Scientific Approach To Weight Loss

By Kavian S. Milani, MD

Virginia Family Medicine

. http://www.virginiafamilymed.com/

More Weight Control, Nutrition & Exercise Articles

Scientific Approach To Weight Loss

The good news is that everyone who wants to lose weight can do so with some help. The critical element is calorie restriction. The diet is the most difficult part of weight management. Weight management is essentially a calories consumed vs. calories expended balance. A strict diet helps tilt the balance towards weight loss.

Given the medical tools available, it is actually easier than one may think. Any medically managed program should provide an additional 4-5 pounds of weight loss per month. The hard part is not the first 10 pounds but how to sustain it over the next 12 months, and how to avoid a “yo-yo” diet.

After the first successful period of weight loss the body reacts in a number of ways and metabolism actually slows down. The body produces a hormone called ghrelin, which increases appetite to negate any weight loss to restore the original (non-desired) weight. After a 20 pound loss ghrelin increases by about 30% creating a ravenous appetite that will quickly force one to gain the weight back, negating any success. This can last up to a year. Patients and physicians struggle with this issue and patients lose momentum and become discouraged when any success is reversed despite their best effort.

Most importantly, researchers have found that even one year after a weight loss program, levels of circulating ghrelin remained higher than before the weight loss program was instituted. This finding is key to helping ensure a successful weight loss regimen.

We currently have no drugs that can directly target the ghrelin signaling system, but we do have access to medications, such as Saxenda and/or phentermine, that have different mechanisms of suppressing appetite and opposing the ghrelin tide that swells during weight loss. When willpower alone may fail in weight management, countering the effects of ghrelin will prevent our fundamental physiology from undermining our progress.

In the next installment of the series we will explore the role of stress, happiness and the psychology of weight loss.