Why Bariatric Surgery?

In this article

Why is dieting and exercise not working? What are the body's set points? How my body act against my will to loose weight? Why I may need bariatric surgery? How effective is the bariatric surgery?

Why is dieting and exercise not working?

If you’ve been trying to lose and maintain weight but you haven’t had any luck, you are likely fighting against the normal workings of your body. Body weight and fat levels are regulated by a complex system of signals in your body. These signals control your appetite, digestion, energy balance, and metabolism to keep your body weight and fat at a steady level, or “set point”.

What are the body's set points?

Your body’s set point is part of a basic biological instinct. When body weight and fat levels fall below your set point, your body activates defence mechanisms to maintain body weight and fat in order to prevent starvation, even in people with obesity. Throughout most of human history, calories were scarce and hard to get, so we have numerous natural defences against starvation. We have no defences against overeating because we never needed them before.

Everyone’s set point is different and can be changed. It appears that the body regulates fat set points similarly to how it regulates other body functions such as blood glucose, cholesterol, and blood pressure. Set points are affected by genetic, developmental, and environmental factors. Changes in any of these factors can lead to an elevated set point for body fat storage. For example, changes in the chemicals and nutrients contained in our foods can affect our brains in ways that increase the amount of food we eat and increase our body fat set point.

Additionally, as you gain weight, your set point is increased and your body works to defend the higher set point. Your body is smart, and it adapts when new things come its way. But, sometimes it’s not for the better. Your body doesn’t realise it’s overweight and it continues to store higher amounts of fat than necessary.

How my body act against my will to loose weight?

Because your body works to defend its set point, dieting and exercising are rarely effective in helping people with obesity achieve and maintain a healthy weight long-term. When you go on a diet, your body thinks it’s being starved and its survival instincts kick in. As a result, your body stores energy-rich body fat, and you can’t lose weight easily.

A landmark Swedish study found that, on average, a 200-pound patient fighting obesity with diet and exercise alone would only be able to achieve a sustained weight loss of 4 pounds over 20 years.

When weight is lost, lower body fat levels trigger hormones that encourage the body to get back to its previous weight set point. A New England Journal of Medicine study showed that while dieters may initially lose weight, their bodies change levels of hormones that encourage weight regain in response to the weight loss. These hormones increase appetite, decrease feelings of fullness, and slow down metabolism. The study also found that these hormones had not returned to pre-diet levels even 12 months after the initial weight loss, meaning their bodies were still encouraging weight regain a year after they stopped dieting.9 This is a powerful defence mechanism and may explain why the majority of weight loss attempts fail. 95% of obese people who lose weight with a rigorous weight loss program will regain the weight (or more) within 2 to 5 years.

Why I may need bariatric surgery?

In order for a person with obesity to achieve significant long-term weight loss, the body’s weight regulation system must be reset so that the body will stop storing excess fat. By altering the complex relationship your body has with food and its metabolism, bariatric surgery helps reset your body’s ability to effectively manage weight. New research indicates that some types of bariatric surgery (gastric bypass, sleeve gastrectomy, and bilio-pancreatic diversion) have metabolic impacts that enable a new, lower set point, allowing the body to return to a lower body fat level. By altering the anatomy of the stomach and/or intestine, these surgeries affect hormonal signals, resulting in decreased appetite, increased feelings of fullness, increased metabolism, and healthier food preferences. These positive changes allow your body to lose weight without the internal fight to return to the higher set point.

How effective is the bariatric surgery?

Without the medical intervention that bariatric surgery provides, many patients with severe obesity are not successful in managing their weight and related health conditions. Bariatric surgery has been shown to resolve diabetes, sleep apnea, joint pain, high blood pressure, high cholesterol and many other problems related to obesity. Bariatric and metabolic surgery is the most effective treatment to date, resulting in sustainable and significant weight loss along with resolution of weight-related health conditions in up to 80% of people.