Scientists have been working to understand why those who lose weight are almost always recovering – providing lessons for all adults, regardless of size.

Here’s a sobering figure: About 90 percent of people who lose weight eventually gain almost everything.

This outstanding fact underscores how far we have come from overcoming the global epidemic of obesity, as well as the urgent need to be realistic for achieving goals and weight loss benefits.

Why is it so difficult to lose weight? The reason is simple and complex. Gaining significant weight gain – we do not know exactly how much – is not limited to inflating our fat cells; it changes our biology. Our bodies act as if that weight is our normal weight, protecting it like a mother embracing her baby.

First of all, our body slows down our body, so we need to eat less to stay fat. A study of competitors in the TV program “The Biggest Loser,” for example, found that before the competition, they had an average metabolic rest of 2,60 calories a day. After the show, it was 2,000 calories. Six years later, even though most had returned to pre-show weight, their resting metabolism dropped to 1,900 calories a day.

At the same time, our bodies warn us of hormonal symptoms by saying we are always hungry, and the inner voice of the voice says, “eat, eat, eat.”

In fact, our bodies become our enemies, constantly undermining our efforts.

How difficult it is to lose weight is shown in a compelling article by The New York Times in Gina Kolata’s annual journalist magazine following two patients at Michigan Medicine, a medical center studying at the University of Michigan.

The story told a very common myth: two people are repeatedly frustrated by their inability to lose weight and keep it. They both took a critical step, undergoing bariatric surgery at Michigan Medicine. The pounds have fallen and their health has improved, but both are completely dissatisfied with their change.

Researchers at Duke University found that 10 years after abdominal surgery, about three-quarters of obese patients maintained weight loss of more than 20 percent of their employed weight. For a person who weighs 300 pounds, that means a continuous weight loss of 60 pounds. (Less positive results have been found in those with a sleeve of gastrectomy or flexible gastric banding.)

This study, however, does not disclose the discovery of a mythical magical character (or scalpel). The majority of patients in the study, who started with a body mass index of 47, are still considered overweight (BMI 30 or higher). They do not have the carcasses promised in the magazines and strive to obtain real programs such as “The Biggest Loser.”

This inspiring study, then, provides further evidence of the great challenges facing those who undergo a major surgical procedure to cope with their weight.

The good news is that obesity research over the last few decades has found why it is so difficult to maintain weight.

Important lessons on weight loss

Since the 1980s, when many scientists thought that fat cells were storage vessels, we have discovered that they are the engineers in a large, complex network that connects the brain to control hunger, metabolic rate, and other vital functions.

Unfortunately, these details of how our bodies work did not lead to a reliable intervention to control it. Two lessons are clear. First of all, people don’t regain weight because they have no energy. Instead, powerful biological responses contradict their best efforts in every way.

Perhaps the most important message came from my Michigan Medicine colleague, Charles Burant, M.D., Ph.D., “Don’t Survive at First.”

Easier said than done, I know. But Burant’s insight suggests a new and stronger way of looking at obesity. While most people know how difficult it is to lose weight and keep it away, our culture still cites it as a normal state of health – a problem that can be treated with simple diet and exercise therapy.

Obesity, on the other hand, is better understood as an incurable condition. Once we have allowed it to happen, it is almost impossible to go back. You would think that the poles could not stand.

And yet, of course. Recent research suggests that a mother’s weight and her eating habits before and during pregnancy can affect the genes that control her baby’s weight.

This picture, however, is not entirely bad. We also find that a small amount of weight loss offers many health benefits. Obese people who lose even 10 or 20 percent of their body weight – as in Duke’s study – often enjoy lower blood pressure, blood sugar levels, and inflammation. They also report feeling better physically and mentally.

While the surgery is effective, our weight loss clinic at the University of Michigan also helps obese patients to lose and maintain 10 percent of their body weight without going under a knife. That effect, which can have measurable health benefits, is hardly overcome; it is available through a complex diet, exercise and counseling program.

In this program, as well as in our bariatric surgery program, we are looking for indicators that will improve our ability to prevent weight gain and faithfully ensure weight loss.

As we continue to explore weight science, we know two things for sure.

Obese people should focus on how they feel rather than how they look.

Realistic goals can provide lifesaving benefits.

Obesity research also tells us that we need to pay more attention to people who are not overweight. For them, the advice is clear: Be careful. Watch

CITY TIMES