Three Reasons Weight Loss Fails

In case you haven’t noticed, most people who try to lose significant amounts of weight through sheer force of will inevitably gain it back. Weight loss fails not because of a failure of willpower. It fails because your brain works so well to regulate your weight and protect you from the existential threat of weight loss by making three things happen:

1. Food Becomes More Attractive. In a weight-reduced state, your brain makes you more acutely aware of all the food cues around you. Food that previously had no appeal suddenly looks more appealing. Both food images and aromas become more appealing. And the food tastes better because eating it triggers more intensely pleasurable reward signals in your brain.
    
2. Hunger Soars. When you’ve lost a significant amount of weight without any physiological intervention (like bariatric surgery), leptin and other hormones that regulate hunger serve to put your body into a heightened state of hunger as a way of ensuring that you recover the energy stores and body mass that you’ve lost. And that heightened state of hunger persists for as long as your reduced weight persists.
    
3. Metabolism Slows. Most of the energy your body burns is the energy it uses to keep you alive. It’s called your resting metabolic rate. With sufficient weight loss, your brain’s hypothalamus makes dramatic reductions in how much energy you burn at rest to help compensate for the energy stores that you’ve lost.

 
In her book published earlier this year, Secrets from the Eating Lab, Traci Mann explains these phenomena quite clearly and completely. She also presents a compelling case that the notion of willpower as a factor in weight control is mythical.

So what’s the point of acknowledging that weight loss is so likely to fail? For starters, we need to stop beating up on people with excess weight and obesity. And then, we need to recognize that managing the chronic disease of obesity requires a great deal more than than just behavioral strategies for weight loss. It requires that we apply principles of chronic disease management to prevent progression of the disease. It requires development of and access to more potent treatments for obesity.

Progress to reduce the health impact of obesity will come faster when myths are abandoned so that scientific insight can provide definitive guidance.

Click here to read more from the Washington Post, here to read more from NPR, and here for more about Secrets from the Eating Lab. Click here for more on hunger from the New York Times.

Chocolate Gelato, photograph © Sebastian Mary / flickr
Hungry Little Robins, photograph © Julie Falk / flickr
Fire, photograph © Luis Alejandro Bernal Romero / flickr

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August 31, 2015