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Losing Weight Takes More Than Willpower

Steph Whiteside/WSIU
Kathy Dauksza (left) lost 50 lbs with the help of Dr. Megha Manek (right)

Doctors often advise patients to lose weight - but that’s easier said than done. If you’ve been trying to drop the pounds and are struggling, it’s not just an issue of willpower.

“The brain is fighting you on multiple fronts,” said Dr. Megha Manek, a physician at the Southern University School of Medicine. She works with patients who are trying to lose weight.

Patients like Kathy Dauksza, who lost 50 pounds working with a wellness program at the university.

“I was 57 years old and I could see that my weight was going to kill me faster than it was going to keep me alive, and I had a brief epiphany that jeez, now is the time,” said Dauksza. “It’s either now, or a piano box. And I wanted a better quality of life, so I chose wellness over the piano box.”

“Based on statistics from the WHO released in Jan 2019, obesity has released epidemic proportions globally. We estimate 2.8 million people dying each year as a result of being overweight or obese,” Dr. Manek said.

For patients whose weight puts them at risk for serious diseases, losing weight is critical.

In Illinois, 31 percent of adults are considered obese. That puts them at risk for health conditions like heart disease, type II diabetes, and certain types of cancer.

But even when it’s important, losing weight can be a difficult goal to achieve. That’s thanks in part to your brain.

“Addictions and strong habits, they basically alter the chemistry and the connections of the reward system in the brain,” said Dr. Mehul Trivedi, who studies neuroscience and behavior at SIU School of Medicine.

When you engage in a habit repeatedly, he explained, those connections get stronger and stronger.

“You can't cut a formed connection. You can create a new, competing connection, but there will always be that old connection that was responsible for developing the bad habit,” he said.

That can be especially challenging when people overeat as a response to emotions, like stress, since those existing habits are so strongly developed in the brain.

But new research techniques which allow doctors to observe the brain in action, show that new connections can become strong enough to compete with old habits.

“They are showing that the brain is forming these new connections, rather than changing the connections that were already existing based on the person's developing the habit,” Dr. Trivedi said.

Kathy says she’s had to work on lists of things she can do instead of eating as a reaction to stress or other emotions.

Those include working out, walking, drinking water, or creating art.

“I mean there’s just so many other things to do besides eat,” she said.

On top of that, Dr. Manek notes that the brain resists losing weight and that resistance influences hormones that control hunger and fullness.

“There are hormones like insulin and leptin, that changes with our weight loss and that makes us much hungrier,” she said. “The levels of ghrelin go up and that makes us extremely hungry. So all the good hormones like insulin and leptin go down, and our bad hormones like ghrelin go up and that makes us want to each more.”

Leptin and ghrelin are both hormones involved in weight and appetite. Leptin helps signal the brain that you’re full, and keeps your body from feeling hungry when it doesn’t need energy. As you lose weight, the leptin levels in the body fall - and that can mean an increase an appetite and difficulty knowing when you’re full.

Ghrelin, on the other hand, is the hormone that tells your brain when you should eat. When people lose weight, ghrelin can increase which also leads to a bigger appetite.

That doesn’t mean you should lose hope - programs like the one Kathy took part in can help people gain the tools they need to change their habits in spite of the brain’s resistance.

For Kathy, that has meant training herself to challenge old habits and making her behavior match her new mindset.

“How can I change my behavior, to match my new way of thinking? “ she asked. “Sometimes I find I’m stuck, right  about to act on an old way of thinking and something happens, a little epiphany happens and I have to adjust and in that moment I really have to make a decision. Health or not health?”

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