In a recent study entitled “Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations,” researchers claimed that obesity is a chronic complex disease with a series of biological causes that cannot be solved merely with diet and exercise. This was published in the journal The Lancet Diabetes & Endocrinoloy by Dr. Christopher N. Ochner from Icahn School of Medicine at Mount Sinai and New York Obesity Nutrition Research Center at Columbia University Medical Center in New York, along with colleagues. The researchers highlighted that alterations in obese individuals’ lifestyle choices are not enough to overcome the adaptation mechanisms that occur in obese people when they try to lose weight.
Obese individuals during dieting innately respond to various biological processes that induce them to eat more high-calorie food, leading to weight gain. Around 80% to 95% of obese individuals that lose weight in the end will recover it. There are biological adaptations that occur during the development of obesity, which decrease the effectiveness of efforts for healthy weight loss and may remain even in formerly obese individuals.
“Although lifestyle modifications may result in lasing weight loss in individuals who are overweight, in those with sustained obesity, bodyweight seems to become biologically ‘stamped in’ and defended,” said Dr. Christopher N. Ochner in a news release.
Dr. Ochner said that some people can never be “cured” from obesity, but instead live in state of “obesity in remission.” Dr. Ochner added that these individuals remain biologically different from the non-obese people with same age, sex and bodyweight.
The authors stress the importance of addressing the biological factors that affect weight loss and maintenance for long-periods of time; however the strategies currently used are restricted to anti-obesity medications, surgery for weight loss and blockage of intra-abdominal vagal nerve. Unfortunately, the researchers claim that these strategies do not completely counteract the biological processes that occur during adaptation to obesity. Still, these strategies change neural or hormonal signaling associated with appetite that may lead to a 4% to 10% decrease in weight.
“Obesity should be recognized as a chronic and often treatment-resistant disease with both biological and behavioral causes that may require biologically-based interventions, such as pharmacotherapy or surgery, in addition to lifestyle modification,” said Dr. Ochner.
Dr. Ochner concluded that we should not ignore the biological adaptations that challenge the efforts of losing healthy weight in obese individuals, and that to insist only on behavioral modification will only frustrate the patient either because of failure to lose or keep off weight. This type of attitude will sustain the inability to treat obesity efficiently and may lead to deaths of millions of individuals each year.
