The cause of obesity is long-term energy surplus. The body is like a magical car with an almost infinitely expandable balloon-like gas tank. If you fill-up with ten gallons every week but you only use nine, pretty soon you are hauling around a lot of extra fuel.
The simplicity of this idea is misleading. While body weight is indeed ultimately controlled by energy balance (calories IN and calories OUT), energy balance itself is controlled in very complex ways that have almost nothing to do with free will or choice. One can DECIDE to reduce caloric intake and increase caloric output, but, as any dieter knows, that's far easier said than done. The typical result of such a decision is hunger (which people can feel) and reduced metabolism (which people cannot feel).
To borrow the automobile analogy again, it's about like this: After expanding the gas-tank until it's huge and full of fuel, you decide that every week instead of putting ten gallons in the tank and only burning nine, you'll put eight gallons in and burn ten. Sounds like a plan. But if your car were like an overweight human, it wouldn't work so well. You'd find that suddenly the car would start "feeding" on its own, pulling into gas stations in the middle of the night and secretly gulping down fuel. Worse yet, the car would grow more fuel efficient, morphing from say, a Chevy Tahoe into a Toyota Prius. It's a silly analogy, but you get the point.
Back to the real world of overweight humans, the result of simple and direct caloric deficit is far slower and more painful weight loss than seems fair. Most people quickly give up.
So the history of most overweight people, indeed of most of the patients I see for the first time in my office, is one of long-term gradual weight-gain punctuated by occasional failed attempts at weight loss. Needless to say, such a history is discouraging and leads many people to feel quite frustrated and perhaps hopeless about their body weight.
To make matters worse, there is a common misconception that body weight is the result of a simple choice, much like a hairstyle.
But long-term and life-changing weight loss isn't impossible. In fact, people accomplish it all the time and they do it without living a life of misery and self-deprivation. It isn't easy to do, but neither is it "hard"; it is a "sea-change", a new outlook on oneself, one's responsibility to oneself and to loved ones, and above all, long-term weight loss results from believing that a new life is possible. It's not blind-faith either. It's faith based upon reality, upon the knowledge that if he or she can do, then by God, so can YOU.
And you really can.
That's what THIS is all about.
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