Two out of every three Americans are overweight or obese, which is known to increase risk for many health problems, ranging from diabetes and high blood pressure, to sleep apnea, arthritis, urinary incontinence and some cancers, as well as many other conditions.
The good news is that even modest weight loss can result in a significant decrease in disease risk.
But most of us have tried to lose weight without long-term success. Itβs not due to lack of willpower or failure to commit to lifestyle changes. Itβs that as you gain weight, the bodyβs physiology changes, resulting in resistance to weight loss. Once you have excess weight, when you cut back on calories and increase activity, the resting metabolic rate slows, so you need to eat fewer and fewer calories to maintain your same weight.
At the same time, your hormones and brain neurotransmitters change in a way that results in an increased appetite. These changes can be resisted for a while through commitment to lifestyle change but, at some point, these physiologic processes tip the bodyβs system to regain weight.
Other factors contribute to weight gain as well. Some medications cause weight gain, and there is link between chronic stress and storage of fat. As people gain weight, it becomes harder to be physically active. Insufficient sleep can also impact weight. Ongoing research shows a relationship between changes in the gut microbiome or certain chemical exposures and weight.
A modest weight loss of 3 percent to 5 percent of your body weight has significant health benefits and is achievable with lifestyle changes. Maintaining this weight loss takes long-term commitment but is possible. If your BMI is 27 or higher and you have an obesity-related health condition or your BMI is over 30, medications can be added to lifestyle change to help you achieve approximately another 5 percent loss.
With help from your medical provider to minimize other medications that cause weight gain and optimize your sleep and stress management, you can achieve further weight loss. If your BMI is 35 and above with a related condition or 40 or above, bariatric surgery can help you lose in the range of 30 percent of your body weight and is often successful in curing diseases such as diabetes.
So what to do? If you are currently happy with your weight, you still need to pay attention to lifestyle β eat healthy, be physically active, get sufficient sleep and manage your stress. Be wary of medications that may cause even a small amount of weight gain. If you are already overweight or obese, follow the same recipe for change, but you will need to eat fewer calories overall and exercise more. Consider FDA-approved weight loss medications or surgery.
Excess weight is an epidemic, but we now have known methods for improving health through weight loss.
