When considering overweight and obesity, many questions come to mind: Are the underlying causes bad genes, an unhealthy diet, or insufficient physical activity?
Weight loss is often presented in the media as a simple solution, but the reality is more complex. Many understand that weight loss is not merely a physical process, but is also deeply connected to our thoughts and emotions.
Metabolically, overweight and obesity are underpinned by an imbalance between calorie intake and expenditure: we consume more than we expend, and excess energy is stored as fat. However, this does not adequately describe the challenges an individual faces.
In this article, I touch upon topics related to my book Weight Doctor – Lose Weight Permanently (Tammi), such as what permanent weight loss requires and how quick diets transition to lasting weight loss.
What Does Permanent Weight Loss Require?
Permanent weight loss requires more than just a calorie deficit. The common advice “eat less, move more” is an oversimplified and often insufficient – or even incorrect! – guideline for individuals who have struggled with weight loss for a long time.
Our calorie or energy balance is determined by many factors: our physiology, genetics, environment, socio-economic status, and especially our psychological factors. These influence our weight management and, in particular, our ability to maintain it in the long term.
Our body’s homeostatic system affects appetite, the amount of food we consume, and our energy expenditure. Adipose tissue, previously seen only as an energy store, is in fact a metabolically active and complex cell.
Weight loss alters the body’s balance, increases hunger, and can slow down metabolism. The stomach secretes more ghrelin, which increases hunger, and the digestive tract produces fewer satiety signals. These mechanisms explain why many who have lost weight regain it.
Weight Loss is Too Often Perceived as a Short-Term Project
Viewing weight loss as a short-term project often leads down the wrong path, and incorrect methods frequently result in failure. For permanent weight management, lifestyle changes should be seen as a learning process and practice, with adjustments tailored to oneself. This leads not only to weight loss but also to improved well-being, functional capacity, health, and a better relationship with food.
Successful weight loss is a multifaceted journey, where the path leads towards one’s goals – often through twists and challenges. When prepared for these challenges in advance, with the support of a weight management professional, the prerequisites for success are significantly better.
Permanent Weight Loss Requires a Balance of Eating, Exercise, Sleep, and Overall Life
Why is Overweight so Common Today?
As a human species, we have evolved under vastly different conditions compared to our modern world. Our ancestors lived as hunter-gatherers for a long time, and our genetic heritage has evolved to meet those needs. Life was more primitive, food was scarcer and less processed, and often people had to survive for long periods on limited nourishment.
For this reason, humans have evolved to be adept at storing energy as fat. This has long been beneficial for our species, to the extent that our bodies strive in various ways to return to their highest weight. Partly for this reason, maintaining weight loss after dieting is so challenging.
Overweight is a Global Problem
Obesity is a major public health problem on a global scale. Global obesity has tripled during my lifetime, i.e., since 1975. Approximately two billion people worldwide were overweight (BMI over 25) in 2016, and over 650 million people suffered from obesity (BMI over 30).
Overweight is now a greater killer than malnutrition. In Finland, nearly three-quarters of men and two-thirds of women were overweight in 2017, and a quarter of adults could be classified as obese. Obesity and overweight are now common across all ages and socio-economic classes. As I said – you are not alone!
Comfortable Conditions and Environment Fuel Obesity
What about our daily living environment, what significance does it have for overweight? In short, our surrounding world plays a very significant role in the increasing prevalence of overweight and obesity. Our modern society presents new and challenging elements for us as a human species.
The oversupply and easy availability of industrially produced food (i.e., energy) are at an astonishing level – consider, for example, the sugar cereal or candy aisles in supermarkets, greasy treats at gas stations, or the proximity of vending machines. Restaurants and fast-food establishments compete by offering increasingly affordable, overflowing buffet tables and ever-growing portion sizes. Alcohol (which, by the way, contains a surprisingly high number of calories and clearly increases appetite) is increasingly and more easily available.
Our current lifestyle is, in a way, unknowingly full of automation and passive conveniences that reduce our daily energy expenditure to a minimum – and which even weekly exercise classes often aren’t enough to compensate for! The increase in sedentary work and car usage is clearly linked to the rise in overweight.
Recovery Decreases as Screen Time Increases
At the same time, sufficient recovery for both body and mind, for example in the form of sleep or stress management, remains inadequate for many. Screen time and the internet are familiar reasons for many of us, contributing to a reduction in sufficient restorative sleep. The combination of all these and many other factors is evident in the increasing prevalence of obesity in Western countries and across our entire planet.
It can be said – and this is important to realize – that overweight is by no means solely “your own fault.” Overweight and obesity are no more self-inflicted conditions or diseases than many other conditions or diseases. Furthermore, many studies have shown that blaming an overweight person does not help their situation or enhance weight loss – quite the opposite.
Anyone helping an overweight person – whether a friend or a professional – must approach them through their own situations, wishes, and mindset, not by preaching or moralizing. Slowly but surely, healthcare professionals in Finland and elsewhere are also waking up to this fact, but unfortunately, overweight and obese individuals still too often face prejudice and insults.
Even a Small Change Promotes your Health and Well-being
In my work at Painoklinikka, I offer my patients science-based treatment for obesity and practical support for lifestyle changes, but also hope and help to see their own potential for success.
With almost every patient, we discuss, even briefly, a topic that is both important and empowering: the health benefits of weight loss begin as soon as lifestyle changes are initiated, and even moderate weight loss brings significant benefits!
Permanent weight loss brings many positive aspects, and understanding these factors is motivating and empowering for the change process. For example, well-being improves, movement becomes easier, and playing with children or grandchildren becomes more enjoyable. With weight loss, satisfaction with one’s appearance can also improve, and perhaps even one’s sex life with a partner feels more interesting.
Losing Excess Weight Affects Overall Health
Weight loss has many health-promoting effects. Even a weight loss of approximately 5% (e.g., about 5 kg for a 100 kg person or 9 kg for a 180 kg person) can halve the risk of developing diabetes, i.e., type 2 diabetes, and even a loss of a couple of kilograms reduces it.
If diabetes has already been diagnosed, weight loss corrects blood sugar balance and reduces the need for diabetes medication. Weight loss prevents and slows the progression of cardiovascular diseases and lowers blood pressure, as a result of which, for example, the dosage of blood pressure medication can be reduced.
Weight loss also favorably affects blood lipid levels: A 10-kilogram weight loss lowers total cholesterol by 5 percent. To improve blood cholesterol levels, the quality of fat consumed is most important: prioritize soft vegetable fats and oils, such as rapeseed oil, and aim to avoid regular consumption of hard animal fats (butter, high-fat dairy products, and cheeses). This is a good example of a sensible dietary change that improves health, even without any weight loss.
Also Linked to Sleep Apnea, Asthma, Osteoarthritis, and Cancer
For sleep apnea patients, a 5–10% weight loss can completely eliminate symptoms if the condition is mild. In such cases, CPAP (continuous positive airway pressure) therapy can be avoided. For asthma patients, weight loss improves lung function, reduces symptoms, and decreases the need for medication. For knee osteoarthritis patients, weight loss significantly alleviates pain and improves functional capacity. For individuals with osteoarthritis, a 10% weight loss can halve osteoarthritis-related pain.
Many cancers are also linked to overweight, and even moderate weight loss is a concrete way to reduce the risk of developing cancer. A healthy, varied diet and weight management are good ways to reduce the risk of developing memory disorders, such as Alzheimer’s disease. Obesity negatively affects quality of life and shortens lifespan by up to 10 years. This list could go on for a long time.
It is Never Too Late for Permanent Lifestyle Changes
However, it is most important to remember that it is never too late to make sensible lifestyle changes. In my clinic’s treatment programs, we have had numerous elderly individuals and retirees participating from the very beginning. Many of them feel that now is their turn to prioritize their own well-being and enjoy healthier and lighter years.
Our middle-aged patients, on the other hand, realize that without weight loss, smart dietary changes, and better recovery, they are burning the candle at both ends – and it’s only a matter of time before this manifests as illness.
Young overweight adults, in turn, face an excellent opportunity: even if a significant amount of excess weight has already accumulated, this is a great moment to seize the opportunity, learn new weight loss skills, and thereby enhance quality of life, functional capacity, and many healthy years of life.
By initiating sensible and well-implemented lifestyle changes now, focused on essential matters and tailored to your specific situation, you will gain health benefits and increased well-being from the outset. You will enjoy your life more – and be on your way to permanent weight loss.
Why Do You Want to Lose Weight?
- “Health: I want to lose weight to avoid diabetes and live longer. I don’t want the diabetes that troubled my father so much.” Or “I want to lose weight so I can reduce blood pressure medication and feel less pain in my knees.”
- “Well-being: I would finally like to have the energy to be a good parent, present in my children’s daily lives.” Or “I want to lose weight so I can play with my grandchildren next summer, romp, play, and row together.”
- “Appearance: I want to lose weight so I can feel like myself again, the person I truly feel I am beneath this exterior.” Or: “I want to lose weight so I can buy nice clothes and be happy with them.”
And so on. Only you know the most important reasons for your weight loss. Save the paper where you have listed these reasons. Keep it in a place where you see it regularly. If at some point you find yourself burying your weight loss plan again or needing more motivation, take it out and remind yourself why you want to succeed, why you want to make permanent changes in your life.
It’s Time to Stop Dieting!
When lecturing on obesity treatment and weight management, I often say that, contrary to expectations, I do not work at a weight loss clinic, but at a clinic for stopping dieting. This is, of course, a play on words, and partly semantics, but it contains an important message.
Not every method of weight loss is equally good. If a person with a history of eating disorders, or who has yo-yo dieted for a long time, or who demands too much of themselves and has black-and-white thinking patterns, loses a lot of weight in a short period, I might be more concerned than pleased with the results.
This is because we do not merely want to help a patient become slender at any cost; rather, we want to emphasize the permanence of changes and a holistically empowering lifestyle. These can sometimes be at odds with rapid weight loss.
The Opposite of Dieting is Changes Suited to your Life
By dieting in this context, I mean a project-like and short-term reduction of food, “at any cost,” for example, according to some fad diet.
Its opposite consists of changes suited to your life, aligned with your values, and strengthening mental well-being, for example, in nutrition, daily activity, recovery, and thought patterns, which help you lose weight permanently and safeguard your health.
Many individuals seeking weight loss recognize this contradiction within themselves: they want to diet quickly again, preferably with the help of some fad diet written about in magazines – but at the same time, they realize that path has run its course.
Permanent Weight Loss should Start Now!
The next dieting project will not work again, but will only increase anxiety. The only constructive alternative is to understand one’s own situation and the underlying causes of overweight, to learn sensible lifestyle changes – and to stop dieting. With professional guidance and support, if necessary.
I suggest that you consider ending short-sighted diet regimens and familiarize yourself with the keys to permanent weight loss.
André Heikius
Medical Director, CEO
