Unhealthy weight (both overweight and obesity) is a disease that causes many other diseases such as high blood pressure, diabetes, bad cholesterol, cancers, stroke, and heart attacks.

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Patients with unhealthy weight have damaged their neurohormonal system of the brain, causing a higher weight set point.  The hypothalamus is the part of the brain that controls energy and appetite.  Those who suffer from unhealthy weight have damaged the hypothalamus.

 

How weight gain occurs and reoccurs

 

When anyone (whether this person has healthy or unhealthy weight) reduces the daily caloric balance either through diet or exercise (or both), the pro-appetite hormone (ghrelin) increases and the appetite-suppressing hormones (such as leptin) decrease.  The increase in ghrelin and decrease in the appetite-suppressing hormones lead to increase pro-hungry signal to the brain to eat more calories.  This pro-hungry (better known comically as the HANGRY) state is a normal response to caloric balance reductions. (Think of the Snickers commercial with Marilyn Monroe and William Dafoe).

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In the short term, people can voluntarily ignore this pro-hungry signal and lose weight.  Some lucky people will be able to maintain their weight loss beyond 1 year.  For most, they will eventually give into the pro-hungry/HANGRY hormone signals and regain their weight (yo-yo effect).  Those with unhealthy weight are fighting a normal hormonal response to a reduction in the calorie balance. 

 

Overweight and Obesity are diseases of the neurohormonal system.  Unhealthy weight is NOT a disease of will power.  Just to repeat, unhealthy weight is NOT a disease of will power.  Many patients and health-care professionals still carry this very weight-bias that those patients with unhealthy weight can simply use will-power to lose weight or lack the will-power to stop eating.  Ironically and sadly, many health-care professionals also suffer from unhealthy weight and blame themselves . . .often using only 50 percent of the solution ("I just need to eat less and exercise more").  If losing weight and maintaining the weight loss were so easy, then 70-80 percent of America would not suffer from a BMI in the overweight and obese range.  Our team understands these neurohormonal changes and the frustrations of our patients with unhealthy weight.

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From this knowledge about changes in the hypothalamus and hunger hormones, obesity medicine as specialty was born.  The field of obesity medicine is the fastest growing specialty   

 

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