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In The Lancet Diabetes & Endocrinology, four obesity experts express strong criticism towards the current treatment of chronic obesity. The researchers argue that obesity is a chronic disease with largely biological causes that cannot just be cured with diet and exercise. Ignoring these biological factors could result in the continued inability to treat obesity effectively and the premature death of millions of individuals each year.

At first glance the issue seems quite simple: if you want to lose weight, you need to start eating less and start exercising more. But according to Christopher N. Ochner and colleagues, the issue is a lot more complicated than that. They suppose that few individuals fully recover from obesity, because they are biologically very different from individuals of the same age, sex, and body weight who never had obesity. This biological difference could explain why many people with obesity can lose weight for a few months, but 80 to 95 percent eventually regain the weight they have lost.

"Although lifestyle modifications may result in lasting weight loss in individuals who are overweight, in those with chronic obesity, bodyweight seems to become biologically 'stamped in' and defended", says one of the researchers. According to them, obesity should be recognised as a chronic and often treatment-resistant disease that requires a range of medical interventions including pharmacotherapy or surgery. "The current advice to eat less and exercise more may be no more effective for most individuals with obesity than a recommendation to avoid sharp objects for someone bleeding profusely."

Sources:  The Lancet Diabetes & Endocrinology and Eurekalert

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