The doctor explained the ineffectiveness of diets for obesity

In case of obesity, diets rarely give a stable result, since the body activates defense mechanisms and slows down the metabolism. Pavel Biryukov, a bariatric surgeon at the SM Clinic, told Izvestia about this on February 22.

According to the expert, with obesity of the second or third degree, many people continue to try to solve the problem on their own — with the help of strict diets. When changing the diet, weight can actually decrease, but the effect is usually temporary.

"The reason is that the body perceives drastic weight loss as a threat to survival. In response, it activates protective mechanisms: metabolism slows down, hunger increases, and hormonal balance changes. The body literally starts to "save" energy and resist weight loss," the expert said.

He added that obesity almost never has a single cause. Most often, we are talking about a combination of factors — overeating, genetic predisposition, hormonal disorders, chronic stress, and a sedentary lifestyle. Taking certain medications may also play an additional role.

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As the doctor noted, it is extremely difficult to achieve a sustainable result without the participation of specialists. So, the treatment of obesity is not just a reduction in the number on the scales, but a change in eating behavior and maintaining the effect in the long term.

In addition, Biryukov drew attention to the special relationship between obesity and type 2 diabetes. Excess weight is an active hormonal tissue that affects the functioning of the entire body (regulation of appetite and satiety, blood glucose levels and insulin sensitivity, concentration of estrogens in the blood). With obesity, cells gradually stop responding normally to insulin, the hormone responsible for glucose uptake, the expert noted.

"In response, the pancreas begins to produce more insulin, trying to "push" glucose into each cell. For a while, the body copes, but gradually this mechanism fails: blood glucose levels rise, and diabetes develops," the expert emphasized.

According to the doctor, this is not a "sudden illness", but the result of prolonged metabolic disorders, which affects many organs. Without weight loss and lifestyle changes, it is very difficult to affect blood glucose levels, and the risk of complications — damage to blood vessels, heart, liver, kidneys, and vision — increases significantly.

Currently, many patients turn to injectable drugs based on semaglutide or tirzepatide for weight loss. However, as the expert noted, these drugs do not yet have long-term studies that allow an objective assessment of their impact on health in the future. In addition, after drug withdrawal, weight loss often occurs. Bariatric surgery has proven effectiveness not only in reducing body weight, but also in improving metabolism.

On February 11, scientists from University College London (UCL) found that obese people have a 70% higher risk of hospitalization or death from infections. It was also noted that people with a body mass index above 40 had a three-fold higher risk of severe infection.

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