Please enable JavaScript in your web browser to ensure this site works as intended.

Bariatric and Metabolic resources for a healthier life

EducLearn about weight loss surgery options to lose weight



Understand the effects of bariatric surgery and metabolic health

Your body’s set point and how it affects your weight

If you’ve been trying to lose and maintain weight but you haven’t had any luck, you are likely fighting against the normal workings of your body. Body weight and fat levels are regulated by a complex system of signals in your body. These signals control your appetite, digestion, energy balance and metabolism to keep your body weight and fat at a steady level or “set point”.

Your body’s set point is part of a basic biological instinct. When body weight and fat levels fall below your set point, your body activates defense mechanisms to maintain body weight and fat in order to prevent starvation, even in people with obesity. Dr. David Katz, the founding director of the Yale University Prevention Research Center, said, “Throughout most of human history, calories were scarce and hard to get, so we have numerous natural defenses against starvation. We have no defenses against overeating because we never needed them before.”

Everyone’s set point is different and can be changed. It appears that the body regulates fat set points similarly to how it regulates other body functions such as blood glucose, cholesterol, and blood pressure. Set points are affected by genetic, developmental and environmental factors. Changes in any of these factors can lead to an elevated set point for body fat storage. For example, changes in the chemicals and nutrients contained in our foods can affect our brains in ways that increase the amount of food we eat and increase our body fat set point.

Additionally, as you gain weight, your set point is increased and your body works to defend the higher set point. Your body is smart, and it adapts when new things come its way. But, sometimes it’s not for the better. Your body doesn’t realize it’s overweight and it continues to store higher amounts of fat than necessary.

Understanding Obesity and the Metabolic Impact of Bariatric Surgery

Video Transcript

Research is revealing the true nature of obesity—shedding light on one of today's most common questions: "Why can't I lose weight and keep it off?" The traditional view that...

Why dieting and exercise isn’t enough to fight obesity

Because your body works to defend its set point, dieting and exercising are rarely effective in helping people with obesity achieve and maintain a healthy weight long-term. When you go on a diet, your body thinks it’s being starved and its survival instincts kick in. As a result, your body stores energy-rich body fat, and you can’t lose weight easily. A landmark Swedish study found that, on average, a 200 pound patient fighting obesity with diet and exercise alone would only be able to achieve a sustained weight loss of 4 pounds over 20 years.4

95% of obese people that lose weight with a rigorous weight loss program will regain the weight (or more) within 2 to 5 years42

Unfortunately, your body’s hormones are working against you. When weight is lost, lower body fat levels trigger hormones that encourage the body to get back to its previous weight set point. A New England Journal of Medicine study showed that while dieters may initially lose weight, their bodies change levels of hormones that encourage weight regain in response to the weight loss. These hormones increase appetite, decrease feelings of fullness, and slow down metabolism. The study also found that these hormones had not returned to pre-diet levels even 12 months after the initial weight loss, meaning their bodies were still encouraging weight-regain a year after they stopped dieting.3 This is a powerful defense mechanism and may explain why the majority of weight loss attempts fail.

Surgical intervention is the most effective treatment for obesity to date. Weight-related health conditions were resolved in up to 80% of people.2

Bariatric and Metabolic surgery may help reset your “set point”

In order for a person with obesity to achieve significant long-term weight loss, the body’s weight regulation system must be reset so that the body will stop storing excess fat. By altering the complex relationship your body has with food and its metabolism, bariatric surgery helps reset your body’s ability to effectively manage weight. New research indicates that some types of bariatric surgery (gastric bypass, sleeve gastrectomy, and bilo-pancreatic diversion) have metabolic impacts that enable a new, lower set point, allowing the body to return to a lower body fat level. By altering the anatomy of the stomach and/or intestine, these surgeries affect hormonal signals, resulting in decreased appetite, increased feelings of fullness, increased metabolism, and healthier food preferences. These positive changes allow your body to lose weight without the internal fight to return to the higher set point.

Understand the effects of bariatric surgery and metabolic health

Without the medical intervention that bariatric surgery provides, many patients with severe obesity are not successful in managing their weight and related health conditions. “[Bariatric surgery]is the most effective treatment to date, resulting in sustainable and significant weight loss along with resolution of weight related health conditions in up to 80% [of people].”6 Bariatric surgery may resolve diabetes, sleep apnea, join pain, high blood pressure, high cholesterol, and diabetes.

Diabetes was partially or completely resolved in 68% of patients following gastric bypass.2

Significant improvement with type 2 diabetes

Evidence suggests that metabolic and bariatric surgery changes the chemical signals between the stomach, intestine, brain, and liver – changing the underlying mechanisms of diabetes. Recent research from the Cleveland Clinic showed that gastric bypass and sleeve gastrectomy surgeries are more effective than intensive medical treatment alone when it comes to managing uncontrolled type 2 diabetes in overweight or obese patients.7 The study authors concluded that “bariatric surgery represents a potentially useful strategy for management of uncontrolled type 2 diabetes, capable of completely eliminating the need for diabetes medication in some patients and a marked reduction in need for drug treatment in others.”

Findings indicated that:

  • At least 3 times more surgery patients achieved normal blood sugar levels than intensive medical therapy patients.8
  • 42% of gastric bypass, 36.7% of sleeve gastrectomy and 12.2% of medical therapy patients achieved HbA1c <= 6.0%.8
  • Bariatric surgery significantly reduced the need for diabetes medications and eliminated the need in more than 50% of patients.8