Losing Weight Has Nothing to Do With Willpower
And willpower won't fix it
Overweight and obesity are diseases. As much as we don’t want to hear or say that, it’s what the science and research shows.
It’s not a matter of personality or lifestyle that drives obesity, not exclusively or predominantly, it’s rather a complex biochemical disfunction.
And yet, when the pounds creep up year after year, it becomes tempting to blame a lack of motivation or self-control.
Modern science, however, continues to reveal biological forces underlying obesity that overwhelm even rigorous diet and exercise regimens.
By understanding the molecular mechanisms driving weight gain, we can enact more effective and compassionate solutions.
Appetite and weight
Weight maintenance relies on a complex system balancing energy intake, usage and storage.
It starts with the brain.
The hypothalamus region of the brain serves as the central control center integrating peripheral signals about nutritional status to regulate appetite and metabolism accordingly.
Numerous hormones and neurotransmitters participate in this regulatory web.
Key appetite-influencing hormones include leptin, ghrelin, glucagon-like peptide-1 (GLP-1), peptide YY, cholecystokinin (CCK) and insulin among others.
The gastrointestinal system secretes many of these compounds in response to food consumption, which then circulate to the hypothalamus to signal satiation following a meal.
For example, cells in the stomach lining release ghrelin when empty, triggering hunger signals. Shortly after eating, lipid cells and the small intestine ramp up production of leptin and peptide YY, which suppress appetite by acting on nervous system pathways emanating from the hypothalamus.
Likewise, nutrients entering the small intestine cause it to secrete GLP-1 and CCK, which suppress hunger signals to the brain. The pancreas releases insulin to enable sugar uptake from the bloodstream into cells for immediate energy usage or storage as glycogen or fat for later.
Normally this finely tuned system limits calorie intake to match energy expenditure. However, modern environmental factors like highly processed foods, lack of exercise, chronic stress and endocrine disruptors can throw these biological processes out of equilibrium.
High-calorie processed foods, particularly those rich in sugar and refined carbohydrates, compel overconsumption by hyperactivating the body’s appetite reward system mediated by signaling molecules like dopamine and endorphins.
They drive excessive calorie intake beyond homeostasis needs.
Constant insulin spikes from such foods can accelerate development of insulin resistance. Consequently, the brain fails to register all the calories being consumed and stored. In this way, obesity often associates with metabolic dysfunction akin to diabetes.
Excess visceral fat also promotes imbalance by secreting inflammation-inducing chemicals.
It alters hormonal signals to keep weight elevated. For example, rising leptin secretion from expanding fat cells should tell the brain that ample reserves exist. However, sustained high levels can trigger leptin resistance, masking this feedback loop. Hence perpetual hunger continues driving calorie excess despite substantial overweight.
Chronic stress boosts cortisol, which triggers visceral fat accumulation and insulin resistance – all contributing to disrupted hunger signaling. Environmental endocrine disruptors like phthalates and BPA may also distort appetite-regulation pathways.
Through these various means, conscious control over eating can get overwhelmed by biological imbalance. Knowledge of the science empowers compassion for those afflicted by obesity rather than presuming some personal failing. It also informs therapies better aligned with physiology.
Bariatric surgeries like gastric bypass directly alter digestive anatomy to facilitate weight loss through reduced stomach capacity and calorie absorption.
And these surgeries work well. Very well.
However, such invasive interventions bring significant side effects and complications.
Recognizing the central neurological underpinnings of appetite regulation, researchers now investigate medications targeting this pathway.
One promising approach focuses on enhancing glucagon-like peptide-1 (GLP-1) activity. The gut hormone GLP-1 blunts appetite by stimulating leptin release while inhibiting ghrelin production.
A 2022 study in Obesity Reviews analyzed results across multiple clinical trials using the GLP-1 agonist semaglutide. It’s sold under brand names Ozempic and Wegovy for treating diabetes and obesity, respectively.
Across several studies, participants receiving semaglutide achieved average weight loss around 17% compared to placebo groups only losing about 3% over 68 weeks.
Subjects also showed improvements in related markers like waist circumference, BMI, blood pressure, blood lipids and blood sugar.
While more research is needed, GLP-1 agonist medications demonstrate similar effectiveness to surgeries without undergoing such intensive procedures.
They offer promise providing long-term aid for sustained weight loss akin to diabetic treatments.
But with a caveat. In my cases, after droppping the medication, the weigh loss is halted or reversed. Not what we want.
As a side note: (Some) plants are shown to increase GLP-1 which aids in weight loss.
Other pipeline pharmaceuticals target additional neurotransmitters and enzymes influencing appetite such as dopamine, serotonin and cannabinoids.
The bottom line
When we show compassion rather than judgment for those struggling with excess weight, space opens up for addressing root biological causes.
A complex interconnected web of hormones regulates appetite and fat storage which can become imbalanced by modern environmental and lifestyle factors.
This drives humans to overeat far beyond what conscious willpower can overcome.
It’s not willpower, and willpower alone won’t fix it.
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