Category: Life Style

According to the Obesity Medicine Association, obesity is defined as ” a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, bio-mechanical, and psycho-social health consequences.”

Wow, that’s a mouthful. Let’s unpack that definition one or two words at a time.

First let’s look at “chronic, relapsing.” Our bodies actually fight to defend a higher set point even at the expense of unhealthy weight. We are superb energy conservationists, designed to maintain homeostasis. Our brains can become blind to the satiety hormone leptin that is released from fat cells(mostly because of what we are eating) and then weight loss itself increases the hunger hormone ghrelin that is released from the stomach. Blind to satiety, driven to hunger. That’s a recipe for weight recycling.

Understanding the chronicity of obesity really sheds light on why so many of my patients are able to say without exaggeration, “I have been battling weight my entire life.” Furthermore, anyone who has gone on a diet only to regain the same 10, 20, or even 100 lb testifies to the relapsing nature of the disease. No wonder it’s so hard to lose weight; it’s the very nature of the disease!

With medical treatment for obesity, however, the dysfunctional cycle of weight loss and regain can be broken. After performing a complete history, physical, lab and body composition analysis, an obesity medicine specialist helps you to strategize unique, sustainable lifestyle change which correct the communication between the gut, the brain, and the fat cells. The focus is on small changes in nutrition, activity, sleep, and stress management. Sometimes medications are needed to target metabolic function, hunger and satiety hormones, or cravings. Bariatric surgery can also be a helpful tool.

Understanding the chronic, relapsing nature of obesity helps understand why weight loss and weight loss maintenance may need to be treated differently. At Oregon Weight and Wellness, we have what I call the R3 program to protect against weight regain. We establish a Realistic Goal Weight, a Refocus Weight, and a Reach Out Weight.

Many diets promise enormous amounts of weight loss in just three months. After working with people and truly understanding the chronicity of the disease, my conviction is that we need to work together over time and seasons, ups and downs, through celebrations and hardships, not rushing the process.

This Weigh Different approach builds resilience and helps you maintain your healthy goals. Its a marathon, not a sprint and we are in it with you for the long haul.

I love fall. The crisp morning air, the contrast of the colorful leaves against clear blue skies, the colder nights. This year my husband and l vacationed in New Hampshire’s Green Mountains just to see the fall foliage of the East Coast. The locals call people like us “peepers.” It was breathtaking for sure but you know what?  Autumnal Oregon is just as breathtaking.  There is a maple tree outside my bedroom window I could stare at for hours. I should say there was a tree. It’s gone now.

I protested vehemently three years ago when my husband announced he needed to chop down my majestic maple which had given me hours of daydreaming pleasure every October when its huge leaves turned a brilliant yellow. Something about its proximity to the house, the roof, the septic, he explained as he revved the chain saw. The kids were ecstatic of course when they didn’t have to rake its leaves anymore.

We still have leaves, mind you.  I made my husband plant fourteen more maples on the perimeter of our property to take the place of the one he sacrificed. With kids grown and gone, leaf duty falls to me. I actually look forward to it, re-framing the work as a productive form of exercise, fresh air, vitamin D, being outside with my dog, all that good dopamine producing positive thinking. And I capitalize on efficiency by blowing the leaves onto the grass first, then cutting the grass and vacuuming the leaves at the same time with my mulching lawn mower, grass catcher in tow. Think of all that compost. It’s energizing.

But today I ran out of gas. Literally. I was halfway finished with the job when the engine kicked off. I tracked down our gas cans. The two I found were empty. Simple enough, I reasoned. Just put the cans and the dog in the car and drive the three miles to the local gas station, have a chat with the owner Cindy while she fills them, and get right back to work. No big deal. But I felt drained. I could not move. Why?  Why did I have the energy to do the work of blowing and mowing but zero energy for the simple task of filling up gas cans? The all too familiar tape played automatically in my brain:  “You are lazy.”

I have heard that more than once from patients when I inquire about the barriers they face for positive behavior change.  “I guess I’m just lazy,” they often reply. I did what I encourage my patients to do in this paralyzing moment and investigated that negative thought. Is it true? What is the history? What is the proof? The truth is I’m not lazy just as I know my patients are not lazy. We do tend to take the path of least resistance, however.  It’s human nature. We come by it honestly and energy conservation serves us well most of the time. It is thermodynamics.

I still did not want to wrestle my dog into the car. So I told myself the next truth: I have enough energy to take the next small step.  I called my husband. “Don’t we have a gas can around here that actually has gas in it?” He told me where a third, full gas can was hiding.  I found it, filled the tank, and finished the job.  

Telling myself the truth and not condemning myself for my humanity changed the potential energy I knew I had into the kinetic energy I needed to take the next small step. Telling myself the truth sparked action.  Telling myself the truth makes all the difference.

This weigh different thing is personal for me.

Allow me to explain:  As I shared, I have four children, healthy children, who all had that pre-adolescent weight gain prior to their growth spurt (ok, except for you, Zach).  But my youngest son, Zeke, kept gaining weight. Worried and wondering, I elbowed my husband and whispered in his ear, “Kenny, we have to do something.”

“He’ll be fine,” Kenny replied, playfully dismissing my maternal worries in complete denial, I might add, of the firestorm of metabolic hormones raging in Zeke’s young body.

So I did what most mothers would do. I watched him. I watched him and I micromanaged his eating.

“Zeke, are you really that hungry?  Why don’t you wait a few minutes and see if you still need seconds.”