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Why Is It So Difficult to Lose Those 10 Pounds?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 16 in the September 11-12, 2004 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

For thousands of years the basic premise of human survival depended on the ability to conserve body mass. Obesity was rare, and did not aid survival. Obese people tend to suffer more heart disease, diabetes and other conditions. To understand obesity, you need to understand the functioning of fat cells. A new understanding into how these cells function is emerging. It seems that we truly are what we eat. Fat cells are the newest organ. Collectively, these cells communicate, interact and perform a unique function. It is now accepted that fat cells can multiply if extra fat storage is required. When this ability is activated in childhood by overeating, future adverse health can result.

The foods we eat are broken down into components and the fat is stored in fat cells. It is constantly being metabolized and released into the blood stream as fatty acids. Fat cells also secrete numerous messengers. Leptin is produced to signal the brain that the cell is full. The brain then turns off food cravings. Chronic overeating can desensitize this process. Fat cells also produce Resistin which can contribute to insulin resistance and diabetes. Other substances such as Adiponectin can result in beneficial anti-inflammatory effects. Fat cells also make other unique substances such as Tumor Necrosis Factor and Angiotensinogen. All of these seem to interact to maintain our body weight. It is a remarkably efficient system. This system has the ability to regulate and maintain our weight to within a few ounces. Altering the sensitivity of this system by as little as two percent is enough to result in obesity within five year, but it can be altered in a positive direction with regular exercise.

Uncovering the physiology of this system will no doubt result in new weight reduction agents. Exercise and sensible eating is still the only way to achieve healthy weight loss. Changing your diet can result in a new equilibrium at a lower weight without ever stepping on the scale. Reduction must come slowly for benefits to be obtained. The other message is that there is no such thing as a diet. To lose weight, permanent changes to eating patterns must be made. Withholding carbohydrates and burning fat instead of sugar is a last resort for body survival. This situation is currently being advocated by a few "diet plans". It is my belief that it is neither sustainable nor beneficial. The "cost" to survive in low sugar conditions is the production of ketones and other potentially harmful substances. As we learn more about the physiology of this process, I am certain that these diet fads will disappear. It still comes down to "grow fresh, prepare fresh, eat fresh" and I will see you on the ice!


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