Body Weight Regulation: Essential Knowledge to Lose Weight and Keep It Off

By Joseph Proietto

The main purpose of Body Weight Regulation is to educate the reader on the best strategy for losing weight and keeping it off long term. But after many years of managing obesity, the author has found that to achieve the best results, it is essential to understand the true nature of obesity. Thus this book first discusses the way the brain regulates body weight and how obesity cannot be caused only by poor lifestyle choices. It reviews the overwhelming evidence that obesity has a strong genetic or epigenetic basis and gives an evidence-based, detailed strategy on how to lose weight and keep it off . Body Weight Regulation discusses practical advice on how to structure meals that can be used during the weight-loss and weight-maintenance phases.

• Language: English
• Publisher: Xlibris AU
• Release date: Aug 12, 2016
• ISBN: 9781514497036

Joseph Proietto

Author Joseph Proietto (MBBS, PhD, FRACP) has treated patients for more than twenty years and has undertaken both laboratory and clinical research on obesity. He is the senior author in two landmark papers. The first, published in 2011 in the prestigious New England Journal of Medicine, discovered the biological reason why it is so difficult to maintain weight loss long term. The second, published in 2014 in The Lancet Diabetes & Endocrinology found that it is easier to lose weight rapidly and that rapid weight loss does not lead to more rapid weight regain.

Book preview

Copyright © 2016 by Joseph Proietto.

Library of Congress Control Number:   2016910107

ISBN:   Hardcover   978-1-5144-9701-2

   Softcover   978-1-5144-9700-5

   eBook   978-1-5144-9703-6

All rights reserved. No part of this book may be reproduced or transmitted

in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without permission in writing from the copyright owner.

Any people depicted in stock imagery provided by Thinkstock are models,

and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

**On Title Page: Illustrations By: Mark Ruben Abacajan

Rev. date: 09/15/2016

Xlibris

1-800-455-039

www.Xlibris.com.au

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CONTENTS

Acknowledgements

Introduction

Chapter 1   What Is Obesity?

Chapter 2   The Complications of Obesity

Chapter 3   The Regulation of Body Weight

Chapter 4   The Causes of Obesity

Chapter 5   Why Is it so Hard to Maintain Weight Loss?

Chapter 6   How to lose weight

Which Diet?

Does Exercise Matter?

Chapter 7   How to Keep Weight Off

Appendix 1: Tasty Recipes for the Daily Meal

Appendix 2: Plot Your Weight Change

References

ACKNOWLEDGEMENTS

I have many people to thank for the production of this book. Firstly, thank you to all my work colleagues and students who undertook much of the research that is described in the book and forms the basis of the program described here. Many are co-authors of the research papers listed in the reference section.

A big thank you to my wife, Daphne, the author of her own recipe book (I Am What I Eat), who checked out and advised on the recipes.

The low-carbohydrate recipes are not my original creations. They were taken from many excellent recipe books and websites and were occasionally modified to make them carbohydrate-free. Some of the books and web sites that the recipes were copied from include:

The Cook’s Book by Jill Norman.

The Australian Pork website (http://australianpork.com.au/).

Epicure, Tuesday May 21, 2013 (https://epicure.com/).

The Gourmet Traveller–The Italian Cookbook website

(http://www.gourmettraveller.com.au/recipes/recipe-

collections/2011/4/italian-recipes/).

Mediterranean Kitchen. Bay Books.

Women’s Weekly, Summertime Cookbook.

Women’s Weekly Easy Curry Cookery.

Women’s Weekly Best Ever Recipes.

Better Homes and Gardens, Italian.

An Odyssey into Greek Cooking by June Marinos.

Allrecipes.com.

INTRODUCTION

The Purpose of This Book

This book will serve three functions:

1. It will inform the reader about the biology of body-weight regulation and the causes of obesity.

2. It will give evidence-based detailed strategies about losing weight and keeping it off.

3. It will give practical advice about structuring meals during weight-loss and weight-maintenance phases.

Why the Author Is Qualified to Write This Book

The author, a bachelor of medicine, bachelor of surgery (MB BS); PhD; and Fellow of the Royal Australasian College of Physicians (FRACP) has treated obesity in public hospital clinics for more than twenty years and has undertaken laboratory and clinical research on obesity. He is the senior author of two landmark papers. The first, published in 2011 in the prestigious New England Journal of Medicine, revealed the biological reason why it is so difficult to maintain long-term weight loss; the second, published in 2014 in The Lancet Diabetes & Endocrinology, explained that it is easier to lose weight rapidly and that rapid weight loss does not lead to more rapid weight regain.

How the Book Should Be Used

The book offers a detailed description of the optimal way to lose weight, as well as information for keeping it off. However, both non-professional readers and health care professionals are strongly advised to read the first few chapters before initiating the program. The author has noted that his patients find it helpful and liberating to have an understanding of the regulation of body weight, the causes of obesity and of the biological mechanisms that make it difficult to maintain weight loss.

Evidence-Based Research

All the information provided in this book is backed by published scientific studies. References are provided at the end of the book that can be freely accessed through searchable medical databases such as PubMed or Google Scholar. For the non-professional reader, much of what is written in scientific articles may be overly technical; however, many can be helped in the interpretation and meaning of the information by their family doctor, who should play a key role in the patient’s weight-loss journey.

CHAPTER 1

What Is Obesity?

What is obesity? This question seems simple and self-evident, but there are subtleties that may surprise you. Obesity is the excess accumulation of fat. The human body has the capacity to store energy to be used when food is scarce, not unlike keeping money in the bank to use if we fall on hard times. The body can store both fat and glucose (sugar). While we have the capacity to store many weeks’ worth of energy in the form of fat, we can store only two days’ worth of glucose. Fat is a good solution as the preferred form of stored energy because it is lightweight, and per gram it contains twice the energy stored in glucose.

The capacity to efficiently store energy offers substantial survival advantage. We have not always had easy access to food, supermarkets, or refrigerators. Agriculture, established in the Middle East approximately ten thousand years ago, increased our food sources. Before that, humans had always been hunters and gatherers. Both of these activities required physical labour. Food supply was not steady, so there were frequent periods of food shortages. It is easy to see how the ability to efficiently store energy in times of plenty offered a significant survival advantage.

Fat is stored in adipocytes, deceptively simple-looking specialized cells. When viewed under a microscope, an adipocyte looks like a little bag containing a large fat droplet. However, we now know that adipocytes have surprising and powerful functions. They not only store and release fat in a tightly regulated way, they produce hormones (adipokines) that have a function in the immune system and in the regulation of body weight. Such fat cells are found in many parts of the body. A layer of fat under the skin (subcutaneous fat) offers insulation as well as energy storage and smooths the contours of the face and body. This is clearly demonstrated in patients who do not have fat cells due to one of the lipodystrophies, a group of rare conditions with genetic or autoimmune causes leading to deficiency of fat cells.

Humans also store fat within the body, particularly around the intestines, called