13 January 2015

The obese can teach us how to lose weight


Why can obese people not just make the extra effort, change their diet and lose weight? New research from University of Copenhagen shows that patients who have been through gastric bypass surgery can teach us important lessons about weight loss: if we are to change our eating habits, we need to take into consideration the experiences we have had with our favourite foods – so that eating remains linked with quality of life.

- Dieticians, medical staff, and the obese themselves all know how to count calories, but it has proven extremely difficult to translate this knowledge of food into permanent weight loss. Eating habits are difficult to change because they are inextricably linked with wellness, identity, and bodily experience. My research shows that it if we want to improve our chances of attaining permanent weight loss and simultaneously maintaining quality of life, it may be necessary to establish a link to our previous unhealthy lifestyles, says PhD Line Hillersdal, who has just defended her PhD thesis at University of Copenhagen's cross-disciplinary research project Governing Obesity.  

Line Hillersdal has interviewed 32 patients who have undergone gastric bypass surgery – more specifically the type of gastric bypass where the size of the stomach is reduced. Her research has focused on the gastric bypass patients’ eating experiences before and after surgery.

Eating habits change dramatically

Gastric bypass is a major surgical procedure, which changes eating and dietary habits dramatically: After surgery, the patients can no longer hold large quantities of food, but need to eat smaller amounts at regular intervals. The patients also need to eat in a different way as foods rich in fat, sugar and fibre may cause discomfort in the smaller stomach.

- For many obesity patients, the post-surgery diet is contrary to everything they used to like about eating – the very experience of eating as well as the social aspect of it changes – and for some it feels like an encroachment, Line Hillersdal points out and adds:

- Many gastric bypass patients associate fullness with eating food in large quantities or food that, on paper, is unhealthy. The gastric bypass operation cannot change that. Because of this it can be problematic when dieticians advise them to eat more vegetables or, if they want to indulge themselves, have a small piece of dark chocolate. The patients I have interviewed say that they do buy dark chocolate, but that it just lies uneaten in the cupboard because they do not associate dark chocolate with a pleasurable eating experience.

Heavenly mouthfuls may help us lose weight    

Gastric bypass patients tackle the limitations imposed on their eating possibilities very differently: some are capable of changing their eating habits while others become depressed, get eating disorders and begin to put on weight again. But some find little loopholes that enable them to change diet and still manage to find pleasure in eating.

- Several of the patients used the term “a heavenly mouthful” to describe the experience of having a condensed version of something they used to love eating and that does not fit into their new healthy lifestyle – such as for example buttered toast. This allows them to have the desired taste experience without eating too much unhealthy food.

Even though the obese patients’ struggle to lose weight and change diet may seem exceptional and extreme, Line Hillersdal argues that their experiences with gastric bypass surgery can teach us important lessons about changing diet and eating habits.

- The chances of achieving permanent weight loss increase if the person who wants to lose weight can maintain a link to what he or she feels is a pleasurable eating experience. This link can be established through “heavenly mouthfuls”.


PhD Line Hillersdal
University of Copenhagen
E-mail:  njh933@hum.ku.dk
Phone: + 45 21 17 93 28