On 4th June 2021 the U.S. Food and Drug Administration approved Wegovy (semaglutide), a new drug treatment for weight management. The under-the-skin injection is an appetite suppressant, mimicking the hormone glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate food intake.
The approval of Wegovy reflects the state at which modern society is at when it comes to losing fat and keeping it off. Dieting failure rates, although disputed, are often quoted as very high. In 2016, over 1.9 billion adults were overweight, 650 million of whom were obese.
Losing fat and keeping it off can be difficult. Why?
Just move more and eat less. Simple, right? The problem with this is that while the statement is simple, the process is anything but. We are surrounded by innumerable fad diets that claim to be the way to finally help you shed those pounds. Carnivore, paleo, low carb, vegan, blood-type and warrior diets, just to name a few.
We are also bombarded with marketing from businesses selling superfoods that claim to cleanse your gut and speed up your metabolism. Remember acai berries? Unique exercise routines claim to ‘torch your fat’ and help you gain muscle as quickly as possible. What sounds simple, just moving more and eating less, is mired in infinitesimal complexity.
Many of our towns and cities are ‘obesogenic’ environments. Let’s go back several thousand years before the advent of agriculture. Our ancestors were hunter-gatherers searching for resources, which at times would have been scarce. Long periods of time could go by without sustenance and a failed hunt could mean no food for the next few days.
Contrast the hunter-gatherer lifestyle to the lifestyle many of us live today. We have access to shops and restaurants within a short walk’s distance. Within those shops and restaurants are choices of hyper-palatable, calorie-dense foods. A short walk isn’t even needed now. We just need to tap a few buttons on our phones, and food is delivered to us within a few minutes.
The obesogenic environment promotes overconsumption of calories. Many foods are manufactured with additives that make us want to eat more and the effort required to do so is minimal.
Habit & cultural norms
Perhaps you’re used to having 2 sugars with your coffee. Maybe you spread a generous helping of butter on your toast. You might be downing an energy-dense post-workout shake after a training session. Often these small habits that you don’t think twice about add hundreds of calories to your daily intake.
In some countries such as Tonga, there’s a cultural tradition to offer food to guests. If more food is offered, this is a sign of greater respect. Tonga has an obesity epidemic with 90% of the population overweight or obese. Mutton flaps exported from New Zealand, which contained 40% fat, were exported in large quantities to Tonga. The flaps were considered unworthy of consumption by people in New Zealand and were often used in dog food.
Some have argued that without sufficient public understanding of the health concerns associated with overconsumption, the exported mutton flaps were eaten by people in Tonga. The situation was so bad that some dentists were even wiring jaws shut so people could go on a liquid diet to lose weight! Tonga banned these mutton flaps in 2020.
Conversely to the point above, there’s an argument that obesity is a problem in Tonga because people are disregarding their culture. Traditional diet in Tonga consisted of dishes made of fish and vegetables. But natural, whole foods are now looked down upon. There’s an allure to having something foreign, whereas traditional Tongan foods are viewed as inferior.
Controlling the overcosumption of calories in a way that makes us feel satiatied is key, however you choose to do this (preferably with a regular exercise program). Perhaps you enjoy counting calories and consuming below a maintenance figure every day. Or maybe you prefer to push the counting aside and focus more on changing habits that don’t promote overconsumption.
The ‘best’ diet for you will be one that’s sustainable, that manages your hunger and keeps your calorie consumption under control. It’s unlikely a magic pill can do the work for you. Even if Wegovy cuts your hunger and you lose weight, once you’re off… it’s down to you. And that’s when you’ll need to keep eating satiating foods that are low in calories.
And the good news is, losing weight doesn’t mean you need to eat less. As long as you’re consistent in your low-calorie, satiating food choices, you can eat a lot and still lose weight.