Do You Really Need to Lose Weight?

As a Bariatric Specialist, patients and colleagues often ask me about tips/tricks to achieve fat loss. It’s important to first ask the key question: Should I be trying to lose weight? The answer is ambivalently yes/no. If yes, it is imperative not to proceed without a comprehensive support system. BMI (Body Mass Index) is a quantitative index used to categorize an individual’s mass as “normal”, “overweight”, or “obese”. Most people in the Overweight category (BMI 25 – 29.9) or the Obese category (BMI >30), believe that weight loss will be good for them … surprisingly not in every case! Most people who are trying to lose weight do so with a primary goal of improving self-image above optimizing health. Excess weight increases pre-disposition for conditions such as diabetes, high blood pressure, and liver complications. If left untreated, these conditions develop into life-threatening diseases. All persons with BMI>25 should have a comprehensive physical and thorough screening for weight-associated health conditions. However, many people with a BMI >25 have no signs of weight-related health problems, and can actually remain healthy over the long term. There is little doubt that losing extra fat would make these people healthier. The hurdle is that long-term weight loss is an extremely difficult endeavour. The majority of people who lose weight regain it (and sometimes more). This is known as weight cycling; losing and gaining weight several times over the course of a lifetime, which has adverse effects on metabolic health. Also, it most certainly has negative psychological effects. People who have weight cycled often harbor feelings of shame and hopelessness, low body image, and tend to be socially withdrawn. I typically encourage relatively healthy, overweight patients to shift their focus away from weight loss and toward healthier living. Choose to engage in healthy habits such as becoming more active, eating more vegetables and fewer refined foods. The big player is getting adequate sleep, which will improve health at any weight. Many people who carry extra weight have difficulty accepting that weight loss is not required for better health and well-being. Nutritional, physical and psychological support from a dedicated team of professionals WILL be helpful. For people who have weight-related health issues, focusing on weight maintenance is the healthier option to promote overall well-being. When a person loses weight by making changes to diet and exercise patterns, changes occur within the body that resists further weight loss and actually encourage weight gain. Hormones that signal hunger increase and fewer calories are burned. Modifications to appetite and metabolism do not diminish with time. If you have been successful in shedding and sustaining weight, your efforts are commended! If you or your physician thinks that you would benefit from additional sustained weight reduction, you have options. It may be time to seek additional support and programs which offer a comprehensive approach including mental health optimization, obesity medication, or bariatric surgery. Invest in your life; invest in your health – because you are worth it.


Dr. Sarah Chapelsky, MD, FRCPC (GIM) – Bariatric Internist – FH Medical