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Healthy Balance

Obesity Myths: Why It’s So Hard to Lose Weight

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If you’ve ever tried to lose weight, you know how hard it can be. Maybe a particular diet and exercise regimen worked for awhile, but you later re-gained the weight. Maybe friends and family have made hurtful comments or pushed fad diets.

There’s a lot of misinformation surrounding weight loss and obesity, a condition defined as having a body mass index (a comparison of your height to your weight) of 30 or higher. To clear up these obesity myths, we turned to Catherine Varney, DO. She’s a family medicine doctor who is also board-certified in obesity medicine.  

“Obesity is the underlying cause of all these chronic diseases that we’re seeing in primary care — diabetes, high blood pressure and high cholesterol,” she says. “There’s nothing obesity doesn’t touch — even depression, anxiety, sleep apnea, PCOS (polycystic ovarian syndrome), fertility and osteoarthritis.”

She adds, “If we can get obesity under control, we can get all these other things under control.”

Willpower and Low-Fat Diets: What Really Helps You Lose Weight?

We asked Varney to help us debunk some myths when it comes to obesity and weight loss. 

Myth 1: Weight loss just requires willpower

Varney: Obesity is a disease, not a lack of willpower. The closer someone gets to their weight-loss goal, the harder it becomes. This is why a lot of people give up. Your body doesn’t like change.

Your brain has evolved to want to eat whenever it passes by something high calorie or dense with nutrition, because we don’t know when it’s going to come again. It’s the caveman mentality, but we’re surrounded by high-calorie foods, not times of famine.

Myth 2: Exercise is the best way to lose weight.

Varney: Exercise only helps 3% to 5% with losing weight. But it’s important for maintaining weight once you shed the pounds.

Exercise can even be dangerous, so it’s not always initially part of a treatment plan. For some, exercise isn’t appropriate until they lose a certain amount of weight.

Myth 3: A low-fat diet will make you lose weight.   

Varney: The best diet depends on the individual. What works for one person might not work for another. This is due to a complicated system of genetics, metabolism, environment and other conditions someone may have.

Studies show that a low-carb for the first six months is the best diet for weight loss. But for weight maintenance, there’s not much difference between low-fat and low-carb.

Myth 4: Medications won’t help you lose weight.  

Varney: Medications are effective. Several drugs are FDA-approved for weight loss.

Phentermine suppresses the appetite while patients are making lifestyle changes. It brings a little increase in metabolic rate, and importantly, quiets the brain. If you’re inside the head of someone with obesity, you wouldn’t believe how much they are constantly being yelled at to “eat, eat, eat!”

Another drug, diethylpropion, is closely related to amphetamines. But it’s not ‘speed,’ and it's not addictive. 

And Saxenda, which was introduced as a diabetic drug, also quiets the link between the stomach and brain.  

Myth 5: You need to lose significant weight if you want to improve your health.

Varney: Genetically, it might be very hard for someone to reach an ideal weight but the real goal is just improvement of health.

Studies show that just a 10% reduction of body weight is huge in decreasing your risk of heart attack or stroke. You get the best benefit from weight loss at the first 10%, so losing 18 pounds if you’re 180 is a big step.

Unable to Lose Weight?

Bariatric surgery at UVA may be an option for you.

Myth 6: Bariatric surgery is a simple solution to obesity.

Varney: Bariatric surgery is effective, but some need medication or other prescribed measures to take and keep the weight off. When someone loses an extreme amount of weight in a short time, they will develop a slow metabolism that persists for years.

For example, researchers found that six years after being on “The Biggest Loser” reality show, one man burned 800 fewer calories a day than a typical man of his size. His metabolism was nowhere near normal.

Myth 7: Conventional wisdom on weight hasn’t really changed.

Varney: Obesity science is changing rapidly. The diet and medication regimens that I was prescribing 5 years ago are completely different from what I’m prescribing now.

For a long time, it was low-fat, low-fat, low-fat. Now we have 73 good peer-reviewed studies that show a low-carb diet is best for weight loss.

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