And the most unfair part of this disease is that weight gain itself is yet another contributor to weight gain, which is one of the reasons the disease is considered progressive. Weight gain causes a number of hormonal, metabolic and molecular changes in the body that increase the risk for even greater fat accumulation. Such obesity-associated biological changes reduce the body’s ability to burn fat for energy, increase the conversion of glucose (carbohydrate) to fat, and increase the body’s capacity to store fat in fat storage depots (adipose tissue). This means that more of the calories consumed will be stored as fat. To make matters worse, obesity affects certain regulators of appetite and hunger in a manner that can lead to an increase in meal size and the frequency of eating. Weight gain, therefore, changes the biology of the body in a manner that favors further weight gain and obesity.

Obesity is not a cosmetic issue but it is a serious health issue. You are only 47 and you already have several diseases related to the disease of obesity. Many of these diseases will diminish the quality of your life and may shorten your lifespan. Weight loss will obviously not be easy and it rarely works, as you have pointed out, with a quick diet with its 10-pound weight loss that invariably goes back on since you never changed everything else in your life that could be changed. Find a supportive team led by a bariatric physician who treats  overweight and obese patients with diet, nutrition, exercise, behavioral therapy, appropriate medications, or any combination of these treatments. Identify saboteurs, both people and situations, that promote the behaviors that you must change for health and do all that you can to eliminate them from your life. Enlist your family in this journey because many of them will succumb to the diseases associated with the disease of obesity. After this, it is one day at a time with gradually increasing exercise and a “diet for life and a diet for living well.” I wish you much success as you begin this journey.

I have asked Dr. Brian Landzberg, a board certified gastroenterologist and member of our Medical Advisory Board,  to answer your questions about fatty liver disease.

Dr. Pat