If you believe the recent commentary from four specialists, diet and exercise alone will help less than one percent of us. “the average adult with sustained obesity has less than a 1% chance of reattaining and maintaining a healthy body weight without surgery” (Dr. Ochner, LA Times 2/13/15)
The reason that the specialist spoke up was not to tell us to all stop trying, it was to remove the stigma that they say is attached to obesity, where patients are seen as simply lacking personal control. “(B)ody weight seems to become biologically ‘stamped in’ and defended” say the specialists, confirming what most of us have found already the hard way. A pound may show up one holiday season and not leave for a decade or more, if ever.
Even if you manage to lose the weight, those carefree days of splendid excess need to be in the past as you: “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.”
Many patients and doctors “still believe it’s all about personal choice: that if the patient just tries hard enough, and if we can just figure out how to get them a little more motivated, then we’d be successful.” If that leads to motivation, great. But when frustrated, the attitude of your medical helper can change to: “you already know what to do, I told you what to do,” which is too simplistic and harmful.
The surgeons are speaking the truth, that nothing we’ve tried thus far has succeeded at losing weight for individuals over the long term (the 1% are those who manage to completely change their lives permanently, never returning to excess).
If diet and exercise are not enough, what else can we do? Hormonal changes and microbiome alterations immediately come to mind. “microflora from normal mice was transferred to the germ free mice and it was noted that the germ-free mice developed overweight in a period of two weeks, with an increase of 57% in their total body fat, despite no change in energy consumption or energy expenditure” (here) So changing your gut, and changing what you eat, permanently, still offers opportunities to permanently change your weight.