If you have regained weight in the current health crisis, there is good news for you. Historical studies show that weight regain happens in 85% of people who lose weight non surgically, and approximately 45% of people who lose weight surgically. Individual outcomes can be much different with specialized, ongoing care, but much of that is interrupted currently, as with the current interruption at Rainier Medical. But, this is a marathon, not a sprint, and a new phase will come, so what to do in the meantime?
With the current Covid-19 health crisis, circumstances are difficult for many people and so weight regain is likely to have occurred in many people who have lost weight. There are two important things I would like people to know and take to heart:
1) There is a "honeymoon phase" during which the metabolic health benefits of weight loss may persist even after weight is regained, and
2) You can reduce your health risks by three important changes even if they do not result in weight loss, and they may result in weight loss.
The Honeymoon Phase
In the honeymoon phase, the insulin resistance, glucose tolerance, and lipid panel improvements that were realized with weight loss persist even after weight regain. For example, a person may have had a HA1c of 6.9, then lost 30 pounds, then had a HA1c of 5.8. They may gain back 25 pounds and still have a HA1c of 5.7. This is probably because they gave their pancreas a "break" or a "rest" and the first phase insulin response, which is the normal response to eating food, returned. Thereafter, food can be handled more normally. Type 2 Diabetes comes from pancreatic "burnout", so losing the 30 pounds was like a vacation for your pancreas! We can all relate to a vacation to treat burnout, right?
While weight loss confers health benefits, it is not always a direct 1:1 correlation between weight changes and health changes. This is why sometimes, people can lose weight in an "unhealthy" way, and sometimes people can be very "healthy" and have a higher than normal body weight. Specifically and more simply put, you can eat healthier, improve your physical fitness, and manage stress without losing a pound, and significantly reduce your health risks. This may be the best strategy at certain times and/or for certain people. The current health crisis may be one of them. How are your health risks going down if your weight is not going down? The mechanisms are likely two fold:
1) Reduction in fat cell dysfunction. This improves insulin resistance and the secretion of adipokines (read blog for more information).
2) Reduction in chronic inflammation. Obesity can be an inflammatory state. While acute, or short term, inflammation, is adaptive to health injuries or illness, unchecked, or chronic inflammation, causes damage. This is likely a mechanism by which obesity worsens the prognosis of Covid 19.
Focus your energy on that which is within your control. Focus your energy on the present and forward. Our body weight is not directly under our control. Our choices, habits, routine, environment, and reactions are under our control (although we are not perfect, so be gracious!). Take control of what you can control. Those are the things that matter, anyway.
Let me know how I can help.
Dr. Valerie Sutherland