When You’re Fat, You’re Always Fat – There Is No Escape
Isn’t it curious that when you finally lose weight, you always manage to gain it back? Your body weight may not be due to your lack of exercise but rather your hormones, according to a study. The hormones leptin and ghrelin have been recognized to play major roles in how much you eat.
Leptin is a hormone made by fat cells that helps regulate how much you eat by inhibiting hunger. Leptin is opposed by the actions of ghrelin, a hormone that makes you hungry. An imbalance between the two, may be the reason you eat more than you should.
A study, published in the New England Journal of Medicine, enrolled 50 overweight or obese individuals in a 10-week weight-loss program. They found that weight loss led to significant reduction in leptin levels and an increase in ghrelin levels. This in turn resulted in the study participants gaining back the weight they previously lost.
“Eating less results in a lower metabolism, leptin levels, and an increase in ghrelin levels, which makes you hungrier. This makes you eat more and you end up gaining back your weight,” according to the study.
The reason these biological mechanisms occur may be due to our hunter-gatherer ancestors, when there was an advantage to be lean when food was often scarce. Now however, food is quite plentiful without much work. You can drive three minutes down the road for a hamburger. The same calories you get from a hamburger would have taken your ancestors days of walking and running.
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How do we plan to solve weight gain due to a leptin and ghrelin imbalance? The authors write, “Bariatric surgery has well-documented favorable effects on appetite-mediating hormones, hunger, body weight…”Bariatric surgery is the modification of a patient’s stomach to be smaller, so they feel fuller faster.
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There are three types of bariatric surgery: laparoscopic adjustable gastric band (lap band), gastric sleeve surgery (sleeve gastrectomy), and gastric bypass.
A lap band is a ring with an inner inflatable band wrapped around the top of the stomach. This creates a small pouch which can be adjusted by filling or removing solution from the inner band. This procedure can be reversed and provides the lowest chance of a vitamin shortage.
In contrast, when a patient receives a sleeve gastrectomy, the patient is essentially having a part of their stomach removed. This procedure provides greater weight loss than gastric band but with some more downsides. This procedure cannot be reversed and there is a greater chance of a vitamin shortage. Also, taking out part of your stomach may affect gut hormones or other factors such as gut bacteria that may affect appetite and metabolism
Lastly, there is the gastric bypass. A gastric bypass is when a pouch is created from the top part of the stomach and is connected to the middle part of the small intestine. This also provides greater weight loss than gastric band. The procedure is difficult to reverse and provides the greatest chance of a vitamin shortage of the three surgeries. The bypass changes gut hormones, gut bacteria, and other factors that may affect appetite and metabolism.
A study following people for 3 years after surgery found that those who had gastric band surgery lost an average of about 45 pounds. People who had gastric bypass lost an average of 90 pounds. Most people regained some weight over time, but weight regain was usually small compared to their initial weight loss.
In the past, obesity has been known as a disease of affluence. Now, because of modern agricultural techniques, food is plentiful in the U.S. More than one-third (36.5%) of U.S adults have obesity and two-thirds (70%) of U.S adults are either overweight or obese, according to the Center for Disease Control.
Diets and exercise fail most people with severe obesity. Obesity can cause a multitude of health problems such as high-blood pressure, diabetes, and increased mortality. Bariatric surgery may be a solution to this modern epidemic.
Bio: Zi is taking a writing class for the Professional Writing Minor at UCSB. He’s just tryna pass.
Sources:
https://www.cdc.gov/obesity/data/adult.html
https://en.wikipedia.org/wiki/Leptin
https://en.wikipedia.org/wiki/Ghrelin
https://www.nejm.org/doi/full/10.1056/NEJMoa1105816
https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery