How people are actually going to lose weight in 2018.


I have written a lot lately describing why our diet failure rate is at 95%. Admittedly, I have been nearly obsessed with making the point that folks who cannot lose weight have a d#$% good reason why that is. That they face challenges many lean folks don’t feel, and that to shame or condescend them is nonsensical (let alone ethically deplorable).

That said, almost every post is followed by comments asking, “OK, so what do I do know?”, and “Is there anything at all that works to overcome this barrier to weight loss?” Indeed, there is.

First, procedures work. It is important to start here because this is how we learned all of the stuff from the other posts. There is no “willpower” implantation procedure. These new procedures work by altering the hormones and metabolism that otherwise stop folks. Bariatric surgeries, interventional obesity procedures (bariatric artery embolization, cryovagotomy) bypass the response that has stopped so many, for so long.

Second, medications work. We are a long way from phen-fen. Also, stopping medications work.  Common medications like antihistamines are often significant contributors to weight gain. Obesity medicine physicians have a long list of medications that we often stop or change at the first visit as “low hanging fruit.” *

Finally, retrograde neuroplasticity works. It specifically overcomes attrition. Plainly said, changes made to the body will modify the brain. This is the opposite of what we have been doing all along. “Change starts from within,” “mind over matter,” and “no pain, no gain,” were all misdirected sentiments. It is not surprising that we have such a high failure rate with our current approach when we come to the realization that it is literally backwards, that success follows change from the outside-in.

And what are those principles? Attention to recovery, flexibility in diet and exercise, and the C-PASS principles: Capacity, Progress (not perfection), Accountability, Self-monitoring, and Stimulus control. These are the things you can do at home to directly address the body’s response that would otherwise make you quit. It’s like taking an anti-anxiety pill so you can make it through an MRI. See you again soon!



* Do not stop medications on your own. Talk with your doctor please.




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