The ghrelin monster

A woman I interviewed for How We Did It said something striking to me. Deb Anderson had bariatric surgery -- a procedure called duodenal switch that reduces the size of stomach and creates a system in which the nutrients of food aren't entirely absorbed by the body, so the calories in it aren't either.

Deb went on to lose 140 pounds after the surgery. She went out one night to a Cracker Barrel and when it came time for dessert, she ordered a "buckeye." Now, for those of us in the Northeast, a buckeye is a chocolate-covered peanut butter nugget. Before the surgery, Deb admitted she could eat half a dozen of them easily. But on this night, she ordered one, cut it in fourths and ate only one quarter of the buckeye.

This wasn't a supreme act of will. Deb says she just didn't want the same foods in the same amount as she did before the surgery. She craved fruits and veggies, not fried foods and sweet desserts. Here's how she puts her surprising discovery of the change:

"I thought, Gee, did he do surgery on my brain or my stomach?"

It turns out, the surgeon just might have done surgery on both!

I was reading an article by Dan Hurley in Discovery magazine last night, The Hungry Brain. In the article he talks about a study showing that people who have had weight loss surgery have an easier time maintaining their loss than those who lost weight through diet and exercise.

That really surprised me! Turns out, surgery not only reduces the size of the stomach but it decimates the stomach's amount of an appetite inducing hormone called ghrelin. Those who lost weight through surgery saw their ghrelin levels plummet. The conventional weight losers saw their ghrelin levels skyrocket in direct proportion to how much weight they had lost -- the more lost weight, the higher the levels of ghrelin and the greater their appetite.

This explains a LOT. It explains why it's so hard to maintain a loss. It's not just a matter of willpower. Deb had lost and regained weight many times. "I'm smart," she said, "but I just couldn't outsmart it."

I have to be honest and say that most people who talked to me about regaining their weight in their past failed attempts to diet did so because they went back to their old habits. Environment -- the endless food cues and opportunities that bombard us every day -- plays a huge role in maintaining a weight loss. You have to remain vigilant and fight the daily urges that arise from your environment.

It's not as grim as it sounds. Like Deb, I found my desires changed over time. The food messages don't get through as often as they used to. But this new research into appetite hormones might just lead to something someday and give us all a better chance at maintaining a hard-won weight loss.