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As a lawyer who has concentrated for two decades in helping those injured by weight-loss surgery malpractice, I have been saddened by the attitude of some, including physicians, that morbidly obese people simply lack self control, and if only they really tried, they can exercise and diet their way to significant weight loss. A welcome new study confronts that assertion and explains how obesity becomes defended by our bodies.

In the study, published in the journal Lancet Diabetes and Endocrinology, the prescription of eating less and increasing exercise is dooming the millions of American adults and children suffering from obesity to failure.

“Once obesity is established…body weight seems to become biologically ‘stamped in’ and defended,” wrote Mt. Sinai Hospital weight management physician Christopher N. Ochner.

The study confirms that those who have been obese for years simply cannot be expected to return to healthy weights through diet and exercise alone. The reason has to do with our inborn adaptive biology- once an individual becomes obese any attempt to change the equilibrium is attacked. The body starts to burn fewer calories, and pumps out hormones to increase hunger.

“Few individuals ever truly recover from obesity,” the authors wrote. Those that do, they add, “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.”

The data support the assertion that only a very small number of the chronically obese population can return to and maintain a healthy body weight without surgery.

Weight loss surgery, whether gastric banding, sleeve gastrectomy, or gastric bypass, can, if all goes well, be a true blessing.

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