“I eat almost nothing, but I’m getting fat”. A reader’s story and an answer from an endocrinologist

The editorial office received a letter from reader Svetlana. She told her story of her struggle with excess weight and asked for advice. We publish the letter with the permission of the heroine.

“My situation, I think, is familiar to many. After marriage and the birth of children, I had no time for myself – to clean, cook, wash, clean again, take the children, take the children, do their homework, walk the dog and so every day! There was no time to eat. Sometimes I didn’t even have time to drink tea during the whole day. But the most interesting thing is that my weight and fullness never went away.

As long as I can remember – always diets, hunger strikes, detoxes. I do not remember when I last ate cake, and here again plus five kilograms for the last month. I read a lot of literature on this subject and decided that it’s time to be examined. Suddenly my problem is a lack of vitamins, trace elements, impaired metabolism …

It’s been two years. Once glimmering hope to find the cause of “inside the body” has worn out the family budget, cans of dietary supplements remained undrunk, in the desk appeared weighty stack of tests, and on the scale was plus a kilogram.

But I didn’t give up. After consulting with a nutritionist, I went on interval fasting. Three weeks of excruciating hunger in the evenings led to the loss of only two kilograms. Soon there was no more strength for such strict dietary restrictions, and I gave up hunger strikes.

Now I continue to gain weight. I don’t know what to do about it. Every Monday, I’m still trying to get a grip on myself.

Never blame yourself for gaining weight. And our reader is not to blame for what is happening to her. You have to figure out the problem, and that’s the main thing, almost half the success.

I can tell you right off the bat:

• it’s not hormones – endocrine diseases that could lead to obesity are detected in one in a thousand;

• it’s not metabolism, which is a completely abstract concept that means nothing in real clinical medicine;

• it’s not vitamin D deficiency or the entire Mendeleev table. Our grandmothers, who survived one civil war and two world wars, ate much worse, but were slim as goats; the story about minerals and vitamins is commercialism and advertising;

• it is not fluid retention, as a healthy and large body cannot retain 20 kg of fluid, according to the number of extra kilograms – this will not allow a normally working heart, kidneys and other organs.

Tests are the bane of modern society. In order to refer for them – you do not need a doctor, they are sold, they have become a commodity like pies at the train station. Some negative memory of the past has instilled in modern people a fundamentally wrong, and often dangerous notion that the more tests you do, the healthier you will be.

According to the laws of statistics, if Svetlana studies 100 parameters in her blood, even if she is practically healthy, she will find deviation of five of them from the reference, which is incorrectly called the norm. What do you think the reader will think about her metabolism and the cause of her overweight, seeing the deviation of five parameters on the analysis form?

Svetlana has already lost weight on different diets, and lost weight, one way or another, on all of them. More or less. Indeed, any diet, which directly or indirectly, through all kinds of tricks leads to calorie reduction, is effective.

So, any “diet” with calorie restriction leads to weight loss. Actually, to lose weight is not a problem, a person will endure everything. The problem is to keep the weight.

Diet is a finite concept, it is a kind of vow not to eat something or, on the contrary, to eat for a while. It is not prescribed for life.

To be clear, let’s give an example.

A patient even with severe alcohol dependence can stop drinking alcohol for some time (conditionally, until the New Year). He will fall into depression, he will dream about vodka, at the same time he will see December 31 ahead as a light at the end of the tunnel, when he will certainly get drunk.

Question: what was the point of putting up with it until December 31? What did it accomplish?

An obese patient may agonize, daydreaming about stuffing himself to the brim with fried chicken and potatoes. He’ll lose weight, but then he’ll crash and gain even more weight back. So, dieting is ineffective, the way of eating and living needs to be changed on a permanent basis.

Would you believe that a gasoline-powered car can go without gasoline? Or that your cell phone can run without charging for a month? Or that a light bulb can light up without electricity on the grid?

Why then should I believe that Svetlana gains kilograms of body weight, but eats almost nothing? All these are examples of the law of conservation of energy.

Let’s stop here for now and put it this way:

Sveta, if you are convinced that you eat nothing and gain weight – do not waste time on examinations, do not jump into the circle of endless restrictive diets. Start keeping a food diary for two or three weeks (write down everything except water, coffee and tea without sugar!) and see what, how much and when you eat, without deceiving yourself… Most likely, everything will become obvious.