Most people consider bariatric surgery when they’re just so sick of the relentless diet struggle. They come to the realisation that they may have lost and gained the same 50, 100, or even 150 pounds many, many times over in the span of their lifetime. And yet they remain overweight, unhealthy, and stuck, both emotionally and physically.
The Science of Weight Loss
There are, indeed, people that that can go on a diet, lose a percentage of their body weight, and sustain their healthy lifestyle change into their future. But science (and lived experience!) has shown that that's usually about 5% of the overweight population. And maths will tell us that that's not very good odds! Five people out of every hundred that have this struggle do well, yet 95 people lose a few pounds, only to invariably end up right back at square one in less than no time.
Weight Set Point - Why 95% of People Struggle
In recent decades, scientists have suggested that there exists a phenomenon called the “weight set point”, or “metabolic set point”. This theory argues that the body preserves and protects its highest-ever weight, and will allow for a 10% reduction in weight before staging a massive resistance to further loss. This is confirmed, experientially, in that, on a diet, most of us are able to lose about 10% of our body weight with relative ease.
We begin with gusto and all goes well initially, until all hell breaks loose and there’s a quick and powerful relapse into regain, invariably at that 10% cusp. The drivers of this relapse are intense compulsivity and cravings, often beyond those we face when not in calorie deficit.
- We assume we’ve run out of steam, and lost willpower.
- We berate ourselves, deciding we’re ‘losers, of weak character.
The Regain Cycle
The relapse takes hold, as does the fast and furious regain. What is uncanny is how weight regain seems to stabilise at almost exactly the starting weight. More often than not, the dieter is astounded to find that their body is preserved at almost exactly the same weight as they began their sordid ordeal.
Scientists have thus arrived at the idea of a weight setpoint; that our body preserves a resting weight, and despite temporary and fleeting losses, we gravitate back towards this higher weight no matter what effort we've applied to reduce it.
It’s at this point that many people turn to bariatric surgeons for hope. It appears that there are certain medical interventions that actually override this physiological tendency of the body to preserve its highest weight; bariatric surgery being one such intervention (and this is why most bariatric patients are able to lose 40%, 50%, 60% and even some up to 100% of their excess weight, without that physiological backlash.
Bariatric LOSS Can Be (SOMEWHAT) Miraculous. Bariatric Maintenance Takes Serious Work!
Despite overriding the metabolic set point, bariatric surgery is not a miracle cure. There's a lot of hard work that is required, especially in the maintenance phase. In the short term, you may well override that setpoint, and my counsel to clients is often that the value of bariatrics is in the opportunity to get the weight OFF. But the onus still remains on the individual to do the work of disciplined lifestyle change, behaviour modification, emotion regulation, mental health management and effective life skills acquisition and implementation, in order to maintain that bariatric loss into the future.
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