Losing Weight: Beyond Diet and Exercise!

By Michael D. Williams, MD, FACS & Brendon Curtis, MD

Screen Shot 2019-10-11 at 4.59.44 PMHave you been monitoring what you eat and how much you eat, along with exercising regularly but don’t seem to be losing any weight? Or, have you gotten really motivated and committed to becoming healthy, made some lifestyle changes, which resulted in weight loss but then struggled to maintain your new low weight? That’s because weight loss and maintenance are much more complex than simply dieting and exercising. There are multiple hormonal, physiological and environmental factors that determine weight loss.

Researchers have discovered the “set point” concept. There is information to suggest that
the body tries to maintain a particular weight depending on the genetic, biological, and environmental factors it’s exposed to. Somewhat like the way a thermostat sustains the temperature of your home, the body seems to maintain a particular weight range. Each time you go on a diet or significantly reduce daily caloric intake, the body goes into reserve or “starvation mode” in order to conserve energy and maintain weight. What makes it even worse is whilst reducing caloric intake, many people simultaneously start aggressive exercise programs, which naturally increases one’s daily energy requirements. Dieting and exercise collectively create a negative energy balance.

This creates the desired effect of driving the body to burn reserve energy, resulting in weight loss. However, in keeping with the set point theory, physiological mechanisms are then activated to conserve energy and return the body system back to its previous set point weight. Consequently, patients may experience increased hunger, slowing down of the basal metabolic rate, fatigue and lack of energy. These biological, counteractive mechanisms can easily discourage patients and drive one back to old habits and subsequent weight regain.

Adopting a diet low in processed foods, carbohydrates in particular, and high in fiber, vegetables, fruits, whole nuts, and lean meats, may help to establish a lower set point and assist in weight loss and maintenance. Recommendations from the American Heart Association of getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week also help to keep a lower set point. Other lifestyle changes, such as stress management, getting six to eight hours of restful sleep per night, and avoiding late-night meals and snacks, may also be beneficial in reducing weight set point.

Finally, weight loss surgery activates numerous hormonal and physiological pathways that help to reduce and maintain weight loss. Numerous research studies have shown that bariatric surgery, such as the sleeve gastrectomy and Roux-en-Y gastric bypass, currently are the best-known mechanisms in producing and maintaining a lower set point, resulting in a more rapid and sustained weight loss.

At Laparoscopic and Endoscopic Surgery Institute, we are committed to the treatment of being overweight and continue to keep up with current research, including manipulation of hormones, bacterial gut flora, new endoscopic devices, and medicines that enhance energy expenditure and set point management. We do this to continue offering patients excellent care using both surgical and nonsurgical options.

Please give us a call to discuss this topic further and to see if you are a candidate for
weight loss surgery.

Laparoscopic & Endoscopic Surgery Institute • www.bariatricsmd.com • (770) 500-3660

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