Obesity is a chronic disease that continues to grow in U.S. as well as the rest of the world. Throughout human history, calories were relatively scarce and hard to get, and physical activity was unavoidable. That is why we have no defense against overeating. In general, the obesity epidemic can be contributed to the modern environment:
- Increased Nutrient Content of Food
- Lack of Exercise due to Modern Conveniences
- Inadequate Sleep
- Weight-Gaining Drugs
The traditional view of maintaining a “healthy lifestyle” overlooks how the body regulates energy. The body controls weight by energy balance mechanism and defends itself against changes. A more recent explanation of the mechanism by which weight loss surgery works is the Set-Point Theory. The brain plays a major role in our weight management, like our blood pressure. A signal sent from the intestine to your brain adjusts appetite and metabolism. Body Fat Set-point is affected by:
- Genetic Predisposition
- Environmental Exposure
- Developmental History
The set-point theory asserts that the body adapts to increased fat level and elevated weight and sets it as a new set-point or a new normal. The body recognizes this newly elevated set-point as an ideal and resists even modest diet restriction to prevent starvation by increasing hunger & cravings and reducing satiety & metabolism.
Fighting obesity with diet and exercise alone is not an effective long-term solution. A dieter’s body may encourage fat to regain after initial weight loss by complex mechanisms. An obese body sees calorie reduction diet (Calories In < Calories Out) as a starvation threat and tries to defend itself. As the weight goes up, the longer you are overweight and the more issues you have to push the set-point upward, the more ingrained and stubborn the set-point becomes.
Bariatric surgery procedures, such as gastric sleeve and gastric bypass, changes body’s set-point and shift your neurohormonal axis to a lower weight. Once the patient gets weight loss surgery, the patient’s brain sees a lower set-point. As a result, the body is in overfed mode and loses appetite and metabolism kicks in. This will last as long as 6 months to a year until body comes to an equilibrium. During this period, many patients lose appetite and have to set a reminder to eat. The patient has a lot of energy since they are trying to burn the extra fat. If patients report low energy after the surgery could be related to low-calorie intake.
The body of patients after bariatric surgery will also look for quality calories and is hungry for healthier choices, like fruit and vegetable. It is crucial to get the right nutrition and multivitamin (individualized) after surgery especially in this adjustment period for long-term success.
Non-surgical dietary weight loss options are NOT long-term. Bariatrics is shown to be the most effective long-term treatment for obesity as it resets your set-point and it gives you a second chance.
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