Why can't you lose weight ... and keep it off?

America is fat

You’ve heard it a million times: America is fat. As a nation, we’re getting fatter every day, our kids are fat, it’s making us sick, and many of may die earlier because of it. The obesity problem in America affects our already strained health-care system, our national productivity, and our quality of life.

We spend more than $40 billion every year on diet products and services, trying not to be fat-that’s not a little concern, that’s more than the Gross Domestic Product of half the world’s nations. We really don’t want to be fat. So why are we? Why is this problem only getting worse? What are the consequences of this seemingly inexorable weight gain?

^{Graphic Credit: Courtesy of Jessica Dimmock/HBO}

Survival instinct

Over the course of human history, there has never been any reason to limit our food intake. In fact, it’s the opposite. Because we need food to survive, we are genetically programmed to love it. It was beneficial to our ancestors to eat as much food as they could find and to store excess calories as fat, so it shouldn’t be surprising that most of us have that behavior and biology encoded in our genes to some extent. Unfortunately, our elegantly designed systems are just as powerful today as they were in less prosperous times. In a world full of burger joints, pizza parlors, and vending machines, our biological imperative to store fat instead poses a threat to our survival.

^{Photo Credit: Courtesy of Jessica Dimmock/HBO}

Battling our own bodies

The common belief that when we lose weight our body fights to bring us back up where we started appears to be true. When we lose weight – however necessary it might be for our health and happiness – our internal fat thermostat sounds an alarm, mobilizing all its forces and entering full-on famine-protection mode to thwart our best-intentioned efforts. Even after ten years of successfully maintaining a significant weight loss, the body doesn’t readjust. Your brain still thinks you’re in a state of deprivation, and it manipulates your body in ways you don’t even notice: You’re hungrier, less easily satisfied, and more frequently tempted by sweet and fatty foods. You are less inclined to exercise, an effort by your body to conserve what fat stores it still detects. You even process food more efficiently, getting more miles per gallon out of what you eat.

^{Photo Credit: Courtesy of Visko Hatfield/HBO}

How to keep it off

The National Weight Control Registry, which is mentioned in the book The Weight of the Nation: To Win We Have to Lose, has been tracking more than 5,000 people who lost significant amounts of weight and kept it off for a long time. The average participant has lost 66 pounds and kept it off for 5½ years, but weight losses range from 30 to 300 pounds, and many participants have kept it off for decades. In surveying their behaviors, the researchers discovered that almost all the successful “losers” shared a few important behaviors:

• 62% watch fewer than ten hours of TV a week
• 78% weigh themselves at least once a week, many daily
• 78% eat breakfast every day
• 90% exercise about one hour a day on average
• 98% continue to eat a healthier diet
• 100% say their quality of life is higher

^{Photo Credit: Courtesy of Jessica Dimmock/HBO}

To win, we have to lose

For every pound you lose, someone else is probably gaining one. And, sadly, the statistics are telling us that that person could very well be a child. We need to work together as a nation to make some big changes to the systems that govern the food we grow; the economies that drive the food we manufacture, market, and serve; the policies that regulate what we market and serve, particularly to kids; the values we place on the overall quality of the schools to which we send our children; the design of our communities, parks, and roads so they promote health; and the perspective of our health-care system so that it’s focused on preventing illness from happening, rather than just treating it once it develops.

^{Photo Credit: Courtesy of Jessica Dimmock/HBO}

Unintended consequences

The challenges presented by the obesity epidemic are different from the ones posed by cancer, HIV, addiction or Alzheimer’s. We’ve seen those as wars we have to fight, and we’ve devoted billions of dollars to those battles. But obesity is not only a disease; it’s also a condition of our modern lifestyle. The obesity epidemic is the unintended consequence of human progress. We learned how to double and triple our agricultural yields, enabling us to feed not just our country, but also the world. We processed the crops we grow into an infinite array of delicious foods. We constructed suburbs and superhighways and shopping malls. We invented everything from vacuum cleaners and microwaves to television, computers, and iPads. The obesity epidemic developed concurrently with all those improvements in our lifestyle. And who would choose to go back to a time where we lived without these things?

^{Photo Credit: Courtesy of Jessica Dimmock/HBO}

So, what can we do?

Sixty years ago, people littered with impunity, seat belts weren’t an option (let alone the law), and even Santa Claus smoked. Collectively or working together, we managed to recognize those problems and reverse those trends, and raise a new generation that recycles, buckles up, and sees smoking as a serious health risk. But, as authors John Hoffman, Judith Salerno, and Alexandra Moss write in The Weight of the Nation: To Win We Have to Lose, until we embrace a different view of the purpose of modern life, and begin to value health as much as convenience, comfort, and cost, not much is going to change. It’s time for America to make the healthy choice the easy choice—instead of the hard, inconvenient, or more expensive one.

^{Photo Credit: Courtesy of HBO}