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Exercise and Healthy Food May Not Be the Full Cure for Obesity

It’s a prescription for weight loss so common it’s almost a cliche: eat healthier and exercise more to lose weight. When I had 10 pounds to lose after giving birth to my son, I walked each day and watched my diet until I was back at my pre-baby weight. Eating healthier and exercising more, worked for me.

But a new study from the Icahn School of Medicine at Mount Sinai in New York says it isn’t that simple, especially for the obese. The study’s lead author, Dr. Christopher Ochner, says obesity should be seen as a “chronic and often treatment-resistant disease with both biological and behavioral causes,” and should be treated with biological interventions (such as gastric bypass surgery) as well as lifestyle changes.

The study says that obesity changes the body so profoundly that it remains conditioned to be obese, and diets often set off a biological “fat-loss defense” that makes it nearly impossible to keep from regaining lost weight. It also notes that 85 to 90 percent of obese individuals who lose weight, gain it back within a relatively short term.

By framing obesity as a biological problem and not simply the result of bad dietary and exercise habits, Dr. Ochner’s proposals are actually quite revolutionary. Previous studies have shown that many people associate traits such as laziness, lack of intelligence and greed with obesity, blaming the obese entirely for their weight problems - and not taking reasons such as “my metabolism is slow” or “I’m naturally heavy” for an answer. 

Ochner’s study suggests that some people are naturally inclined to be heavy, and diet and exercise to lose weight will only put their obesity into temporary “remission,” not cure it. Ochner’s model says that once a person has become obese, the changes to their body and brain will prevent them from ever successfully losing weight using diet and exercise alone. 

The study points to one form of gastric bypass surgery, known as Roux-en-Y, that has been shown to be effective in reversing appetite-related hormones caused by obesity, which affects how the brain responds to food. The study states that this type of surgery is the only obesity treatment that works in the long-term. 

So should obese people give up on diet and exercise? For now, Ochner and his team are outliers, and most doctors still recommend diet and exercise before the drastic step of gastric bypass surgery. Still, his study raises important questions about how people become obese and how they can lose the weight for good. 

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