But what about my genetics?’ she asked me somewhat exasperated. This was towards the end of a discussion I was having with a young overweight lady who had a long, frustrating, and typical experience with yo-yo dietieng, fads, gimmicks, and an overall unsuccessful dieting history. She was fed up, frustrated, and tired. This was understandable so. She wanted to know my opinion on the cause of her struggles. Why is it so hard for her to lose weight when many of her friends have no issue at all. It was this question and many similar ones over the years that prompted me to spend time in my fellowship training researching the physiological, genetic, environmental, and psychological roots of weight gain. I wanted to help my patients, friends, and family answer these questions. It was my hope that if I could help them understand the mechanisms I could help them make lifestyle changes that would benefit them in the long term. I also hoped the knowledge would protect them from the predatory marketing and huckster culture that pervades the multi-billion dollar weight loss industry.
Why is it that some people gain weight and some people don’t? This question carries with it a great deal of emotional charge. The charge comes from the fact that many people want to find fault and create blame when looking for the roots of this problem. They want to blame the overweight for being lazy or uncommitted. This creates a defensiveness and insecurity that is a huge obstacle to getting to the truth of the matter. I spent the entire second part of my book The Weight Loss Counter Revolution (available on amazon) dealing with this issue. If you want the details, check it out. For the bottom line, keep reading.
If you delve into the mechanisms – genetic, hormonal, environmental, etc. – all roads lead to the hypothalamus and the drives of hunger and satiety (i.e. the sense of feeling full). The hypothalamus contains the parts of the brain that determine how full or hungry you feel which in turn influences how much you eat. This, of course, will determine how much you weigh. Keep in mind that the drives will trigger eating but if you resist the drives, you will resist the weight gain.
So genetics and hormones do not make you gain weight directly. They make you more hungry and less full which makes you eat more which makes you gain weight. There is a tremendous amount of evidence supporting this claim. Too much for one blog post – you’ll have to take my word for it (or read my book).
What comes out from this is that you are responsible for how much you weigh but it’s not your fault. You are not to blame. The faster you can separate those two concepts the faster you can start on the road to success. What I mean when I say you are responsible is that you are able to respond – which is the root meaning of the word. Since the mechanisms of weight gain all affect appetite and satiety, if you are able to overcome these drives and eat less you can lose weight. What I mean when I say that it is not your fault is that you didn’t get to choose your hypothalamus. You didn’t choose the sensitivity of your satiety centers or the length of time it takes you to feel full.
This all creates a situation where, for an overweight person, the drive to eat is far greater and losing weight is far more difficult. Since the drive to eat is second only to thirst and the desire to breathe in intensity, this is a very difficult task but difficult is not the same as impossible. If you are overweight, you are able to respond to the challenge their weight creates. If you are able to respond, you are responsible for your weight.
This is good news. Only people who are responsible are able to make the changes necessary. If you were a slave to your genes or hormones, this would be a hopeless cause. All that is left is for you to take that responsibility and be the person you are capable of becoming.
The Weight Loss Counter Revolution 
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