The Future of Weight Management

The science of weight management has changed considerably over the last decade. Not only do we have a much better understanding of how our bodies regulate weight, but we also are better equipped with strategies on how to lose weight. Unfortunately, despite the rapid rate at which we are learning, our knowledge is far from complete. The complexity of the body systems involved creates a challenge, as we simply do not have all of the information regarding weight loss. For instance, any number of body systems can be involved in weight regulation, including hormonal, digestive, and/or psychological, but the role each system plays may differ between people. There is simply no "one-size-fits-all” strategy.
At times, it may seem that current research creates more questions than it answers, but the truth is that we are making progress. We now know the impact that sugar and carbohydrates can have on our weight. When we consume carbs, we cause our body to release insulin, alerting our cells that there is food available. In addition to causing our cells to absorb the sugar from our blood, insulin also triggers our body to store fat. In contrast, when we consume diets higher in fat and moderate protein, our body does not need to release insulin; therefore, it does not receive the same signals which lead to fat storage. It is for this reason, among others, that low-carbohydrate nutritional plans have been successful for so many.
There may come a time in the not too distant future (it's called ‘nutrigenomics'), where we might be able to measure various gastrointestinal and brain hormones that affect appetite and metabolism, and possibly identify those patients who have ‘leptin' resistance, and be much more able to find diet and exercise plans that are more individualized.
As you know, even when we strictly follow meal plans, losing weight is still frustrating. While the United States has approved multiple non-dietary strategies, at present in Canada, there are a limited number of options available to us. For example, the US has many more pharmaceutical approaches to complement nutrition plans. In Canada, even among the limited number of approved drugs, many are not suitable for the general population or simply may not work. Instead, they are meant to be used only in specific medical conditions. As a general rule, Health Canada approves drugs a couple of years after the American FDA has done so. Thus, we can hope that a broader spectrum of drugs will become available to us over the next couple of years. As we continue to gain a better understanding of how our bodies regulate weight loss, we hope that drug development will continue, discovering more numerous and more effective drugs to aid in weight management.
We are also becoming much more aware of those drugs that lead to weight gain, or make it more difficult to lose, and with this understanding, work with patients to make better choices; or, if we need to use them for a specific condition, we are learning of other drugs which may help counter the weight gain effect.
Newer surgical approaches are coming which are much less invasive such as the ‘endosleeve', and a device that can be implanted just underneath the skin to interrupt the signaling of the gastrointestinal hormones to the brain; this results in much less hunger, and significant weight loss.
So, it is true that we do not have all of the answers as to how to lose weight and keep it off. In the future, we will have a much more complete understanding and this new information will lead to the development of improved approaches and drugs. Until that time, however, it is important that we take advantage of our current knowledge. We know that while weight management takes time, if we stick to our meal plans, incorporate exercise when possible and continue to seek guidance when needed, then we can lose weight. We are here to help you along your journey.

You can do it! You will do it!

Dr. Doug