Have you ever tried to lose a considerable amount of weight, maintained it for a while, but then all the weight lost came back? One can lose 10 or 15 kg, eat the same way for months, and feel healthier, but then hunger returns, the scale starts moving up, and the old weight slowly returns, according to Dr Ashish Gautam.
How does it impact us? Dr Gautam explains, “When leptin levels are low, you are hungrier and energy expenditure drops. Ghrelin, the so-called hunger hormone, can rise when people lose weight, increasing their motivation to eat.
GLP-1 and peptide YY play a role in controlling satiety and food intake.”
For people in South East Asia, bariatric surgery may be considered for those with a BMI of 29 or higher, and those who have conditions such as ‘type 2 diabetes, obstructive sleep apnoea, osteoarthritis or fatty liver disease’, according to Dr Gautam. Because muscle tissue requires energy, per Dr Gautam, losing muscle while dieting can further reduce your energy expenditure. Thus, the calorie deficit that leads to weight loss decreases as body weight decreases. Eventually, the same diet will keep the new weight, while small changes in food intake or activity can lead to weight gain. The brain and gut also play a role in this. Weight loss may enhance brain responses to food cues, which may, in turn, amplify hunger signals. “The body may also use energy more efficiently, and food may become more rewarding. These changes can persist even after a person loses weight,” he added. However, he clarified that research is underway to explore the relationship between gut bacteria, obesity, weight loss, and weight regain. Microbial patterns can influence how much energy the body derives from food and how that energy is used. He suggests, “Foods that are high in protein and fibre help you feel full. A healthy eating pattern can include vegetables, whole grains, legumes and other minimally processed foods. Exercise burns calories and saves muscle. Weight training helps preserve lean body mass during and after weight loss. Sleep directly affects appetite and food choices. Stress can also affect hunger and eating behaviour. As for how bariatric surgery works, Dr Gautam explained that it changes the digestive system and affects appetite, food intake and metabolism.
The brain controls hunger, satiety, food reward, and energy balance, according to Dr Gautam. “People with a BMI of 35 or higher may also be considered for surgery without these conditions,” he added. “Long-term follow-up includes proper nutrition, physical activity, supplements when needed and regular medical care,” he added.
