by Kaye Bailey
LivingAfterWLS, LLC. (C) 2017 - ALL RIGHTS RESERVED
You and I, members of the weight loss surgery patient community, understand the endless battle against our own body when we take action to lose excess weight. We may not understand the metabolic science but we know from experience that efforts to lose weight and keep it off are resisted by the body with the same hard-headed determination a rebellious teenager resists curfew.
We have excess body weight because a survival mechanism that stores excess body weight to prevent starvation is an over-achiever. The disease obesity is complicated by our evolution from hunter-gatherers for whom any weight loss was a threat to survival. To combat that threat the body evolved a physiological process to make it so weight could be easily and quickly regained.
"The body actually senses the weight loss as a threat to survival and begins to release hormones that lead to feelings of hunger to ensure a strong motivation to obtain as many calories as possible," says Los Angeles area bariatric surgeon Dr. Michael Feiz M.D., F.A.C.S . He explains that these biological processes may very largely account for what is known as the "yo-yo" effect in which individuals manage to lose weight, only to quickly regain it.
I was among the many obesity sufferers who before weight loss surgery had managed to lose and regain significant weight several different times. What a head-trip this cycle is! The euphoria of weight loss followed by the shame and disappointment of weight regain. You too? I understand.
A 25 Million Year Process
Looking at the greater picture, the fight to los e weight is not singular against our own body: the fight is against 25 million years of human evolutionary history. "Humans are not self-made creations dietarily, but rather have an evolutionary history as anthropoid primates stretching back more than 25 million years," reports Katharine Milton in the American Journal of Clinical Nutrition. She continues, "This is a history that shaped their nutrient requirements and digestive physiology." We carry that history and the accompanying nutritional needs and metabolic physiology in our DNA.
In the personal struggle to manage obesity a nod to our ancestral evolution is in order. "It seems prudent for modern-day humans to remember their long evolutionary heritage as anthropoid primates and heed current recommendations," reports Milton. Such is easier said than done: the difficulty in treating obesity was formally recognized in 1958 when the Cornell Conference on Therapy reported, "Most obese patients will not remain in treatment, most will not lose significant poundage, most would regain it promptly."
Not much has changed in the 60 years since the Cornell Conference. Dr. Feiz explains that, while it is common knowledge that exercise and strict adherence to a balanced, low-calorie diet are surefire methods for weight loss, the difficulty of making sticking to low calorie diets over the long-term means that people with large amounts of excess weight to lose typically struggle both to lose it and, even more so, to keep it off. Dr. Feiz notes that one way in which bariatric surgery is effective is that it can address these physiological and hormonal factors that make dieting so difficult.
The Weight Loss Surgery Option
"For people with severe obesity and large amounts of excess weight to lose, weight loss surgery is the best medical intervention known to improve both the quality and length of their lives." Speaking specficially of the gastric sleeve procedure Dr. Feiz said, "This is a scientifically proven weight loss surgery technique that works in two ways. Firstly, the procedure removes a significant portion of the stomach, which makes its overall capacity much smaller. For the patient, this results in feeling satiated faster from smaller meals and servings. Secondly, the procedure curbs the release of ghrelin, a hunger inducing hormone."
Surgery does not release patients from personal responsibility, but it does provide an eye-opening realization that obesity is a disease
--a medical condition treated with major gastrointestinal surgery-- and sufferers must employ all means to fight responsibly
against this ailment just as they would any other life-threatening condition. Dr. Feiz says, "Of course, the full benefits of the procedure are not attained unless the patient fulfills his or her commitment to eating significantly less overall. As part of treatment and recovery from obesity a program that includes a dietitian and counseling will guide the patients' changing relationship with food.
This is 25 million years of biological evolution we are battling. Be kind to yourself and build a support army including your bariatric center, your social and family support groups, and your ongoing intelligence gathering. Remember, all of life is evolutionary and we each are a work in progress.
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