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Why it’s Hard to Lose Weight

Posted June 6, 2008 at 12:00 PM by Kathleen Blanchard

Section: Her Health, Body Image, Her Motivation, Her Nutrition, Diet Myths, Her News

ENTERNo one can completely answer the question – why is it so hard to lose weight? More people than ever are being sent to the operating room for bariatric surgery after an unsuccessful relationship with weight loss pills and programs. We might ask what’s really going on. 

Your body isn’t necessarily unhappy when you gain weight.  It simply doesn’t care, so it offers no defense. The quantity and quality of the foods we eat can produce a chain of reactions. Weight gain leads to a genuine desire for more food, producing further weight gain – fat cells produce a complex interaction of hormone release and metabolic changes. We become physiologically less than perfect. Severe obesity leads to extreme obesity.  Researchers note a fivefold increase of obesity in people with very high body mass.  Ongoing studies reveal that something unusual really does happen in fat cells that make it hard to lose weight.  “Fat leads to more fat.”

When we take in fewer calories, the body senses the change. Leptin levels and steroidal hormone levels increase.  Leptin tells the brain to eat more. The result is less energy expenditure, causing weight loss plateaus.  You can only get so far, and then weight loss stops. Medications used to treat diabetes also contribute to weight gain and increased cholesterol levels, providing a cycle of events that so far defies solution. Diabetes is becoming extremely prevalent.

There are only four drugs currently approved by the FDA for weight loss – not a very big arsenal when you consider the obesity burden.  FDA approved drugs include Sibutramine (Meridian), Phenteramine Diethypropion (Tenuate), and Orlistat (Xenical, Alli).  Sibutramine is the most effective. Orlistat has helped with diabetes prevention, even without significant weight loss.  These supplements provide only modest amounts of weight loss at best, and do nothing to teach good dietary habits and lifestyle changes.  It’s mandatory to use weight loss supplements with a complete lifestyle program of exercise and proper nutrition.

Experts believe that targeting the Endocannabinoid system with medication will produce better results for weight loss.  New types of drugs are developed that may help break the vicious cycle of hormonal changes that perpetuate weight gain and inability to shed pounds.  One drug example is Rimonabant, not yet approved in the United States. 
The take home message is that it’s extremely difficult to lose weight once you’ve gained too much. Modest amounts of weight gain are easier to reverse. Once you reach a certain point, weight loss becomes a huge challenge – thus the popularity of weight loss surgery.  Exercise becomes more difficult, appetite increases because of the signals sent to your brain urging you to eat, and harmful hormone levels begin to rise, causing a complex series of events. 

We often hear that weight loss is easy if you try hard enough.  The truth is, with too much weight gain it can become almost impossible.  Researchers are trying to target better options to treat obesity, recognizing that we don’t have many tools at our disposal. 

Don’t let weight gain sneak up on you.  Recognize that if you don’t do something sooner than later, you’ll limit your chances of successful weight loss.  There is no such thing as “fat but fit”.  Start by trying to get rid of a few extra pounds, and stick with it.  Never be discouraged if you gain back a few pounds.  Start simply by increasing your energy expenditure and decreasing calories.  Eventually, it will be very difficult to lose weight.

Kathleen is a Registered Nurse.  You can read more by visiting her blog.


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