The battle against obesity is life long and you must face it going forward. Revert back to prior patterns and the weight will return with a vengeance. The reason for this is that every time we gain weight and then lose weight we essentially are priming the system for weight gain again if we enter into a state of caloric imbalance again. Each time we gain and lose weight, leptin levels rise and fall. In the process adiponectin levels fall and then rise. As they rise more fat cells can be made. So when caloric excess returns, more fat cells will be around to be stretched and thus produce more leptin. This will generate a more intense leptin resistance and thus a more rapid weight gain.

This should not be used as an excuse not to lose weight, but instead as a motivator to keep the weight loss off. You can not change your body's genes or its physiology. As a result the processes that caused the weight gain to begin with will always be in place. If the behavior patters of improperly timed and excessive eating, sleep deprivation, physical inactivity, elevated stress, depression and pain, emerge again, the weight gain will surely follow.

Obesity is a treatable disease, so do not give up hope. The treatment however rests in your hands, not in your doctor’s prescription pad. Whether you feel your weight is a problem for you or not, it is a problem for your body, and ignoring that will have consequences. Treating the consequences of being overweight, without treating the underlying cause, is putting a Band-Aid on a wound that will not heal. The lack of understanding of the mechanisms that give rise to obesity had led to failed advice after failed advice. The result has been a passive acceptance of obesity as a normal condition. Doing so has condemned 70% of Americans to a lessened life, a life with less comfort, a life with less joy, a life with less satisfaction, a ultimately a life with less life. The most tragic effect of this epidemic however, is that we are teaching our children this passivity to obesity. The time has come to draw a line in the sand. Scientists around the world have worked countless hours and unlocked the secrets to understanding obesity. They have given us the sword to draw that line in the sand, it is now up to us to pick up the sword and make a stand. Life is a gift our parents gave to us, we can not waste it, and we can not deprive our children of the same gift. Reversal of obesity, and childhood obesity especially, should be the number one goal of health professionals, parents and the government. If not, we will pay for this lack of foresight for decades to come. As the Rabbi Hillel said, ‘If not now, when, and if not me, then who?” It is time to reach for homeostasis, to balance our hunger hormones. It is time to begin.