New research suggests that doctors need to do a bit more than telling their obese patients to exercise more and eat less in order to lose some weight. Instead, doctors should start treating obesity from the biological mechanisms point of view, figuring out what makes it so hard for obese people to successfully lose weight, and make sure they don’t gain it again.
What actually happens when people decide they want to diet in order to lose weight is that their body believes that it’s starving. In response, there are a few biological mechanisms which turn on, stimulating people to eat more food, so the lost weight would be gained back. Christopher Ochner, an assistant professor of pediatrics and psychiatry from New York explains that, for one, the brain signals the body to slow down the process of burning calories, preserving fat, and it also encourages the attraction stimuli for high-calorie foods.
Ochner states that these survival mechanisms usually developed to make sure people didn’t die during famines or periods when food was in short supply. Nowadays, however, the same mechanisms kick in when a person weighing 400 lbs. tries to los 30 lbs. Ochner believes that the same reasoning might help us understand why is there such an overwhelming percent (80-95) of obese people who gain weight again after losing it. He explains how studies show that people who have suffered from obesity for many years have their body weight sort of “stamped in”, becoming a part of their organism.
Therefore, researchers encourage doctors to go beyond the classic advice about dieting and working out, because these two solutions are most likely not going to be sufficient for losing a significant amount of weight in obese patients. Instead, Ochner urges doctors to pay more attention to prescribing biological treatments for obesity, either in the form of drugs or even surgery.
On the dark side of this solution is the fact that biological treatments available on the market in the present are very expensive. In addition to steep prices, most of them do not possess data concerning long-term efficiency for newer drugs. The only obesity treatment there is, which has been proved to successful over the long term is the weight-loss surgery, also known as bariatric surgery. This operation affects the shape and the length of the stomach and the intestine.
Ochner stated that, unfortunately, there are not enough treatments which address the ever-growing problem of obesity in the United States. Moreover, doctors would like to be able to have a wider range of treatments to prescribe their patients, safe and more available to the public. In the meantime, Ochner suggests that doctors should be more open to obesity medication or even recommending surgery. This does not mean they should stop encouraging their patients to change their unhealthy lifestyles by eating less and exercising more.
Ochner’s paper, co-wrote with his colleagues, was published in the latest issue of The Lancet Diabetes & Endocrinology. They recommended that obesity treatments should not rely solely on changing the patient’s lifestyle. That should be only one factor in a more complex treatment, as doctors should also consider the benefits and the risks of biological medicine. For each patient individually, researchers encourage a practice of also taking into account the patient’s obesity-related disorders before prescribing anything.
Even though he did not take part in writing the new paper, Dr. Pieter Cohen, an assistant professor of medicine at Harvard Medical School, supports the idea of having a better grasp on the biology behind the difficulty of losing weight in obese people. His explanation is that, over the history of human kind, losing weight was only associated with illness or scarce food, so the body learned to develop certain biological mechanisms against that very loss.
However, Dr. Cohen says that he is reserved in prescribing weight-loss medicine to his patients because there is inconclusive data on their safety and efficiency over time. His stance is that there needs to be better and more sufficient data in favor of the medicine exiting on the market, before he will prescribe them.
Another point of view presented in the paper that Cohen disagreed with, was calling obesity a disease, which he believes to be more of a risk factor for developing health problems. He thinks obesity should be treated if it affects the patient’s future health. He also believes that a healthy lifestyle could have its benefits, even if it does not lead to weight loss. If an obese person eats healthier and also exercises regularly, they might not lose weight, but they will surely become a healthier person.
Ochner and different experts also believe in encouraging the population to lead healthier lifestyles before reaching the point of obesity, because it was proved that overweight people have a higher chance of losing weight than obese people.
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