There's No Cure for Obesity

The work doesn't stop once you lose the weight

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Despite what you may see in breathless advertisements, or read from the latest diet book guru, or hear from celebrity diet spokespeople, there simply is no cure for obesity. Although you probably already know that in your bones (after all, if there were a cure, the world would certainly not be struggling with weight), I'm guessing that you may still approach weight-management efforts as if a cure was possible.

In my experience working with thousands of people, the majority seem to believe that there are two phases to weight management—the weight-loss phase and the weight-maintenance phase—and that the losing phase will require far more restriction than the maintaining phase.

And therein lies the rub: If the ability to gain weight in our modern environment is considered the condition, it's one that never goes away, which means weight-management efforts are treatments, and when treatments stop, conditions recur. So if you've lost weight following a strict approach, only to relax it once the weight is lost, you might be unpleasantly surprised to see your weight return.

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Two weeks ago, the New England Journal of Medicine published a piece highlighting the myths, presumptions, and facts that surround our current understanding of obesity. Among the facts mentioned is this one: "Continuation of conditions that promote weight loss promotes maintenance of lower weight." The point can be expanded upon by some of my favorite weight-management truisms:

• The more weight you'd like to permanently lose, the more of your life you'll need to permanently change.

• If you can't happily eat less, you're not going to eat less.

• If you can't happily exercise more, you're not going to exercise more.

• Your best weight is whatever weight you reach, when you're living the healthiest life you actually enjoy.

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So remember, whatever you choose to do to lose the weight, if you stop doing it, the weight's going to come back. What that means, of course, is that if you don't like your life while you're losing weight, you're going to gain your weight back. Putting this another way, whatever strategy you choose for weight management, if you see the strategy as a temporary means to an end, the end will likely only be temporary.

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If you're on a diet that leaves you regularly hungry or having cravings, you're going to quit. If you're exercising beyond the point of liking it, with the hours or the effort a source of dread, you're going to quit.

Our shared affliction, the human condition, simply isn't good at letting us live lives of unnecessary, perpetual suffering. So even if you do manage to lose boatloads of weight through misery, since suffering through under-eating and over-exercising is wholly unnecessary, the suffering, and the losses, won't last.

If you're planning a weight-management effort, or if you're in the midst of one, make sure you ask this one all-important and straightforward question: "Do I like the life I'm living?" If the answer's no, I'd recommend you try something else, because if you don't like the life you're living, you're not going to keep living that way. And for obesity, there is no cure, only ongoing treatment.

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Hungry for more? Write to eatandrun@usnews.com with your questions, concerns, and feedback.

Yoni Freedhoff, MD, is an assistant professor of family medicine at the University of Ottawa, where he's the founder and medical director of the Bariatric Medical Institute—dedicated to non-surgical weight management since 2004. Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters, and is also easily reachable on Twitter. Dr. Freedhoff's latest book Why Diets Fail and How to Make Yours Work will be published by Random House's Crown/Harmony in 2014.