Many common problems seen by counselors relate in some way to being overweight, and no other problem has been so poorly treated. The traditional idea has been that people who are overweight obviously overeat. Logically, based on this idea, the treatment involves decreasing food intake to solve the problem.

        However, recent research questions the "overeating" hypothesis of obesity. Several studies have reported that overweight people simply do not eat more than their normal weight peers. In fact, one researcher worked with two women who weighed more than 260 pounds and maintained their weight on only 1,000 calories per day.

        The question, then, is what causes obesity if not overeating. The evidence is mounting that body weight is controlled by a center in the brain called the "weight regulating mechanism (WRM)" and that this center chooses a "setpoint" weight for each person and then does all in its power to maintain that weight.

        The WRM apparently acts like a thermostat in a house that turns on the heater or air conditioner to maintain the "setpoint" temperature of the house. In a similar manner, the "fat thermostat" in the body turns certain systems on or off to maintain the "setpoint" body weight (the weight it thinks is proper for that person). For example, when a person goes on a restricted intake diet, several important adjustments take place to keep that person from losing too much weight. First, after a week or so of the restricted intake, the body begins to decrease its metabolic rate to compensate for the decreased intake. The metabolic rate may decrease by a third of its original level. This means that a decrease in intake from 1,500 calories a day to 1,000 calories a day (a one-third decrease in intake) would be completely compensated for by a decrease in metabolic rate. Second, when the weight begins to decrease, the fat thermostat feeds information to the hunger centers in an attempt to increase the intake of calories. This accounts for the hunger experienced by most dieters. A third change occurs in the fat cells of the body. An enzyme, lipoprotein lipase (LPL), whose job is to help fat into the fat cells for storage, is increased dramatically until there is from three to ten times more available. This means that any food eaten during the diet can be more easily stored in the fat cells. This is why it is so easy to regain lost weight after a few weeks or months after going off a diet. The fourth change causes the dieter to feel fatigue, malaise, and headaches in an attempt to slow down activity. It's as if the body realizes that activity will use calories, so it causes the person to feel bad so that energy is conserved.

        Some scientists think that these changes are part of an "anti-starvation defense system" designed to protect the organism from losing too much weight. Obviously, a person who tries every diet that comes out actually programs his body to be an efficient fat storer; and, the more he diets, the worse the problem becomes.

        So how does a counselor help a person who wants to lose weight? The first step is to help them stop dieting. Remember, dieting just makes the problem worse because the body feels threatened and makes changes to conserve and store fat. The second step involves lowering the fat thermostat. If the fat thermostat is set lower, the body can actually learn to waste energy to help get the body weight to the new setting, just as it conserved energy to keep the weight up during restricted intakes.

        How do you lower the setpoint? Scientists have found certain foods that raise the thermostat and other foods that lower it. For instance, rats fed a "supermarket" diet (corn chips, bologna, marshmallows, bananas, and so on) got extremely fat; when put back on the less rich rat chow they lost the excess weight. This and other similar studies suggest that the diet for lowering the setpoint must be low in fats and sugars and must increase the complex carbohydrates such as vegetables, beans, grain, and fruit. Eating a low-fat, low-sugar diet high in complex carbohydrates not only allows the thermostat to go down, but it also decreases the caloric density of food so that fewer calories are ingested when a person eats to his own satisfaction. A recent study showed that subjects on a low-fat, low-sugar diet needed only 1,570 calories a day to feel completely satisfied compared to 3,000 calories a day for those eating the typical high-fat, high-sugar American diet.

        Avoid the typical bacon-and-egg breakfast in favor of oatmeal or other cooked cereals.

        To decrease sugar intake, avoid desserts, sweet snacks, and sweetened breakfast cereals. For example, a dish of grapenuts with skim milk and a few raisins could substitute for ice cream as an evening dessert, and whole-wheat bread (without butter) or fruit could be substituted for candy or cookies as a snack.

        Exercise for about twenty minutes a day the first week or so and then increase the duration until the exercise period lasts from forty-five to sixty minutes a day.

        Having established the pattern, continue to exercise daily. Research shows that daily exercise is much more effective than exercise every other day, even if the total exercise time is the same. During the first few weeks or so, you can exercise twice daily but not for more than twenty to twenty-five minutes each time. Too much exercise often results in injury during the early stages.

        The value of aerobic exercise is much greater than previously thought. In addition to lowering the fat thermostat, aerobic exercise also helps make all of the weight loss fat. Dieters often lose as much muscle as they do fat. Loss of muscle decreases their ability to burn fat, lowers their metabolic rate, and can cause weakness. Also, aerobic exercise actually increases the body's ability to burn fat by causing an increase in the enzymes needed to burn fat effectively. In other words, exercise not only conserves muscle but makes that muscle better able to burn fat. Therefore, long-distance running or similar aerobic exercise is ideal for anyone trying to lose weight.

        In addition, exercise helps modify abnormal insulin responses (which helps the body store less fat) and causes a release of chemicals called endorphines that make a person feel better. finally, aerobic exercise burns a significant amount of energy. Walking only one mile a day could theoretically account for ten pounds of fat loss a year, and an hour a day would lead to a forty-pound loss each year.

        To summarize, successful weight control requires adherance to three basic rules: (1) stop dieting, (2) decrease fats and sugars and increase complex carbohydrates in the diet, and (3) exercise daily for forty-five minutes to an hour at a moderate pace using some large-muscle rhythmic activity.

        You must be aware of these differences in basic body build and help people accept themselves as they are. If this program is followed carefully, most people will lose weight until they reach their best and most naturally healthy weight.

Suggested Reading

Remington, Dennis W.; Garth A. Fisher, and Edward A. Parent; How to Lower Your Fat Thermostat. Provo: Vitality House International, Inc., 1983.

About the Authors

Dr. A. Garth Fisher, professor of physical education and director of the Human Performance Research Center at Brigham Young University, received his bachelor's degree from BYU, his master's degree from Sacramento State College, and his Ph.D. from the University of New Mexico. An exercise physiologist, Dr. Fisher is a fellow of the American College of Sports Medicine. He is the author of many articles and books.

An active Church worker, he has served as a stake president, a bishop, an Aaronic Priesthood quorum adviser, a gospel doctrine teacher, and in other callings.

He and his wife, Geraldine, are the parents of nine children.

Dr. Dennis W. Remington, M.D., is a family physician and a specialist in Bariatric medicine (treating obesity and related disorders). He is the director of the Eating Disorder Clinic at the BYU Student Health Clinic and is an eating disorder consultant for the Utah Valley Regional Medical Center Mental Health Services.

In the Church he has served as elders quorum president, in a bishopric, and as a high councilor.

He and his wife, Jolayne, are the parents of three children.