In my last article, I explored the reasons why overweight persons may not be losing weight even though they think theyre on a diet. But for the morbidly obese, with a BMI greater than 40, the calorie-in minus calorie-out equals weight change may not necessarily hold true as it does in the overweight.
I recently got into an argument with one of those Instagram weight-loss gurus over this fact.
The statement over 95 per cent of dieters fail was the genesis of the conflict. This statement was popularised by those with the perfect solution to solve the problems of frustrated dieters of all sizes.
Come to me all who labour in vain and I will lose the weight for you and it will be easy.
Great marketing but absolutely no substance to it.
My IG foe was bashing this false narrative about the failure rate of diets when I pointed out the nugget of truth within: When you have a BMI of over 40, your chances of losing weight and keeping it off in the long term is less than five per cent.
This did not sit well with someone who made his money off selling hope to the very people who are likely to fail on his diets.
The response to me providing the evidence from a high-quality long-term study with up to 20 years of follow-up was, of course, to bash the study and present an inferior study with four years of follow up.
But the data I dug up was even more damning than I originally thought. Morbidly obese patients who are put on diet and exercise programmes can lose anywhere from zero to one per cent of their body weight over 15 to 20 years. Those are depressing stats for anyone. More so for morbidly obese persons who are desperately trying to lose weight. But why is this so?
Fat cells are looked on as storage bins that fill up and expand as you eat more calories than you burn. But fat cells are much more complex than this. In fact, there are some scientists who believe that fat should be looked on as an organ just like the liver and heart. Fat produces hormones and other substances that play a role in regulating metabolism and gene expression across the body. Fat actually changes your hormones and genes! Then there are the hormones produced by the gut.
As you begin a diet, your stomach begins to produce more hunger hormones. So its not in your mind that you feel hungrier on a diet. But the worse part of trying to lose large amounts of weight is that as you lose weight, your metabolism slows down so you have to eat less and less to remain in a calorie deficit and continue to lose weight.
Part of this fall in caloric requirements is simply due to the fact that as you drop weight, you need less energy to move around your lighter body.
Look at it in this way. If you are walking around with a bag weighing 50 pounds, you are burning a certain number of calories in order to feed your muscles holding the bag. When you lose weight, you are putting down the 50-pound bag. You need less calories because you are no longer labouring with that weight. You therefore need to consume less calories because you are burning less calories, that is, your metabolic requirements fell. If you dont cut your calories as you shed weight, you will hit a plateau, or worse yet, regain the lost weight.
What frustrates most persons who are morbidly obese is that in addition to this simple need to eat less because you weigh less, the body also actively cuts its metabolic rate as you lose weight.
The most famous study looking at this metabolic adaptation followed the highly successful dieters on the TV show The Biggest Loser. The researchers found that in addition to regaining a significant portion of the lost weight, the metabolic rates of the former contestants were ridiculously low. Those who had kept the weight off had to be hitting the gym very hard to compensate for their slow metabolism.
The sad truth is, your body will try its best to get you back to an unhealthy weight once the hormonal changes of being severely obese kicks in.
This is a fact that I hammer home to all prospective bariatric surgery patients. If you slip up after surgery and start consuming calorie dense foods like snacks, sugary drinks or even natural juices, the weight can return very quickly.
Morbid obesity is classified as a chronic disease for a reason. You never really cure it by losing weight. You put it into remission. And like all chronic diseases, it can come back if you are not vigilant with your lifestyle and treatment.
Your best bet at success is to avoid becoming morbidly obese in the first place. Because if you do, surgery may be the only viable option for you to lose weight and keep obesity in remission.
Of course, those who peddle diet pills, shakes and programmes will never tell you that. Primarily because, like my Instagram colleague, they are wilfully blind to the truth.
After all, a 95 per cent failure rate will keep you paying their bills as long as you are willing to buy more hope.
Dr Alfred Dawes is a general, laparoscopic and weight-loss surgeon; Fellow of the American College of Surgeons; former senior medical officer of the Savanna-la Mar Public General Hospital; former president of the Jamaica Medical Doctors Association. @dr_aldawes. Email feedback to firstname.lastname@example.org and email@example.com
Read the original:
Severe obesity: The harsh truth | Health - Jamaica Gleaner
- Effective Exercise Tips If You Want To Lose Weight Ahead Of Summer - Medical Daily - January 21st, 2020
- SMART Carpet and Flooring Issues New Year's Resolution Reminder: 'Remember Your Promise to Lose Weight and Stay Fit This Year? Get Started With Brand... - January 21st, 2020
- Losing a little weight can lower the risk of breast cancer - WTNH.com - January 21st, 2020
- Going for Short Walks Every Day Led to This Guy Losing 140 Pounds - menshealth.com - January 21st, 2020
- Is jogging really effective for weight loss? - The Standard - January 21st, 2020
- 'After Being Prescribed Diet Pills, I Found A Natural Way To Maintain My Weight With The 80-20 Diet' - msnNOW - January 21st, 2020
- 21 January 2020 6 steps to successful weight loss for women Obesity researcher Dr Nick Fuller - News - The University of Sydney - January 21st, 2020
- Feeling down and sluggish? Your thyroid could be to blame - ABC 4 - January 21st, 2020
- How to lose weight and live longer, by Britain's top diabetes expert - The Times - January 21st, 2020
- Rebel Wilson's trainer praises her dedication to losing weight, says she has been 'putting in the yards' daily - MEAWW - January 21st, 2020
- Losing weight in aid of Stepping Stone Hospice - Southern Courier - January 21st, 2020
- Small Diet Changes And A Push-Pull-Legs Routine Helped This Guy Drop 23Kg - Men's Health - January 21st, 2020
- Your Health Family: Feeling down and sluggish? Your thyroid could be to blame - KOAA.com Colorado Springs and Pueblo News - January 21st, 2020
- Quick Bodyweight Workouts to Do When You Don't Feel Like Going to the Gym - Men's Journal - January 21st, 2020
- The inspiring story of one man's 330lbs body transformation - JOE.co.uk - January 21st, 2020
- This is basically promoting eating disorders Shoppers slam The Range for selling a bikini body weight loss aid - goodtoknow - January 21st, 2020
- Keto diet isnt the answer for weight loss, experts say. Heres what is - USA TODAY - January 20th, 2020
- Trying to lose weight? Eat your meal alone - Times of India - January 20th, 2020
- Losing weight off this organ helps improve sleep apnoea - The Star Online - January 20th, 2020
- 'I Followed The 80-20 Diet Rule And Tracked My Macros With MyFitnessPalAnd I Lost 40 Pounds' - Women's Health - January 20th, 2020
- James Martin weight loss how did the chef lose weight? - The Sun - January 20th, 2020
- Effective Steps for CrossFit Athletes to Lose Weight Without Counting Calories - BOXROX - January 20th, 2020
- Diet Demand Touts Benefits of Heart Healthy Diets for Longevity and Weight Loss - GlobeNewswire - January 20th, 2020
- Adele's body transformation was 'never about losing weight' - 9TheFIX - January 20th, 2020
- Fitness Revolution is helping me achieve my goals - Lake Placid Diet by Andy Flynn - LakePlacidNews.com | News and information on the Lake Placid and... - January 20th, 2020
- The reason is not divorced: why Adele is rapidly losing weight - The Times Hub - January 20th, 2020
- Singapore #Fitspo of the Week: Rayson Yong - Yahoo Singapore News - January 20th, 2020
- The Military diet: how does it work and can it order you to lose weight? - T3 - January 17th, 2020
- How to lose belly fat: 5 ways to feel better and reveal your abs in 2020 - T3 - January 17th, 2020
- Rebel Wilson flaunts amazing weight loss transformation after declaring 2020 her 'year of health' - Fox News - January 17th, 2020
- Weed and weight: Why are cannabis consumers slimmer? - Leafly - January 17th, 2020
- Weight loss with the 5:2 diet: requires willpower but can be powerfully effective - T3 - January 17th, 2020
- Women say having clear skin, losing weight and clean hair is the secret to getting an instant confidence boost - The Sun - January 17th, 2020
- Drinking This Much Water Per Day Was the Key to Jessica Simpson's 100 lb Weight Loss - Showbiz Cheat Sheet - January 17th, 2020
- How to lose belly fat with 5 simple tips and reveal those abs - The Sun - January 17th, 2020
- Weight Loss: Is it possible to lose weight without performing cardio? - Times of India - January 17th, 2020
- Tom Kerridge: The Lose Weight and Get Fit chef on trying to regain fitness and why carbs are back on the menu - inews - January 17th, 2020
- How to lose weight with just 5 healthy food swaps - Better Homes and Gardens - January 17th, 2020
- Malaysian teen shares painful experience of being body shamed despite losing weight, going to the gym - Malay Mail - January 17th, 2020
- Steve Harvey Tells Ellen DeGeneres He Stopped Trying to Lose Weight and He'll Just Make More Money Instead - AmoMama - January 17th, 2020
- 'I Made A Decision To Get Fit, Lose Weight And Push On To Being An Outfield Player' - Balls.ie - January 17th, 2020
- 22 Ways to Lose Weight Without Breaking a Sweat - Greatist - January 15th, 2020
- Why you may not be losing weight on the keto diet - INSIDER - January 15th, 2020
- Woodlands business owner aims to teach proper dieting for weight loss - Houston Chronicle - January 15th, 2020
- What 10 Obesity Experts Wish You Knew About Weight Loss - Prevention.com - January 15th, 2020
- Truth About Kate Middleton Starving Herself, Losing Weight While Trying To Get Pregnant - International Business Times - January 15th, 2020
- We must consider the consequences of diet culture - Daily Trojan Online - January 15th, 2020
- How To Lose Belly Fat: Avoid One Drink Regarded By Many As Healthy - International Business Times - January 15th, 2020
- Mum thought diet was making her lose weight - but it was breast cancer - Derbyshire Live - January 15th, 2020
- Is it your New Year's Resolution to lose weight, and lead a healthier lifestyle? - Leyton Orient FC - January 15th, 2020
- What is the DASH Diet? Guidelines for Losing Weight on the DASH Diet - Parade - January 15th, 2020
- Best breakfast for easy weight loss - eat this protein-fuelled food to lose weight fast - Express - January 15th, 2020
- How to lose weight in 6 months, according to this guy who lost 30 kgs by following this healthy plan - GQ India - January 15th, 2020
- Len Romes Local Health: Are you keeping to your resolution? - WYTV - January 15th, 2020
- 'I Counted Calories And Stuck To The 80-20 Rule To Lose WeightAnd I've Lost Over 150 Pounds' - Women's Health - January 4th, 2020
- Healthy Actions: Lets start the new year off on the right exercise foot - Akron Beacon Journal - January 4th, 2020
- Weight loss: What is the best way to slim down? Expert reveals top tips - Express - January 4th, 2020
- Blown your resolutions already? Tips for getting what you really want. - Seattle Times - January 4th, 2020
- Simon Cowell delighted with appearance following 20lbs weight loss - ABC FOX Montana - January 4th, 2020
- Tennis ace Jelena Dokic shows off incredible weight loss transformation after losing 53kg in 18 months - New Idea - January 4th, 2020
- How Keto and Walking Helped This Guy Lose Nearly 90 Pounds - menshealth.com - January 4th, 2020
- Could this be the last diet you'll ever need to do? - The Times - January 4th, 2020
- Weight Loss Tip of the Week: How to Use Matcha Tea to Lose Weight - LatestLY - January 4th, 2020
- Full cream milk vs toned milk: Which one is better? - Times of India - January 4th, 2020
- How to lose weight and get fit in 2020: 20 easy tips, diet hacks and workout routines to help you get started - GQ India - January 4th, 2020
- Four stone weight loss has changed the life of Tipperary woman Paula - TipperaryLive.ie - January 4th, 2020
- 'Inspirational' mum transforms her life after long battle to lose weight and quit smoking - Bradford Telegraph and Argus - January 4th, 2020
- The New Year's Resolution that usually fails within the first month - Jacaranda FM - January 4th, 2020
- Why dieting can lead to loneliness - From the Grapevine - January 4th, 2020
- The Smart Equestrian's List to Brightening the Winter Blues - TheHorse.com - January 4th, 2020
- Getting fit, losing weight now easier at the Family Y - The Augusta Chronicle - January 2nd, 2020
- Man who lost 200lbs gives tips on losing weight, keeping it off - WISN Milwaukee - January 2nd, 2020
- Tipperary group celebrate year of great weight loss with Chatty Man Alan Carr - TipperaryLive.ie - January 2nd, 2020
- Best cars for achieving your New Years resolutions - Boston Herald - January 2nd, 2020
- Tyler Whitman From 'Million Dollar Listing' Reveals the One Big Weight Loss Move to Make for 2020 - Showbiz Cheat Sheet - January 2nd, 2020
- 5 reasons why you should try running and the best running gear you'll need - T3 - January 2nd, 2020
- NY's resolution to lose weight; study finds fasting could add years to life - KFI AM 640 - January 2nd, 2020
- Mark Labbett weight loss: The Beast drops three stone by cutting out one thing from diet - Express - January 2nd, 2020
- If You're Trying to Lose Weight, Should You Try Whole30? Here's What Registered Dietitians Say - POPSUGAR - January 2nd, 2020
- 'I thought I'd be in a wheelchair forever' - how weight loss has transformed this Blackpool mum's life - Blackpool Gazette - January 2nd, 2020