Dear Doctor Owen:

No matter what I do, I cannot lose weight! I’ve been told that my metabolism is extremely low and that genetics will cause me to be obese for the rest of my life. Is this true? If not, what can I do? I have tried to lose weight many times, but feel like such a failure!

Hopeless

Dear “Hopeless”:

Although people differ in metabolism, the differences aren’t as great as one would think. The average Basal Metabolic Rate (BMR) is 12 for males, 11 for females. This means that a 180-pound woman must eat 11 calories for each pound she weighs in order to maintain her weight:

180 pounds x 11 calories = 1980 calories/day

At age 40, the BMR drops to 11 for males, 10 for females. At age 65, the BMR drops to 10 for males, 9 for females. That is why some people put on more weight as they get older—even though they eat exactly the same as they always have!

Once you have calculated the number of calories/day necessary to maintain your current weight, you will know that intaking calories below that number will result in weight loss. (People need to eliminate 3500 calories to lose a pound of body fat.) When most people see this formula for the first time, they say, “I don’t eat that much!” So, write down everything you put in your mouth for a few days, especially on the weekends, and you will see that you just might indeed “eat that much”!

Remember: Obesity is not a character flaw. Our society, in an obvious and very deep prejudice, makes people feel that being overweight is their fault—that they must have some awful character defect. But this simply isn’t true! In your life, the who, what, when, and where are the things that cause you to increase the number of calories over your basic needs.

Who? What? When? Where?

In my experience, the who includes mothers, spouses and partners, children, relatives, friends, and work colleagues. Everybody with whom we socialize has an impact on what we eat and when we eat it. These people will not go away, so we must learn to deal with them (and teach them to deal with us).

The what is genetics: joint problems, work schedule, medication, and other diseases.

The when is Thanksgiving Day, Mother’s Day, Father’s Day, Mardi Gras, Memorial Day, weekends, weddings, wakes, Groundhog Day, happy days, sad days. . . .

Get my “drift”? Here is my advice:

• Learn the mathematics of weight management. When you see that it is just arithmetic, you will have an easier time dealing with the above factors. And this isn’t rocket science! My Down’s syndrome patients have learned the math faster than patients who are doctors and engineers. The patients with Down’s syndrome simply take the time to learn the math.
• Once you have mastered the math, look closely at the people in your environment. Identify the person or persons with whom you need to cooperate and whose help you’ll need to be successful in your dieting. Then go to them and ask for their participation.
• Set goals and achieve them. When you begin, be realistic and make the goals modest and do-able. As soon as you achieve them, set new goals.
• Get professional help, because losing weight isn’t easy. Eating is a basic instinct; not eating is like not breathing.

Finally, I want to reemphasize that being overweight is not a character flaw. The weight won’t go away by itself, and will only get worse if it doesn’t get better.