We have heard the talk on obesity. The fix to obesity is diet and exercise. Today that assertion is being challenged by a group of respected researchers saying obesity becomes defended by our bodies.

In the commentary, published in the journal Lancet Diabetes and Endocrinology, the prescription of eating less and moving more is dooming the 79 million adults and 13 million kids suffering from obesity to failure.

“Once obesity is established, however, body weight seems to become biologically ‘stamped in’ and defended,” wrote Mt. Sinai Hospital weight management physician Christopher N. Ochner.

The team wants to correct what they feel is a misrepresentation of what can be done to combat obesity. Those that have become obese and stayed at those weight levels for years cannot be expected to return to healthy weights through diet and exercise alone.

For the team, it has to do with our biology. We adapt as a species. Once we become obese, any attempt to remove yourself from the disease gets attacked. The body starts to burn fewer calories, and pumps out hormones to increase hunger.

“Few individuals ever truly recover from obesity,” the authors wrote. Those that do, they add, “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.”

Chronically obese individuals are effectively at war with their bodies that want to return to their highest sustained wight.

The depressing reality according to Ochner? Less than 1% of the chronically obese population can return to and maintain a healthy body weight without surgery.

“It’s not just that most people still stigmatize obesity–as they say, it’s the last acceptable form of stigma,” said Ochner. “What really bothers me working around and with clinicians, is that some of them–a disturbing percentage–still believe it’s all about personal choice: that if the patient just tries hard enough, and if we can just figure out how to get them a little more motivated, then we’d be successful. And that’s just not right.”

Before you think Ochner is giving a free pass for poor lifestyle choices, that’s not what he is saying. It is a necessary step, but physicians should become more aggressive.

And it begins in the preventive stage. Don’t let patients become obese. When they start to hit the overweight levels, he wants the lifestyle choices to be pushed harder, along with medications, FDA-approved treatments and even surgery.

The eat less and move more? It’s not the cure according to Ochner. And the epidemic we face will last for decades before it turns around.

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