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Resolution Fail

By Scott Hamilton, MD
January 20, 2023
Hamilton Blog Headshot Updated 12.21.21

Hustling into church last Sunday, the usher's eyebrows went up. He whispered jokingly, “you're late!” I whispered back, “My New Year's Resolution is to eat more, exercise less, and be late for more stuff!”

Breaking bad habits and starting good ones is hard for humans. Losing weight by eating less and exercising more is the hardest. Our bodies are designed to put on weight and NOT lose it. For over 100,000 years, harsh living and scarcity of food have conditioned our biology to gain weight whenever we can, storing calories for lean times. Even with the invention of farming about 20,000 years ago, people never got fat from too much food; they just starved less often. Full bellies are a very recent occurrence in human history, thanks to the industrialization of farming and food production.

It's been said that curing obesity is harder than curing cancer, again, because we aren't built to lose weight. The causes of obesity are complex. It isn't just because obese people are lazy snack grazers. Science is now revealing that once we put weight on, our brains subconsciously make us eat more and burn less energy when we try to take it off. Our own bodies sabotage our best intentions. And modern food science makes things like Doritos and sodas so delicious, they tickle our brains in ways that make putting that weight on easy and delightful.

The technological and biological problem of obesity begets a technological and biological solution - bariatric surgery. In adults, and now in teenagers, science has shown that life-style modification programs of exercising more and eating less rarely work. Kids may lose weight, but eventually put it back on. Surgery is the only real cure for obese teens. In fact, the paper “Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices” is required reading for board-certified pediatricians.  

On commercials for fast food, kids and parents are always having a blast, sharing good times and, less obviously, truckloads of calories. I want to yell at the fictitious moms and dads, “Stop! You'll ruin your kids' bodies!”

Such thoughts aren't entirely fair to the parents. As discussed above, obesity is easy to achieve and near impossible to lose. Human bodies are geared by hundreds-of-thousands of years of experience to put weight on, hedging against starvation when food got scarce. Only in the past 100 years has food been abundant enough for more than a wealthy few to get fat. Life-style changes, like eating better and exercising more, seldom take weight off, or keep it off.

Obesity is dangerous: early death from heart disease, high blood pressure and strokes; miserable lives of painful joints, shame and depression. The earlier children become obese, the sooner the damage to blood vessels, hearts and joints starts. There are two avenues to tackle the problem of pediatric obesity: prevention or surgery.

Prevention is the cheapest option but requires planning ahead. Parents early on need to steel themselves against pressures to buy calorie-dense, fat producing foods like chips, sodas and fast food. Unfortunately, these are, besides being utterly delicious, less expensive than healthy fruits, vegetables and whole grains. Obesity in the impoverished isn't because they're lazy, it's because of food they can afford. Thus, parents also need to spend more for the sake of their child's health.

Once kids get obese, the only real solution is bariatric surgery. This surgery uses various techniques to impede the body's ability to take in calories. Coupled with a prevention program, teens can achieve a healthy weight and stay there. In Lafayette, you can get help at Acadiana Weight Loss Surgery. They treat teens as well as adults and take Medicaid. Calling them may be the best New Year's weight loss resolution.