The New York Times Magazine current issue discusses the weight loss struggles, contestants of NBC’s reality TV show “The Biggest Loser” have been facing after one year of intense dieting and exercise. Most participants of this show who lost most of their excess weight have gradually gained it back.
Researchers from the National Institute of Health followed these contestants in an attempt to analyze the effect of calorie reduction and daily exercise on weight loss. They have discovered fascinating new data about weight loss, metabolism and body weight regulation. We already know that resting metabolism decreases with weight loss. However, what researchers observed with the Biggest Loser contestants that as they regained lost weight, resting body metabolism did not increase. Instead, resting metabolism became slower as the pounds kept piling on. As if the brain is further maximizing the weight regain process and trying to get back to the initial starting weight as fast as possible.
6 years after weight loss, the body was still fighting for weight regain. The Biggest Loser contestants were on TV, had the most intensive program for weight loss by diet and exercise. Professional exercise physiologist and dietary experts closely monitored every participant in a supportive and encouraging environment. They lost the weight but struggled and failed to keep it off.
When it comes to maintaining weight loss using diet and exercise we are all losers. With gastric sleeve and gastric bypass, the metabolic set point is changed allowing for effective weight loss with no compensatory increase in hunger and appetite or decrease in resting metabolism. Operating on the stomach changes a number of neuro-hormonal signals that control appetite and metabolism. Many of these signals are still poorly understood. However, the concept for durable and effective weight loss has been established. Calorie restriction by itself is not a weight loss solution. Yet, the FDA has recently approved intra-gastric balloon technology. Hopeless attempts at justifying non-sense procedures for weight loss like gastric balloon are hard to swallow in light of our current understanding of obesity and weight loss. The gastric balloon market is struggling at least in Houston, TX. Physicians and patients are too knowledgeable and well informed to be fooled by ineffective weight loss approaches. Even, when used for cosmetic purposes it is hard to justify an $8,000 procedure to loose 15 pounds for 6 months.
From this humble platform, I would like to reach out to the health industry interested in developing a solution for obesity. Please concentrate your efforts on understanding how does bariatric surgery work and accordingly model your endoscopic devices. Don’t come up with devices, like the gastric balloon, that contradict established mainstream knowledge and mechanisms for durable weight loss. It is difficult and hard to crack the obesity enigma. However, it is worth every penny you invest because millions of lives are at stake.