I think people underestimate the role of habit, making poor decisions regarding food, diet, environment and gluttony regarding weight gain. (I won’t mention exercise here). Obviously, internal hormones and cues are very important regarding appetite, satiety and the satisfaction from eating. These internal cues cause some people to eat often and not feel full. However, to blame only these cues is insufficent.
People who eat large amounts can become accustomed to smaller portion sizes – the “small” french fries offered at McDs were once the only available size; the ridiculously large popcorns with golden topping offered at movie theatres are to recent to be written in the genetic coda. The obesity epidemic is happening because people will eat what is in front of them, since food supplies can be scarce. I often crave a bag of popcorn. I buy the light butter 37g mini-bags. I eat it and feel full. If I had a 99g or larger bag in front of me, I would eat all of that. Portion control makes a difference.
If I eat lots of processed foods or foods high in fat and carbs, I will gain weight. Many supposedly healthy foods, from granola bars, breakfast cereals, processed mashed potatoes, buttery popcorn, pretzels and juice are often poor choices if consumed often and in high volume. In addition, sugared soda (and more Americans get calories from soda than any other food source given the volumes consumed) and “hard to resist tasty stuff” like cookies, high fat dairy, candy, chocolate, yada yada are consumed in massive quantities. Our ancestors ate very few donuts.
People who are overweight often became so gradually. The trick is not to not eat if you are hungry. The trick is to eat smaller meals, more often, from a large list of well chosen foods such as skinless chicken, vegetables, low fat dairy, lean ham and beef, fewer processed foods, fewer baked goods, sugar-free soda, no chips, no french fries, no hamburgers. People who are overweight, much more often than not, really do make bad food decisions. This is often not their fault – there is much misinformation out there (and yes, there are bad choices at Subway and healthy ones at McDs), bad labelling (“low fat”=high carb?, “low carb”=high fat?, much temptation. ridiculous portions… but also never more foods that are low calorie and taste pretty damn good. Eat these ones. And if you don’t, the benefits of the surgery lessen with time. But there are indeed benefits to surgery, starting with the impact of diabetes, coronary heart disease, stroke risk and joint problems.
