be slightly less risky to the health. A ratio of waist to hip circumference of 1.0 is normal in men, while a ratio 0.8 is the norm for women. A ratio higher than those numbers means a greater risk of obesity-related problems. There is a genetic component to obesity.
Most overweight people have overweight parents.
Similarly, identical twins separated at birth have similar physiques no matter how they were raised. Medical conditions, such as hypothyroidism and Cushing's syndrome may decrease the RME, but these causes for obesity are relatively rare. In other words, obese people burn off fewer calories than they eat with the excess calories being stored as body fat. No matter what the reason for the discrepancy between calorie intake and expenditure, it still comes down to that. Even with the use of prescription medications that control the appetite, boost the metabolism or have other actions, fewer calories must be eaten than are expended for the body to lose weight.