Most weight-loss measures don't work. It isn't true. There are a lot of approaches that can help people lose weight.
Weight loss is the easiest part. When you stop taking a weight-loss drug, the weight will inevitably come back up.
This doesn't mean that diet and other treatments for obese people are useless. It's far from it.
Researchers checked in on participants five years after they started a WW programme.
Although, on average, people's weight had crept back up, some weight loss could last for up to five years.
A person's lifetime risk of developing diabetes, heart disease and other weight related diseases can be reduced by a short time at a low weight. Losing weight can be demoralising for people with morbidly obese people.
This failure of treatment is often seen as a personal failing because of the stigma surrounding obese people. This is not correct. The weight comes back on.
There are a few reasons why the weight doesn't go away. Our brain doesn't like it when we lose weight. It considers this a reduction in our chances of survival, so it drags your weight back up.
Your brain reduces your metabolism as you lose weight. If there are two people with the same weight, one stable and the other losing weight, the other will have to eat less food in order to stay the same weight.
It turns out that leptin is the main factor in this. leptin tells the brain how much fat you have. leptin is produced if you have a lot of fat. Your brain knows when you lose weight.
Scientists have shown that if you give leptin enough to fool your brain into thinking you have lost weight, then many of the weight-loss related changes are mitigated. There is no treatment based on these findings at this time.
Each person with Obesity has their own combination of psychological, social, environmental and economic factors that contribute to them gaining weight. During a weight loss treatment, most of these will not resolve.
People with Obesity who have lost weight live in an environment where food is plentiful and cheap. Food is often the focus of social activities. We use food as both comfort and reward when celebrating. It takes a lot of effort to eat less.
Commercial group programmes and cognitive behavioural therapy teach us strategies that we can use to manage this, but they don't stop it from being difficult. Our lives can't be made easier by them.
Drugs that target biological drivers only work while they are being taken, while daily stressors and life events can disrupt the healthy habits and routines that people establish when trying to lose weight. Surgery addresses biological drivers, but biology doesn't like it.
It's not realistic to think that a single intervention will lead to permanent weight loss. If we take the example of high blood pressure medication, which is very effective, no one is going to stop the treatment when your blood pressure is normal. It would return up again. It's the same for weight-loss treatments.
Obesity is thought of as a relapsing disease. lifelong access to treatment and support is needed for people with Obesity We shouldn't dismiss effective treatment options because of weight regain because we should be honest with people about what they can achieve and the likelihood of needing ongoing support. Chronic treatments are required after all.
The view of society is that obese people are simply eating less and moving more. People who are obese need to be fat shamed into losing weight. People who are obese are not bad, lazy or morally bereft. It's not a choice if you're obese.
Amy and Giles are professors at the University of Cambridge and the University of Cambridge.
Under a Creative Commons license, this article is re-posted. The original article is worth a read.
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