Why Is It So Hard To Lose Weight?March 7, 2022
Nobody wants to be overweight. Just about every patient I see has tried desperately hard to lose weight, often starving themselves for weeks and exercising until they are injured. Why is it hard to lose weight?
An interesting study was done interviewing people with different ailments and asking these people if they would trade afflictions. Would someone who is blind choose to get his sight but lose his hearing? No, they wouldn’t because people become comfortable with their individual struggles.
But ask someone suffering from obesity and they would trade just about anything to not be overweight, including choosing to have a leg amputated!! In fact, when they offered 48 people who had successfully lost 100 lbs if they would accept 2 million dollars but they would have to take all their weight back, only 1 person said they would go along with the money.
The Science of Obesity and Why It’s Hard to Lose Weight
So, if nobody wants to suffer from weight issues, then why is obesity so pervasive in our society? The answer is fairly complex and multifactorial.
First, understand that our genetic makeup and anatomy are ancient and were forged in times of feast or famine. We have a large stomach that secretes a hormone that makes us hungry. We did not evolve this stomach so we could get our money’s worth at the buffet.
We evolved a large stomach so we could eat as much as possible when there was a kill or a harvest. We needed to eat to survive the frequent fasts.
Survival of the fittest, in this situation, favored those equipped to eat a lot, and those genes travelled for generations.
If you don’t believe genes play a role then simply consider the twin studies that have been done. Identical twins, even if separated at birth, tend to have a similar weight regardless of the lifestyle they are exposed to, but that does not hold for fraternal twins. In fact, researchers in these studies concluded that weight is one of the most inherited traits we have, on par with height.
What do these genes code for? There are multiple factors at play. You probably have a friend who hardly eats. If you do an MRI on people suffering from weight issues and compare them to people with a normal weight you will see that the overweight group has a deficit of dopamine receptors in the areas of the brain that register satisfaction.
If you show these people pictures of food their brain activity lights up in areas that perceive hunger way more than in the normal-weight group. In other words, some people are hungrier than others and it takes more to satisfy.
Hunger is a Very Complex Entity
Hunger is a very complex entity. There are multiple hormones that have an effect on hunger. Those hormones feedback to the very primitive part of the brain, the part of the brain that controls heart rate and breathing. This is not the part of the brain that thinks and considers, so this really is NOT willpower. Hunger is a primitive drive to keep you alive.
To make matters worse, our fat actually communicates with this area of the brain by secreting a hormone called leptin. Having lots of leptin is looked at as protective to the brain. It means that we could survive a fast, but start losing weight and the leptin levels will fall, and that signal is read by the brain as a warning that we may be fasting and the brain will kick in to be sure this stops.
Now, combine the hunger with a slowed-down metabolism and we have a perfect duo for weight gain. When you lose weight rapidly, as you do with weight loss surgery, then you will also lose muscle. When you lose muscle, metabolism will slow. When metabolism slows you are burning fewer calories daily, and weight gain becomes easier.
Remember the TV show The Biggest Loser? Well, most of the participants gained back a significant amount of weight. Johns Hopkins studied them and found that their metabolism slowed dramatically after the show.
The Environment We Live In
The final piece of the puzzle is the environment we live in. The USDA has set a recommended food plate which is heavy in fruits, vegetables, grains, and lean proteins, but in the ultimate hypocrisy, the government gives very little funding to fruit and vegetable growers and most of the money goes to industries that make ultra-processed foods and meat and dairy.
A burger should cost about $14, but due to government subsidies, can be bought for a dollar while a simple salad is $5. For a family that is struggling to make ends meet, a fast food meal is cheap and easy.
To make matters worse, the companies that sell us the food actually have taste scientists that know exactly what we are programmed to crave, and design foods that we simply can’t say no to. They are catering to our inborn drive to eat as many calories as possible.
As Dr. Michael Greger puts it, “the prime cause of obesity is neither gluttony nor sloth. Obesity may simply be a normal response to an abnormal environment.”
ABOUT THE AUTHORGarth P. Davis, MD, FACS, FASMBS has spent 20 years in the field of surgical and medical weight management. Dr. Davis is a recognized expert both surgical and medical management of obesity. He believes strongly in the comprehensive management of patients struggling with obesity. He is also a specialist in surgery of the foregut and has expertise in the management of reflux, heartburn, and achalasia. Dr. Davis is currently with Methodist Weight Management.