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Obesity Fact #5: There is No Cure For Obesity



Obesity Fact #5 in the New England Journal of Medicine paper on obesity myths, presumptions and facts, essentially boils down to the simple fact that we currently have no cure for obesity (not really news to regular readers of these pages).

Thus, as anyone, who has ever lost weight and is keeping it off, is well aware that,

“Continuation of conditions that promote weight loss promotes maintenance of lower weight”

The corollary to this is that, discontinuation of whatever treatment resulted in weight loss (and yes, behaviour change is “treatment”), will result in weight regain.

It is this basic fact about obesity that leads to the basic principle that,

“Obesity is best conceptualized as a chronic condition, requiring ongoing management to maintain long-term weight loss.”

This statement obviously has profound implications not just for people living with excess weight – who will require long-term (if not life-long) strategies to deal with their weight – but also for health systems, which have to provide obesity treatments within the framework of chronic disease management programs.

Therein lies the challenge for every health system on the planet – irrespective of whether or not these health systems eventually find effective means to prevent obesity, there are currently millions of people living with obesity, who need treatment.

Unfortunately, the treatments we have are limited and even the few treatments that we do have are not readily accessible to most.

As I often say, even running for the cure won’t cure your obesity. Unfortunately, you’ll have to keep running to keep the weight off.

AMS
Edmonton, AB

13 Comments

  1. “essentially boils down to the simple fact that we currently have no “socially acceptable modern” cure for obesity”

    There are, however, the 19 century diet, the paleo and primal diets, with no wheat, sugar, processed foods and the like, that do provide relief.

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  2. Give us a little hope please.

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  3. *sigh*

    Dr Sharma says there’s no CURE, not that there’s no treatment.

    Living with chronic illness, be it arthritis, diabetes, obesity or what have you, does not mean hopelessness. The treatments are our current hope – and multi-factorial treatments addressing obesity do work to control the condition – the problem, as with other treatments for chronic illness, is finding the right treatment which blends efficacy and compliance.

    No one treatment for obesity works for everyone, just as no one treatment works for all arthritis sufferers…

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  4. I must admit I was a little shocked by your headline, as I’ve never seen this fact stated quite so bluntly – but yes, it’s the truth.

    For many years, I’ve thought of my reduced weight as a condition I have to manage, much as a diabetic has to manage their condition.

    I can understand why the general population is so reluctant to accept this fact, but perhaps if it were more widely understood, there would be fewer frustrated dieters out there, and – purely from a selfish standpoint – greater understanding of the lifestyle of the weight-reduced.

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  5. It is my opinion that unless it is proven to be a hormonal/biological/medical condition, which is causing one’s obesity, the “cure” is hidden somewhere in our psyche.

    If I were anorexic, I would have free mental health services, free nutritional programs, caring, compassionate and empathetic members of the medical profession patting my hand and stuffing all things wonderful down my throat in order to save me from myself.

    The unfortunate truth, again only my opinion, is that medical doctors (for the most part) see the obese as lazy, poor, uneducated, filthy, gluttons who don’t give a tiny rat’s hiney about their own health.

    From our cradles, society has taught us to believe the same thing about the obese.

    If one is fortunate enough to have medical benefits through employment, then you may be eligible for a couple of therapy sessions with a psychologist, in order to start to understand why you’re obese.

    “Good” food is extremely expensive. Fresh fruits, vegetables, lean cuts of meat, and/or organic food items are ridiculously priced. Preparing meals from scratch takes time and effort. Am I giving the obese an out for remaining obese? No.

    I’m trying to state that when the issue with food was caused from a traumatic experience in one’s life, no matter how trivial it may seem to others, and never addressed and accepted to the point of healing, then there is not a lot the average person feels they are able to control with their eating behaviour.

    Tmommy … there is hope. Never give up.

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  6. Sooze – I think you have missed Dr. S’s point, which is that once someone has lost a significant amount of weight, hormonal and metabolic changes in their body mean that they will never be “normal”.

    There is a piece on this site which reports on research by Dr Rudy Leibel which shows that a weight-reduced person burns off 15-20 per cent fewer calories than someone of the same weight and height who has never been overweight. That 15-20 per cent difference means that the formerly obese have to work a lot harder to maintain their weight than a never-overweight person. Obesity also creates changes to the hormone levels which govern appetite and satiety.

    So in that sense, obesity is a “chronic condition”.

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  7. Sooze

    Good food is not extremely expensive. It is actually considerably more cost effective than buying processed pre-prepared food. The trouble with “good food” if there is any, is that it is time-consuming to prepare. In a society that requires two working parents to support families, having time to cook good meals and make fresh lunches is the problem.

    I also agree that you missed the point of the comment that there is no cure for obesity. The fact is that our bodies work very hard to keep us in homeostasis. If we start out obese, it is very hard to be anything but. I was plump from the time of my birth and come from a long line of very long-lived but overweight women. I, and I am sure they, resent your suggestion that somehow our deep dark inner selves are riddled with mental illness, thus resulting in 100 years of being collectively overweight.

    Clearly you are not an obese person, or you would understand.

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  8. Hi Dr. Sharma 🙂

    I hope all is well.

    I wanted to comment on this whole “thermodynamic ” issue and the constant mention of the conservation of energy law by the commercial weight industry.

    Well, it turns out I spoke directly to many scientists on this topic and the answers I got varied.

    First, the human body is an open system. Because of this fact , the equation for applying the conservation of energy law would be much, much, much more complex than it would be for closed systems.

    This equation would have to account for ENORMOUS AMOUNTS OF FACTORS: such as efficiency factors, heat transfered to and from the body, energy exchanges between system and environment , nutrients, fuel burning etc. and much more. Add to this that we are the most complex out of the open systems.

    Did you know that not a SINGLE scientist ( I emailed 20 in all from major universities- some well known)was able to give me the ACTUAL EQUATION for applying the conervation of energy law to the human body ?( which is an open system)

    They could not even give me a rough idea for what it is! They only said it was extremely complex. I asked for a rough idea if they did not know the more complex version.They still did not know and admitted to me as much !

    Further, I was told by several scientists who are not PURE physicists (like Lawrence Krauss), but SPECIALIZE in applying physics to biology. THEY told me that :

    “The conservation of energy law does NOT apply to an OPEN SYSTEM where UNKNOWN AMOUNTS of energy may be gained or lost from it.”

    This “thermodynamic ” argument has serious flaws and needs to be re- thought. The caloric hypothesis is an error in cognition and it is clung to by people with beliefs about obesityy that are black and white. It frightens them to admit that this is not at all well understood.

    The regulation of mammalian fact cells is hellishly complex. Most people are not even aware that this conservation of energy law has a VERY SMALL reach and does not at all explain obesity in the least. They extend this reach with their assumptions and extrapolations.

    All these commercial weight loss sites out there with their own versions of this equation are certainly wrong. They are laughably simple and incorrect. This equation for applying the conservation of energy law to the human body ( which is an open system) is massive , extremely complex because we are a living complicated system and an open system. This is the consensus of all 20 scientists and something they all had in common.

    We are the most complex open system there is. I can say much more about this topic but I will save it for my blog.

    Take care, Dr. Sharma.

    Best Wishes,

    Raz

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  9. Melinda,

    Thanks for taking the time to tell me what you think of me and to misinterpret what I’d attempted to say.

    I’ve been fighting obesity for over 30 years. My daughter is morbidly obese. I didn’t once mention that a mental illness caused the obesity. I indicated that a trauma (with one of us it was a rape) can lead to an unhealthy attraction for comfort foods, and until it’s addressed… aw, screw it. You’re not going to listen anyhow.

    Again, thank you for understanding and speaking as though you actually know me.

    I shall remove myself from further comments here.

    Well done.

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  10. I’ve really enjoyed this discussion.
    I’ve been testing the different facets of my ability to lose weight recently (have lost 30 lbs but want to lose 50 more), and have realized my cravings are what is keeping me from succeeding. I seriously and wholeheartedly crave foods that are fatty sweets (donuts etc) and fatty simple carbs (chips etc) and provide instant gratification and sustained gratification, and I could consume them without control until the pain and discomfort is too much (stomach issues, headache, etc). I also forget that they do cause body pain and lower self esteem and eat them again in the same way another time.

    It reminds so much of when I over consume alcohol: instant and prolonged gratification and pain on overconsumption. I wonder if I didn’t have the body pain (e.g. bloat, gas, discomfort, etc) if I would keep eating/drinking and not stop. I wonder how this compares to alcoholism – and is this what I’m experiencing? Could it be referred to as Carbism? or Sugarism? Do I need to go to Over-eaters Anonymous to cure this problem??

    Regardless, I wish I knew so I could treat it properly. What form of obesity do I have?? Its such a complex and daunting subject. Thank goodness some folks are studying it!! I am hopeful I will discover what type of obesity I have and what the treatment is. I realize there may not be a ‘cure’.

    Keep up the good work researchers 🙂

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  11. Perhaps there is no “cure” for obesity because obesity is not a disease or illness; instead it is a body size category that may or may not be: 1) accompanied by pathological processes such as alterations in metabolic, endocrine and neurological functions, or 2) associated with actual diseases (e.g. cardiovascular). I recommend the following HAES blog post, which offers an alternative viewpoint on “obesity.”

    http://healthateverysizeblog.org/2013/02/26/the-haes-files-opportunity-costs/

    When dominant discourses (e.g. medical, corporate, popular media) construct a body size category as a pathological condition, then uncritical participants in these discourses help to support the creation of a stigmatized class of people. Stigmatized individuals are routinely ostracized, blamed, scapegoated, bullied, degraded, dehumanized, devalued, oppressed, discriminated against, rejected, resented, and accused of causing their own suffering–including health problems resulting from and/or made worse by these (unjust, oppressive, and harmful) social conditions, which are inflicted (often in the guise of “caring” aka “for their own good”) on innocent people who are unable to conform to physical standards (e.g. body sizes) that dominant discourses construct as “normal” or “healthy.”

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  12. @Sooze: Please reconsider withdrawing your participation from this blog (if I’m correctly understanding your remark about removing yourself from further comments.) As a survivor of severe and chronic trauma, I know how painful it can feel when my honest attempts to communicate (to share my feelings and my perspectives) fail to create a mutual understanding that I was longing to encounter.

    When I was a victim of trauma, it seemed I had no voice—no voice that could be heard by the perpetrators and no voice that could be heard by people who may have been in a position to rescue me. Thus my chances to reach for freedom (to escape the trauma) and to find real help were smashed, along with most of my capacity to hope.

    I’m so sorry that you and your precious daughter have experienced trauma. I’m sorry that you must both struggle to heal from the profoundly painful and damaging legacies of trauma.

    And I’m glad to hear that you are reaching out, together, to help each other and to continue in your process of liberation from terrible suffering. Please know that you are not alone with your courageous decisions to heal your wounded bodies and minds.

    Please accept my best wishes and my heart felt hopes for your continued healing.

    Sincerely,
    hopefulandfree

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