“A lot of communities have recognised obesity as a chronic disease. This is because even if patients lose weight, if you wait long enough, everyone puts their weight back on, with only a handful of exceptions,” said Professor Arya Sharma of the University of Alberta at a symposium during the International Diabetes Federation Conference 2019 here.
He also said that all people, including patients and physicians, believe that controlling obesity is a simple task and is about energy balance on controlling calories, Korea Biomedical Review reported. “We can control calorie intake by eating less and outtake by doing more exercise. So we believe that it will be easy to achieve a certain balance for weight loss. Therefore, in theory, this is not so difficult,” Sharma was quoted as saying.
“However, the problem is there is a black box between controlling the intake and outtake of calories that people neglect,” he said. The professor outlined that black box is a complicated, sophisticated, redundant and effective physiological system designed for one particular purpose, in order to defend an individual’s body from weight loss. “Unfortunately, when we try to lose weight with any method, the body’s system is going to work against the person trying to lose weight. Adaptations to weight loss include hormonal changes, increase in appetite, decrease in metabolic rate, and thermogenesis activity,” Sharma said.
“I am only interested in what the best way is to keep the weight loss and not how to lose weight. The first thing we have to acknowledge is an obesity treatment that a patient can stay on forever or obesity management that only goes on for only a certain period is not a treatment for obesity,” he added. The professor listed methods used by hospitals to treat obesity like behavioral modifications such as dieting and exercise and surgical methods.
“Behavior modification, such as controlling what a person eats or exercises, normally helps patients lose 3 to 5 per cent of their weight. The problem is that the lost weight will come back if the person stops their behavioral modification,” Sharma said. “Surgery is the best way to lose weight as it can cut a person’s weight by 20 to 30 per cent,” he added. However, Sharma asserted that surgery is not an ultimate and permanent solution to treat obesity.
“As an example, there are about 1.5 million people who are qualified for surgery, and Canada conducts 100,000 surgeries a year. To give all the patients the surgery, it would take 150 years,” he said. “Therefore, the problem with surgery is not that it does not work or effectiveness. The problem is that it is not scalable to the size of the obesity population,” the professor added. Sharma further said that the first step to be taken is acknowledging that obesity is not something that can be cured but it is a chronic disease that needs good management. “Designating obesity as a chronic disease can benefit people living with obesity in terms of reducing stigma and providing better access to obesity prevention and management,” he underlined.