Running Down the Up Escalator (Part 1)

One of the games I used to play as a kid was to run down the UP escalator.

To get to the bottom, I had to run faster than the escalator was moving up. If I ran any slower, the escalator would gradually but steadily take me back to the top.

In fact, even to just stay half-way down, I’d have to keep running at about the speed the escalator was moving up. If I stopped running even for a second, I’d be moving up again.

As you may guess, I am using this analogy, to illustrate the challenge of losing weight and keeping it off.

The escalator represents all the complex neuroendocrine responses to weight loss that will always want to take you back to the top – the only way to reach the bottom or to even maintain your place half-way down is to keep running.

Alas, in real life, the weight-loss escalator is even trickier. For one, there is no real bottom – i.e. no matter how fast you run, you will never reach the bottom and be able to simply get off. No matter how far down the escalator you manage to get, you are still running on an escalator that will keep moving you back up to the top the minute you stop running.

But things get even more depressing, because, the further down the escalator you get, the faster it runs. This means that the further down the escalator you manage to get – the harder you have to keep running to just stay where you are.

Or, in other words, when you start from the top, the escalator is running relatively slowly and you may easily manage to get down the first 5 steps. But as you go down, the escalator picks up speed and so, if you just keep up running with the speed you started at, you may not even manage to hold your place 5 steps down.

And, to get to 10 steps down, you’ll definitely have to speed up – unfortunately, with every additional step you manage to make your way down, the escalator moves up even faster.

By the time you manage to get down 20 steps, the escalator is moving upward so fast that it is all you can do to just try and not be carried back up.

Depressing?

If we could only find a way to slow down the elevator. Or even better, if you could only get to the bottom and get off!

Alas – that is not how our bodies work.

Yes, for some people the escalator moves slower that for others – this is why some find it easier to run down and it takes them less effort to maintain their position half-way down. Others have to fight harder to get there and for others, the escalator simply gets too fast eventually carrying them all the way back up – no matter how hard they try.

Bariatric surgery and obesity medication can help slow down the escalator or rather, prevent it from speeding up quite as fast as you try to run down. This is why you can maintain a lower spot on the escalator with the same effort as before – but go off your meds or reverse the surgery and the escalator speeds up again only to carry you back all the way to the top.

Why is the escalator analogy important to understand?

More on that in tomorrow’s post.

@DrSharma
Edmonton, AB