Weight Regain: It’s All My Fault Versus It’s Not My Fault
December 16, 2024It’s All My Fault Versus It’s Not My Fault: Losing weight on your own with weight loss medication or bariatric surgery can lead to a feeling of elation when you see the weight loss occur. Within one year, around 90% of people who lost weight with diet and exercise tend to regain the majority of their weight1. Those who use medication can keep the weight off as long as they are on the medication, but the moment the medicine is stopped, 80% of the people regain weight2. In regards to bariatric surgery, weight regain occurs at around 1.5 years after the surgery3.
Two Forms of Worsening Health
When weight is regained, there are two forms of worsening health. The obvious ones include comorbidities like diabetes, high blood pressure, and other diseases associated with obesity. The hidden suffering leads to severe psychological pain and, at times, full-blown clinical depression. This is the time that patients start to exhibit the “It’s my fault” or “It’s not my fault." The majority tend to punish themselves, believing that they caused the weight regain. The truth is more complex, and the individual should be aware that it is NOT all their fault.
When a person loses weight, the brain, intestines, and endocrine organs start to communicate different signals indicating that something is wrong and weight loss must be stopped and reversed. The metabolic rate is reduced markedly after any form of weight loss. The body begins to send out a greater number of “I am hungry” hormones, contributing to many people having a sense of constant hunger. As a weight loss physician for over 20 years, the most consistent comment from patients regaining weight was “I am always hungry." They say that after weight loss surgery or after starting weight loss medication, their hunger went away and they weren’t thinking of food. At the time of recurrent signals of severe hunger and if the weight loss medicine is stopped, people begin to gain back the weight.
Changing Your Lifestyle
Research shows that people who changed their lifestyle and remained consistent with healthy eating and exercise experienced a much lower rate of weight regain. The majority of people regaining weight are dedicated individuals who try to follow their doctor’s recommendations, but their biology leans towards weight regain. There is a group of patients that never changed their lifestyles—poor choice of foods and no exercise. It is difficult to ignore the person’s responsibility in this journey. The “It’s not my fault” individuals unfortunately don’t recognize their role in contributing to poor weight loss or weight regain. It is crucial for these individuals to work with a behavior modification specialist so that they can affirm that they have the strength to get healthier and lose weight, but they need to change their approach to life.
In conclusion, attempts to lose weight carries a frustrating price of weight regain after successful weight loss. It is important for doctors to listen carefully to their patients. Those that had good weight loss and noticed a lack of fullness after medication or bariatric surgery should be referred to a weight loss specialist as soon as possible, before significant weight gain occurs. Individuals who haven’t changed their lifestyle do not need to have revision surgery or more medication; they need to work with a dedicated behavior modification specialist. Hopefully the notion of blaming an individual for their worsening health must be avoided.
Any attempts to get healthier by losing weight should be applauded.
Good luck!
Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician currently practicing at Dr. Leon Katz Medical Weight Loss Center.
Literature:
- What About My Weight? Insufficient Weight Loss or Weight Regain
After Bariatric Metabolic Surgery. Hamidreza Zefreh et al.
https://doi.org/10.5812/ijem-136329 - Semaglutide 2.4 mg for the Treatment of Obesity:Key Elements of the STEP Trials 1 to 5.
Robert F. Kushner et al. Obesity | VOLUME 28 | NUMBER 6 | JUNE 2020
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318657/pdf/OBY-28-1050.pdf - Long-term weight loss maintenance for obesity: a multidisciplinary approach. Luca
Montesi1 et al. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2016:9 37–46
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777230/pdf/dmso-9-037.pdf
 | ABOUT THE AUTHOR Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. He focuses on patients seeking alternatives to surgery and those needing care after bariatric procedures. Dr. Katz was recently the director of a major medical weight loss program. With extensive experience in establishing successful weight management programs, he now concentrates exclusively on non-surgical weight loss solutions. Dr. Katz is a Diplomate of the American Board of Obesity Medicine and Fellow of American College of Surgeons. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center. |
