Dr Alfred Dawes | The great fat scam

The great fat scam

What would you do if you had a medical condition, sought treatment for it and was put on treatment with a 95 per cent failure rate? Would you be OK with it? Would you feel cheated if your trusted health-care provider knew that the treatment was more likely to fail but did not disclose it and, at the same time, raked in huge profits?

If this practice was occurring at the very least with a small number of victims, I am sure you would be outraged that it should be allowed to continue. Would that outrage grow if you knew that 2.8 million persons die each year from a preventable and poorly treated disease that affects 500 million people?

The truth is that obesity is that disease. And the poor treatment is putting persons with severe obesity (a BMI of 40 and over) on diets.

We have all grown up with the conventional wisdom that if you eat too much you will get fat. I often get into arguments with persons, sometimes poorly informed doctors, who believed that obese persons are greedy and lazy and their lack of weight loss is simply because they won't stop eating and start to exercise. This fuzzy logic is reinforced by weight-loss testimonials of persons who lost tons on the latest fad diet or supplements.

You can hardly turn on your TV, flip through a magazine, or go online and not see a new diet fad or supplement that promises how much you will lose in an unbelievable time. Sexy before and after pictures and catchy names drive a multibillion-dollar industry of diets and weight-loss products guaranteed to make you shed the most weight in the shortest time possible.

Victims of these scams who have been struggling with their weight, sometimes for decades, run from one diet to another, each time getting more and more depressed as the pounds they lost keep coming back, and then some.

In the meantime, weight-loss companies hawking dietary supplements earn billions of dollars in profit annually. In fact, multinational corporations that make the unhealthiest of foods own many of these companies that specialise in diets and supplements. They make money selling you junk to make you obese and continue to milk you as you try to lose that weight, knowing you will likely never come off their products one way or another.

Not only are the obese the targets of these corporations' marketing supplements, they are preyed upon by food companies selling low-fat, low-carb, low-calorie, sugar-free, gluten-free, cholesterol-free, light, lean, diet, zero-processed foods that are more expensive and oftentimes just as bad as the foods they are supposed to replace. For example, the fat-free salad dressings often are so loaded with sugars to compensate for the loss of flavour that they can be even unhealthier than regular dressings. Many of these foods carry the calories per serving size, but persons may not check to see how many servings are in the container.

THE BITTER TRUTH

Persons who have tried these fad diets and weight-loss supplements will tell you that they initially lost weight rapidly, but then it slowed and then stopped. They came off the programme and the weight just came right back. Many end up on these yo-yo diets without achieving any meaningful weight loss over time.

The reason for this is that what we have been taught all our lives is wrong.

Persons who are obese are not greedy or lazy. They are suffering from hormonal imbalances. Hormones such as leptin and ghrelin that slow down your metabolism and make you hungry and crave food the more weight you lose. The more weight you lose, the more your body slows down your metabolism.

If at 350lb, you needed 2,000 calories per day to survive, imagine at 200lb your body slows down your metabolic rate to 1,200 calories per day. At that rate, it is unsustainable to eat that small amount of food consistently. Especially when your hormones have cranked up your hunger and cravings. It is absolute torture, no matter how motivated and determined you are to lose weight and keep it off.

This is what contestants on the hit TV show The Biggest Loser discovered. A recently published study showed that six years after massive weight loss during a season of the show, almost all the contestants had significant weight regain, some to their pre-show weight. One former contestant said it was 10 times harder to keep the weight off than to lose it in the first place.

The researchers found that the large drop in metabolic rate was maintained even as the former contestants regained the weight. Their bodies were determined to get them back to the new obese set point.

The single contestant who did not regain ate much less and exercised much more than others her own weight just to stay at that weight.

While this study was shocking and depressing to many, it was a fact known to bariatric surgeons that once you lose weight, your body slows down your metabolism to match the restricted food intake after bariatric surgery. That is why persons who undergo these procedures lose weight up to a point but never become underweight or malnourished with the restricted calories allowed by their new, smaller stomachs.

To many who are overweight and getting depressed, there is hope.

These findings are more pronounced in morbidly obese individuals whose hormones have already gone haywire. The majority of overweight persons can arrest the slide and lose weight effectively and sustainably by lifestyle changes. Not by fad diets, supplements or low-something processed foods. But by making eating natural foods, portion control, better timing of meals and exercising your lifestyle and not a means to an endpoint.

Some are born with a genetic predisposition to be overweight and it takes more effort than others who just hit a bad patch. The key is not to end up morbidly obese because then it starts to get sticky.

For those who have already crossed that BMI 40 threshold and are morbidly obese, the sad reality is that wasting money on weight-loss programmes will not help you 95 per cent of the time. Your best bet is a surgical procedure to reduce the size of your stomach and reset the hormonal imbalance that now affects you.

Unfortunately, this is still viewed as extreme by some, despite the mounting evidence that shows that obesity is a chronic disease and poorly treated with our conventional recommendations of diets and supplements.

With the worsening obesity epidemic, it is time we stop the insanity of doing the same thing over and over expecting a different result. We need to think outside of the box and look to solutions that work, no matter how much a part of us is telling us by right it shouldn't be so.

• Dr Alfred Dawes is a general laparoscopic and weight-loss surgeon at Island Laparoscopy and Medical Care. Email info@islandlaparoscopy.com; yourhealth@gleanerjm.com.