Stealth Forces in weight Loss
The field of weight loss is like the ancient fable about the blind men and the elephant. Each man investigates a different part of the animal and reports back, only to discover their findings are bafflingly incompatible.
A— The various findings by public-health experts, physicians, psychologists, geneticists, molecular biologists, and nutritionists are about as similar as an elephant’s tusk is to its tail. Some say obesity is largely predetermined by our genes and biology; others attribute it to an overabundance of fries, soda, and screensucking; still others think we’re fat because of viral infection, insulin, or the metabolic conditions we encountered in the womb. “Everyone subscribes to their own little theory,” says Robert Berkowitz, medical director of the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine. We’re programmed to hang onto the fat we have, and some people are predisposed to create and carry more fat than others. Diet and exercise help, but in the end the solution will inevitably be more complicated than pushing away the plate and going for a walk. “It’s not as simple as ‘You’re fat because you’re lazy,’” says Nikhil Dhurandhar, an associate professor at Pennington Biomedical Research Center in Baton Rouge. “Willpower is not a prerogative of thin people. It’s distributed equally.”
B— Science may still be years away from giving us a miracle formula for fat-loss. Hormone leptin is a crucial player in the brain’s weight-management circuitry. Some people produce too little leptin; others become desensitized to it. And when obese people lose weight, their leptin levels plummet along with their metabolism. The body becomes more efficient at using fuel and conserving fat, which makes it tough to keep the weight off. Obese dieters’ bodies go into a state of chronic hunger, a feeling Rudolph Leibel, an obesity researcher at Columbia University, compares to thirst. “Some people might be able to tolerate chronic thirst, but the majority couldn’t stand it,” says Leibel. “Is that a behavioral problem – a lack of willpower? I don’t think so.”
C— The government has long espoused moderate daily exercise – of the evening-walk or take-the-stairs variety – but that may not do much to budge the needle on the scale. A 150-pound person burns only 150 calories on a half-hour walk, the equivalent of two apples. It’s good for the heart, less so for the gut. “Radical changes are necessary,” says Deirdre Barrett, a psychologist at Harvard Medical School and author of Waistland. “People don’t lose weight by choosing the small fries or taking a little walk every other day.” Barrett suggests taking a cue from the members of the National Weight Control Registry (NWCR), a self-selected group of more than 5,000 successful weight-losers who have shed an average of 66 pounds and kept it off 5.5 years. Some registry members lost weight using low-carb diets; some went low-fat; others eliminated refined foods. Some did it on their own; others relied on counseling. That said, not everyone can lose 66 pounds and not everyone needs to. The goal shouldn’t be getting thin, but getting healthy. It’s enough to whittle your weight down to the low end of your set range, says Jeffrey Friedman, a geneticist at New York’s Rockefeller University. Losing even 10 pounds vastly decreases your risk of diabetes, heart disease, and high blood pressure. The point is to not give up just because you don’t look like a swimsuit model.
D— The negotiation between your genes and the environment begins on day one. Your optimal weight, writ by genes, appears to get edited early on by conditions even before birth, inside the womb. If a woman has high blood-sugar levels while she’s pregnant, her children are more likely to be overweight or obese, according to a study of almost 10,000 mother-child pairs. Maternal diabetes may influence a child’s obesity risk through a process called metabolic imprinting,
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