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Fighting Obesity: The Role of Behavior, Biology and Bad Choices
Part 1 in a four-part series on obesity and weight loss

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How Weight Loss Works

Weight gain comes from eating more energy than you expend. It’s as simple as that. In theory, eating 3,500 more calories than your body burns up will lead to a gain of one pound of fat.

But in reality, a calorie may not be the same for every body. Genetic and biological factors may influence the amount of weight lost from dieting as well as weight gained from overeating. In one study, twins were overfed 1,000 calories per day for almost three months. Researchers expected that the weight gain across all the participants would be roughly the same. And it was very similar between each pair of twins, as was the amount of abdominal fat they gained and where the fat was distributed. But across pairs the results were strikingly different: From the same amount of overeating, the weight gain ranged from 10 pounds to 30 pounds.

Some studies have showed that dieting doesn’t result in much weight loss for some people. And for some severely obese people, a lifetime of endless diets may trigger fat-preservation mechanisms to kick in harder, making these people gain more and more as they continue to fight to lose it. If you’ve followed a yo-yo pattern, then going on a drastic diet may not be the smartest approach for you long term.

Going for the Quick Fix

So, if diets don’t always work, wouldn’t a pharmaceutical option be foolproof? Many people are tempted by the lure of popping a pill and watching the weight melt off. Unfortunately, it isn’t that easy. Of the many diet drugs that have been developed in the past 50 years, only two are currently approved by the Food and Drug Administration for long-term use. That’s because many weight-loss drugs that have been used over the years have been found to be ineffective or have serious side effects. Even those that are currently on the market may not be as good as they sound. For example, sibutramine (Meridia) does suppress your appetite, but it can raise your blood pressure. And orlistat (Xenical) blocks the absorption of some of the fat that you eat, but you can also get a side effect called “dumping” where you have, um, uncontrolled bowel movements.

What most people don’t realize is that even the best diet drugs are not really that good. A drug is considered to be effective if you lose 5 percent of your body weight in six months. So if you weigh 250 pounds and lose 15 in six months, or about two pounds per month, the drug “works.” Weight loss may be quicker in the first few months from a drug, but like other approaches, the weight loss plateaus and long term, after two or even three years on a drug, the results are not much better than if someone had stuck to healthy eating and become more active. The clincher, to help the drugs work you’re expected to eat better and exercise. So, why pop a pill and risk unpleasant side effects? From my perspective, the result is no better and potentially worse.

Herbal supplements are even riskier. They are completely unregulated and taking them is like volunteering to play guinea pig. Infomercials sound believable. But notice that all supplements advocate improving your eating and exercise habits along with taking the pill. So if you see results, is it from the magic ingredient or the fact that you improved your lifestyle?

The Weight-Loss Secret

The bottom line to slimming down is to improve the way you live. You may have to fight hard and relearn old habits to protect yourself in this fat-promoting world we live in. But you can do it. And I will help you. In the next installment of this four-part series, I will explain how to psych yourself up to win the battle of the bulge.

Continue to Part 2> Fighting Obesity: Psyching Yourself to Act