Blog #41 written by Andrew Siegel
Kudos to Tara Parker-Popes for her NY Times Magazine article entitled “The Fat Trap.” http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html?_r=1&pagewanted=all
Bottom line: As we lose weight, our bodies change in terms of hormones and metabolism. This biochemically-altered state persists after weight loss, spurring our appetite and ultimate renewed weight gain. Thus, maintaining weight loss is an intense struggle in which we have to combat not only hunger and cravings, but also our body’s powerful internal drives.
After weight loss, ghrelin (the hunger hormone that drives eating) rises from pre-weight loss levels, and leptin (the satiety hormone that suppresses hunger and increases metabolism) decreases from pre-weight loss levels. Additionally, a number of other hormones associated with appetite and metabolism change and remain altered from pre-weight loss levels. In essence, weight loss induces a unique metabolic state that causes a biochemical imperative to eat and regain weight.
Essentially, the body rebels against the weight loss long after the dieting has stopped. This helps explain the sobering truth that once we become fat, most of us will remain fat. That stated, there are those who, in spite of biochemical forces that are obstacles, successfully achieve and maintain a normal weight after weight loss.
In addition to the internal biochemical imperative for weight gain after weight loss, our external environment aggravates the problem. We live in a culture where eating plays an enormously prominent role. In our food-obsessed and food-centric society, it is very difficult, if not impossible, to avoid food cues and eating opportunities over the course of the day. Our culture has reinforced using food for reasons that have no relationship to nutrition and energy, particularly when we eat for emotional reasons, ranging the gamut from reward-eating to stress-eating to boredom-eating.
Weight loss is not an easy task—we all know that pounds go on easily, but come off with great effort that involves fewer calories in and more calories out through exercise. Many people are not successful at losing weight, although those who are truly disciplined can succeed. Of those who do lose weight, most will ultimately regain the weight because of this combination of internal and external factors that conspire to thwart our best efforts. These factors are so powerful that in order to overcome them to allow the weight loss to be permanent, a lifelong modification in our relationship with food must occur. It is possible, but demands a dramatic change in mindset in order to resist our own internal biochemical imperative and the external “hostile” food environment.
Andrew Siegel, M.D.
Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food
Our Greatest Wealth Is Health 