Lori Anderson: Waist management beyond Christmas

It HAS been an incredible journey, one we all have shared. We have been swept along undulating rivers of clotted cream, past golden mountains of oleaginous goose flesh, scaled the bosomy boozy indulgence of the traditional Christmas pud, and made it all the sweeter with shards of chocolate peppermint bark and the odd crinkly Quality Street. Sadly, it is time to alight from the good ship Indulgence and pay the ferryman.

Today, on this groaning Boxing Day morning, more than a quarter of Scots are obese, 27 per cent, up from 17 per cent in 1995, and we are not alone

Fat is no longer a feminist issue but a global one. The world is struggling under the weight of its citizens. In America, two-thirds of all adults are now overweight, with 36 per cent of adults and 17 per cent of children now classed as obese, while even China – which once endured widespread famine – has a population which is 25 per cent overweight. Today 1.5 billion adults or one third of the world’s population are overweight or obese and obesity rates have doubled in 20 years. Staff at Tulane University in Louisiana estimate that, by 2030, 3.3 billion people will be overweight or obese.

It seems that we are biologically predisposed to be a certain weight and our bodies fight against dropping below whatever that magic number may be on the scales. If you fall below the point at which your body is happy, the level of the hormone leptin which tells the brain when to stop eating drops, while the volume of ghrelin which tells us that we are hungry is turned way up.

A study by the University of Melbourne found that one year after individuals had lost weight through dieting, their levels of leptin were still below normal and their ghrelin levels above average. Their bodies had failed to accept the new paradigm – while they were delighted with their beach-ready bodies, their genes wanted them back in a muumuu at once.

When Dr Rudolph Leibel of Columbia University studied patients before and after they had lost 10 per cent of their body weight through dieting, he discovered that their brain activity, which previously was unaffected by images of food, now signalled great excitement.

As he explained: “The evolutionary process has led to a gene pool that is designed to defend bodyweight against falling below a minimum but not to defend against gain.”

So, can drugs help? The question which obsesses the chief executives of the world’s leading drug companies is whether or not a “magic bullet” can be developed that will successfully tackle the global obesity crisis. While dozing off the effects of too much goose and plum pudding this Christmas, they will have dreamed of the glutton’s answer to Viagra and the billions that would soon sluice into their bank accounts if they could only crack such a complex chemical code. Many have tried in the past but diet drugs tend to throw up problem side-effects and the American Food & Drug Administration (FDA) has not approved a diet drug since 1999, that is, until now. Two new drugs have recently been passed by the US watchdog, so are we on the brink of a pharmaceutical watershed? Not quite. Last September, the Californian pharmaceutical company Vivus launched a drug called Qsymia, which contains phentermine, a drug that boosts levels of leptin in the body and so helps to reduce appetite. This is also mixed with a drug previously used to treat migraine sufferers, called topiramate, which also makes people feel fuller.

According to a report in the Economist on Qsymia’s clinical trials, those patients who took Qsymia and embarked on a regime of diet and exercise lost more than 10 per cent of their bodyweight in a year compared to the control group downing placebos, which lost 1.6 per cent.

However, before you throw up your hands in delight, it’s not expected to come to Britain any time soon as European regulators refused to issue a licence over concerns that it could affect the heart and central nervous system.

The pharmaceutical company Arena may have better luck. Next year, it launches Belviq, which tweaks serotonin receptors in a way that makes people feel more full. In clinical trials, the group on Belviq lost 5.8 per cent of their bodyweight, compared to the control group’s 2.5 per cent.

So while we are waiting on a chemical fix, should we squeeze ourselves, like marbled sausage meat, into a lycra skin then slouch off to the gym? Yes, of course we should exercise regularly. Workouts can raise our spirits and ward off depression, they reduce the risk of heart disease, diabetes and breast cancer, but what they don’t do is what has always been claimed – namely speed up our metabolism so that we burn off more calories. This has been disproved and research has shown that we are more likely to work up an appetite after sweating it out at the gym and so we wolf down a bigger than average portion at our next meal thus negating those few calories which we have burned off.

The gym is not the answer, and too much emphasis is still being placed on exercise as a means of achieving weight loss.

If there is an answer it seems to lie with a combination of camaraderie and encouragement from portly peers rather than a doctor’s stern advice.

The diet industry is worth £40 billion a year worldwide, with the average person trying to lose weight four times a year. The most effective method, according to the Lancet, is joining a support group such as Weight Watchers, as a recent study found that those who attended such groups lost double the weight as those who simply sought the advice of their local GP.

There are other little things that can be done which have proved effective, such as putting all sweets and biscuits on to the highest shelf so that in a moment of weakness the effort involved in hauling them down may trigger a sharp change of mind.

If global surveys on obesity have taught us anything, it is that we are not alone, nor should we be. It is so easy to put on weight, for many of us our paleolithic genes want nothing more than the comfort of those extra kilogrammes, as back then it was survival of the fattest.

In today’s overabundant world populated by the modern day sirens KFC, Coca Cola, McDonalds and Krispy Kreme, it can be hard to resist their call. Sugar and fat light up our brains like a pinball machine and their texture tastes so sinfully good in the mouth that we momentarily forget that they are furring up our arteries.

But when we become aware of the damage that obesity will do, not only to each of us but to society as a whole as the NHS buckles under the weight, it behoves us to correct our path and set out on another journey, one more arduous than that of the past few days, but no less incredible.