But when you think about why people ‘regain’ weight, the story is very different, because irrespective of how you lose weight, the biological drivers of weight regain are pretty much a common denominator for everybody. So, regardless of how I lose weight, my leptin levels are going to drop, my appetite is going to go up, my hunger levels will go up, my metabolism’s going to slow down. All of these common things – which will happen in anybody who loses weight for any reason – are going to drive me back toward my original weight or ‘set-point’.
-Dr. Arya Sharma, April 26 in Dr. Sharma's Obesity Notes (blog post entitled Close Concerns: Stopping the Gain)
I'm posting this as a bit of a follow-up to my previous post on what's "normal". There's been a small discussion going on in the weight-loss world decrying medical professionals who hold out little hope of long-term weight loss maintenance.
I just don't understand the big to-do. Why do people get so hot and bothered about the fact that 95% of people regain the weight? That's just the way it is.
Do what you want, people. If you still think it's worth the struggle and your body and your mind are none the worse for trying, do whatever you want. Just don't talk about normal. Keeping the weight off just isn't normal. Sad, but true. You don't have to take my word for it. You don't have to believe a lowly blogger like myself. Just ask Dr. Sharma.
I think people deserve to know both the odds of success and the potential ill side effects -- additional weight gain, disordered eating, etc. For too long, weight loss has been seen as a no-risk solution to all manner of ills. I have no doubt in my mind that exercise and a healthier diet are no-risk, within the bounds of any physical limitations a person may have, but weight loss is not.
ReplyDeleteI know there are people who lose weight and keep it off, either through simply lifestyle changes or through rigorous discipline. The two most important words in people's health journeys are "for me." If I take up walking moderately and shed many pounds, that worked "for me." It won't necessarily work for every human on the planet.
Well said, Fat Chick!
DeleteAt this point, personally, I see many similarities between being previously obese and having various chronic disorders, such as PTSD and fibromyalgia and degenerative arthritis. Doctors seem to know very little about how to effectively treat these (and many other) life long conditions. Medications are limited in their efficacy, and drugs all have various side effects (costs). Each person must discover and/or create, through trials and errors, the kinds of behaviors and approaches that best assist each individual to live the best life possible, which varies considerably over time, whether that means learning to avoid particular foods or becoming highly attuned to one's unique health demands and vulnerabilities. As long as I don't return to eating a Standard American Diet (high in grains and carbs), for example, then my own hunger is quite manageable (well, so far). Each person must negotiate their own expectations, too, regarding outcomes. I'll never have tight abs or a high, firm bustline. Shrug. But I can have improved mobility, avoid T2 diabetes for awhile, and wear a size 10 rather than a 30 (which might enhance my employability in a biased, effed-up system. I can't make my body become "normal" by regaining 100 plus lbs. It doesn't work that way. It was dysregulated and sick before I changed how I eat and lost weight. It is still dysregulated and sick. After all, the major organ (my fat stores) that regulated many hormones has been permanently damaged by extreme fat loss. Until researchers find a way to market hormone replacements, I function at a disadvantage, much like my mother had to function (suffer) after her hysterectomy in the 50s--with no hormone replacement. Of course it's unfair, and terribly abnormal compared to what could be done to restore better equilibrium and balance to millions of people's lives. That's one problem with the medical system under capitalist forces. Yep, it sucks. :)
ReplyDeleteHey, there, Lowly Blogger!
ReplyDeleteI've been following this series at Sharmaville too. I was just amazed at the post where the interviewer kept hammering on and on about Dr. Sharma's thoughts on weight-loss drugs, and he patiently just kept pushing back, over and over, to the effect: ANYONE can lose weight. I'm not concerned with weight loss. The issue is weight maintenance, and we especially need to develop therapies for maintenance AFTER loss. That would be helpful. I think he finally got partially through. Yeesh.