Why Your Set Point Goes Up

We’ve all been told that our weight gain is the result of our individual choices and that our obesity is the result of our own failure to regulate our food intake and remain active.  While this may be true in a few circumstances, it is not true for the vast majority of patients that I see in my office.  When I meet with new patients, I spend quite a bit of time diving into the reasons behind their weight gain.  When did your weight gain start?  Are there others in your family who struggle with their weight?  What medications did you take in the past? Have you ever suffered an injury that resulted in a prolonged period of inactivity?  These questions are critical to understanding why each patient has gained weight and guides what we do in the future to minimize all factors that stand in the way of future weight loss efforts.  

As you read through this list, it is important to note that many of these factors are beyond an individual’s control and merely represent the impact of our environment on our health in exactly the same way that most other chronic conditions like high blood pressure, elevated cholesterol, diabetes, and heart disease do.   Despite this, we do not place the same burden of responsibility on diabetics or those that have suffered a heart attack that we do on those who suffer from obesity.  It would be completely unacceptable in our society to tell a patient admitted to the Emergency Room with a heart attack that it’s their own fault that they’re suffering.  However, if we carefully consider the real causes of obesity, we find that they are incredibly similar to those that cause heart disease.  Let’ start by reviewing the most common causes of weight gain that I see in my practice.