With every New Year comes New Year’s resolutions. For many people that means a resolution to lose weight. When people talk about weight loss, the first thing that comes to mind is diet and exercise. While diet and exercise are very integral to weight loss, and may be a good option for people that need to lose a few pounds, sometimes that is not enough when people have over 100 pounds to lose.
A study published in the scientific journal Obesity in 2016 helped shed some light on why extreme diet and exercise don’t necessarily work for long-term success. The study conducted by Dr. Kevin Hall with the National Institute of Health followed the contestants from season eight of the reality TV show "The Biggest Loser." The show gives obese or overweight contestants three months of intense exercise and nutritional education at a ranch before sending them back home to continue with the weight-loss strategies on their own. While a majority of the contestants on the show did lose a significant amount of weight, the study showed that 13 of the 14 people studied regained weight and four contestants weigh more now than they did at the start of the competition.
This study also showed that at the beginning of the show, these contestants had normal metabolisms for their size. By the end of the show, all their metabolisms had significantly slowed down due to the weight loss from diet and extreme exercise routines. As a result, they were not burning enough calories each day to maintain their smaller size.
Unfortunately, over the next few years, the contestant’s metabolisms did not recover and return to the normal rate for a person their size. Their metabolisms became even slower, which caused them to regain most, if not all of their weight and, in some cases, even more weight. This research explains why so many people have difficulty keeping off weight they lose with diet and exercise. The weight that can take up to a year to lose with diet and exercise can be gained back in just a few months because of how the body reacts with a reduced metabolism.
For people who do have a significant amount of weight to lose, bariatric surgery may be a better option. The slowed metabolic effect is not seen after bariatric surgery, which permanently changes the contours of the digestive tract. While popular impressions endorse that most people treated with bariatric surgery gain back the weight they lose, the latest long-term research shows that a mere 3.4 percent returned to within 5 percent of their initial weight 10 years later.
There also are many metabolic benefits of bariatric surgery that are independent of weight loss. These benefits include normalizing blood pressure, blood sugar and lipid levels and resolving sleep apnea. These benefits are seen even in the small percentage of patients who ultimately lose little weight after surgery.Bariatric surgery may not be the best option for all people who need to lose weight. However, for those who have tried to lose weight with diet and exercise and have not had long-term success, it may be the best option to achieving all the health benefits that are associated with weight loss.
Nicholas Brown is a general and bariatric surgeon with Wichita Surgical Specialists. He is medical director of the Bariatric Surgery Center at Wesley Woodlawn Hospital & ER.