In the name of survival, the body will fight you every step of the way as you try to lose weight. In fact, for every kilogram of weight lost, the body increases appetite to consume 100 extra calories/day.

The hunger hormone system is a set of connections between the stomach, intestine, stored fat, and brain. In its simplest state, the stomach and intestine send signals to the brain regarding the degree and time of gut “fullness.” That is, how long has it been since we have eaten. The brain responds by either seeking food – or not. Likewise, the amount of fat stored at any given time is relayed to the brain through this signaling network. The greater the amount of fat we have stored, the less the body signals the brain to seek food.

This system backfires on the obese individual who begins to lose weight for two primary reasons: the change in calorie intake sends the stomach-to-brain hunger hormone (ghrelin) skyrocketing, and any decrease in the amount of body fat results in a corresponding circulating leptin decrease – which signals the brain to seek food.

So, is there anything we can do? Well, as proceduralists, we have flat out bypassed this response. By removing certain portions of the gut, blocking blood vessels, modulating nerves, etc., we have squashed this otherwise formidable barrier to weight loss. This is a critical point because there is no “willpower implantation” surgery, and people don’t lose weight because “their stomachs are smaller.” These procedures change the levels of these hormones, and people have an easier time. Ditto for many of the new medications.

Likewise, we can change the levels of these same hormones on our own because of a phenomenon called retrograde neuroplasticity. Retrograde neuroplasticity changes the body from the outside in using specific, intentional behaviors – like focusing on progress, flexibility, recovery, and self-monitoring.

Obesity medicine researchers are quickly bridging the long-standing expanse between the fitness “haves,” and “have-nots,” ending the epidemic of chronic diet failures, and closing the door on fat-shaming. The future of weight loss is an exciting expanse, being filled with innovation, discovery, and new methods of intervention.