Ch.

14: Stress & Health

FRQ #4:

Kate, who is 50 pounds overweight, has tried a variety of diets. Although she often loses

some weight under each diet, she eventually gains it all back. Explain why Kate most likely

has difficulty maintaining her weight losses. What are the advantages and disadvantages of

her continued efforts to lose weight?

Body fat is determined by the size and number of fat cells in the body. In an obese person

however, fat cells may swell to two or three times their normal size, and then they divide. Thus,

the number of fat cells will increase. These fat cells may increase due to genetic predisposition,

early childhood eating patterns, or adult overeating. Once they do increase, they can never

decrease. This may explain Kate’s problem. Even on a diet, the fat cells may shrink but they will

never disappear.

Another explanation for Kate’s weight problem could her body’s set point and

metabolism. Our bodies’ “weight thermostats” are set to maintain body weights within a higher-

than-average range. When our weights drop below that set point, hunger increases and

metabolism decreases, leading to weight gain. Also, after rapid weight losses that occur during

the initial 3 weeks or so of rigorous dieting, any further weight loss comes slowly. For instance,

obese patients whose daily intake was reduced from 3500 calories to 450 calories lost only 6% of

their weight, partly due to a 15% drop in their metabolic rates. This shows that the body adapts to

starvation by burning off fewer calories, and to extra calories by burning off more. When Kate’s

diet ends, her body is still conserving energy. Thus the amounts of food that worked to maintain

weight before the diet may now increase it.

 Another reason for Kate’s weight loss dilemma is the genetic factor. For example, despite

shared family meals, the body weights of adoptive siblings are uncorrelated with one another and

with those of their adoptive parents. Their weights more closely resemble those of their

biological parents. Identical twins have closely similar weights, even when reared apart. In

addition, some genes influence intestines signaling when we are “full” and how efficiently we

burn calories or convert extra calories into fat.

A disadvantage to Kate’s dieting is that she will almost always gain that weight back. The

condition of an obese person’s body reduced to average weight is much like that of a semistarved

body. Because it is under the normal set point, each body “thinks” it is starving. When weight is

lost, obese people may look normal, but fat cells may be abnormally small, metabolism may be

slowed, and minds will be obsessed with food. This can explain why participants of weight loss

programs like Kate gain the weight back. One study followed 207 obese patients who had lost

large amounts of weight during a 2 month hospital fast. Within three years, half had gained back

all the weight they lost, and all were obese again after nine years.

One advantage to Kate’s dieting is the temporary weight loss. She can have that “ideal”

body for a while, until her body works again to maintain the right weight. Also, with more

attempts to lose weight, she can eventually succeed.