Why Diet & Exercise Don’t Work in a Patient who is Already Obese

Published on February 20 , 2022 | 4 Minutes to Read

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Exercising and a balanced diet are a great way to stay healthy and active. But does it cause sustained and durable weight loss in the obese patient?

According to a report published in the journal on Diabetes & Endocrinology, obesity is termed as a serious chronic disease with biological causes and not just the result of unhealthy eating and sedentary lifestyle.

The authors of the report encompassed a panel of obesity treatment experts. They opined that weight loss programs could show positive results in the first few months, but 80-90% of them will experience the weight being put back demonstrating the classical Yo -Yo weight loss pathophysiology of obesity. The reason being, that in obese patients the metabolic set point in the brain has gone faulty. The set point needs to be reset and conservative measures like dieting and exercise do not address this.

A Few Case Studies –

1. Mauli Bigelow is a lifestyle blogger. She has always been plus size, weighing about 380 pounds. As a member of plus size and body-positive communities and with nearly 60,000 followers on Instagram, she was ruling the roost, until her health took a dive. She was diagnosed with blood cancer and multiple uterine fibroids. All of these could not be treated conventionally, due to her weight. That was when Bigelow decided to go for bariatric surgery. She was apprehensive about how the communities that she was a part of and her other followers would accept her and respect her choice.

In her own words, “Being fat and being comfortable in your skin are two different things. While being overweight poses severe health risks, it is important for people around you to embrace your weight-loss journey and not shame you for deciding to feel better.”

2. Hudson institute’s Food Policy Centre in Washington, USA, conducted a survey on food choices by normal-weight, overweight & obese people. The food attitudes widely varied across the groups. About 44% of the healthy weight group said nutrition & health was their top concern. About two-thirds of the overweight & obese respondents admitted to knowing that they should pick healthier stuff, but their minds didn’t allow them to make that choice. Also, the obese group mostly ignored the nutrition labels and opted for fried snacks, soda, and sugary items. A shocking fact was that a quarter of the most obese group never exercised!

Lona Sandon, the program director at the institute, says, “Reversing obesity is a rather tricky thing. Obese people have tried various diets & exercises. But when it does not show the expected results, they pursue behaviours that instigate them against healthy practices.”

3. Maxwell Kinyua’s sister was growing big ‘unintentionally’ – as her food intake was right, and she exercised quite often. The lady was diagnosed with hypothyroidism. A condition where the thyroid gland is unable to provide enough energy to the digestive system and hence slows down the digestive process. Although her food intake is not to be blamed, the African nutrition report says people are not eating enough vegetables, fruits and whole grains.

4. Nadja Hermann has always been overweight. His parents were morbidly obese, and his maternal side of the family was overweight. In his teenage years, he tried dieting coupled with a whole lot of exercises. Although he would lose weight, the weight would be put right back on, due to genetics.

5. For John Muthama, years of exercise and moderate dieting had not brought any change to his alarming weight. At 66 years, with a BMI of 59.5, he was Super Obese. The weight was not taken seriously for the last ten years until he developed hypertension and started becoming breathless. When all his efforts to lose weight turned futile, his best bet was bariatric surgery.

Lifestyle modifications may result in lasting weight loss for some overweight individuals. But, for chronic obesity, the body weight seems to be biologically imprinted and doesn’t agree with traditional weight loss methods.

A growing number of studies have shown weight loss surgery has been the most effective and long-lasting treatment for morbid obesity. Bariatric surgery has shown to reverse diabetes and other conditions associated with it.