Insights From Obesity Specialists
“The gut produces hormones like ghrelin, GLP-1, and PYY that tell the brain when to eat and when to stop,” says Dr. Duncan. In people with obesity, these signals are often dysregulated. The hunger hormone, ghrelin, stays elevated while fullness signals become blunted.
“It’s one contributor to what my patients describe as ‘food noise,’ a constant background hum of thinking about food, planning the next meal, or fighting cravings that are not about hunger at all,” she says. “It would be pretty tough to out-discipline a hormone.”
The medical community is also shifting how it approaches treatment.
“The biggest shift is the move away from treating obesity primarily as a weight problem and toward treating it as a chronic, relapsing disease with the end goal of preventing organ damage, not just hitting a number on a scale,” says Toronto-based Fady Hannah-Shmouni, MD, an endocrinologist and geneticist, and the medical director at Eli Health.
People with obesity don’t need to lose drastic amounts of weight to see real health benefits. “Overall, a 5 to 10 percent decrease is clinically meaningful and, importantly, achievable and sustainable for most of the population,” says Dr. Hannah-Shmouni. He explains that losing 5 percent of one’s total body weight can reduce strain on the heart, lower blood pressure, and improve cholesterol levels. Some people can even reverse conditions like prediabetes and mild diabetes with this moderate weight loss.
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