Managing a Disease

 
     Most people seem to be perplexed by the fact that they lose weight and over time will gain it back and sometimes gain even more weight.  I will explain why this happens and what to do about it.  
 
     Everyone knows how to lose weight.  It's not magic or a secret.  We must burn more fuel than we take in.  Sounds simple, but it's extremely complex.  Even most Doctors tell their patients to "eat less and exercise more".   Then why does this not work for us all? 
 
     The complexity of weight loss comes from the fact that Overweight Syndrome and Obesity are in fact diseases.  Thousands of years ago they were survival mechanisms and our ancestors did not have an Overweight or Obesity issue.  In fact through most of recorded history, being overweight was relegated to about 15% of the population who either had rare medical issues that were not understood then, or lived lives of luxury and abundance such as royalty or the wealthiest of any population.
 
     In our modern times, the survival mechanism has become a disease leading to many other medical disorders.  The ability to gain body fat is rarely required of us as food is plentiful and relatively inexpensive.  Food is calorie dense which promotes obesity among the less financially stable individuals in our society.  Fast, cheap, calorie laden foods contribute to rapid weight gain among all segments of society.  Nowadays, the more educated, wealthier individuals are less likely to become overweight or obese.  This phenomenon is the opposite of our ancestors.
 
     Why we Yo-Yo with weight loss and regain is because we treat this as a willpower problem and not the disease that it is.  Society projects the attitude that anyone can be and stay thin if they just have some willpower.  That is shortsighted.
 
     Most everyone has enough willpower to cut back calories or exercise for a short period of time.  It's after a few days of restriction that the eating signals ramp up and the defense against starvation alarms go off in our body and brain and we go back to eating more than we need again.  Anyone who has ever completed schooling, held a job, stayed in a relationship, or had a child has plenty of will power.  With reducing calories, the willpower is easily overridden by biochemistry and psychological resistance.
 
     The disease of Overweight and Obesity is complex.  It's a Genetic, Biochemical, Hormonal, Metabolic, Psychological disease.  It snowballs on itself.  If we have the genes for easy fat accumulation, then the more we eat, the more we want and the cycle picks up momentum day after day.
 
     Thinking a simple diet for a month or two will solve the problem for life is the thinking that creates Yo-Yo weight loss and gain.  This disease is a lifetime disease and must be treated every day for life.  Reaching our desired weight is just the first phase of disease management. Keeping the disease in remission is where the lifetime treatment comes in.
 
     This concept is difficult for all of us to absorb and commit to.  It may be denial or it may be that the food addictions are just too much to control  Developing a treatment plan using all tools necessary is required.
 
     The tools of a balanced reduced calorie diet that is palatable, physical activity that is adequate and sustainable, adjustment of metabolic and hormone issues, and changing our mind and adjusting our psychology about this disease, food, and our lives are critical to keeping us in remission.  
 
     If we fail to acknowledge this and act on it we are destined to a lifetime of being more fat, then thinner, then more fat, then thinner, and on and on and on.  Frustration will set in and the "Give it Up" attitude prevails.  In this mode those of us with the fat genes can gain weight rapidly and massively.  
 
     If the disease is part of our makeup and we don't accept and learn to treat it for life, then secondary diseases like DM, HTN, Hypercholesterolemia, Heart disease, cancer, bowel disorders, arthritis, and organ deterioration will occur prematurely.
 
     When we lose weight we must become determined to never give it back.  By all means necessary we must continually keep our calorie count and carb count down.  This is a matter of life and death.  It is not your fault. It is however, the responsibility of each person to recognize their disease and do anything and everything to treat it and put it into remission.
 
There is truth in our motto:  Live Lean, Live Long, and Live Life to the Fullest.

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Questions 2  The Sequel

     We had so many questions, we decided to create a second blog of questions and answers.  It's exciting when our patients, blog readers, and podcast listeners send us questions.

  Questions

     Everyday we get questions from our patients and from those who want to lose weight who come to us for a consultation.

The Big Picture

We are now tired of being overweight and have made the decision to lose excess body fat and get to a leaner place. 

Never Alone

When we make the personal decision to start losing weight and get healthy, it's typically done in a quiet conversation inside our head.  We don't trumpet this decision to the world. 

The Little Things

 We want to lose weight now and lots of it.  We are disappointed if we only lose 8 pounds in a month.  We go for any program that promises big and fast weight loss.