Obesity continues to be on the rise despite all of its advances in medications and surgeries, not to mention the invasiveness of the diet and fitness industry in this area. More than 72% of the U.S population is overweight or obese, and obesity is now rising in the pediatric population affecting our next generation. Obesity on its own occupies a large part of health expenditures in the globe and has been the catalyst for over 200 other diseases identified. This chronic relapsing disease over time has been one of the most invasive to our nation and the most difficult to treat.
We have seen relapse rates from diet and medication over 90% and post bariatric surgery recurrence rates long term have been more than 70%. The World Health Organization states that 2.8 million people die of obesity each year, a preventable disease. Even when the name was changed several years ago by the American College of Endocrinology the epidemic continued to rise. At what point will the overseeing bodies decide that this is no longer good enough?
As a bariatric surgeon and an obesity specialist, I receive a lot of questions about brain-based weight loss, specifically, 1) how it works, 2) why it works, and 3) “how does the brain affect my weight”. This article is written to break down the medical science behind my Neuro Switch Weight Loss program.
This is why after a decade of doing weight loss surgeries and prescribing weight loss medications, I had to research this more and do what I could to get the word out. I no longer wanted to operate on patients that had the potential of weight regain, I wanted to educate patients and providers on the power of the brain to prevent weight regain.
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Through the NeuroSwitch Program, I can do so much more for patients and even providers than what I was able to do as a bariatric surgeon treating patients one on one. I can now educate thousands and help them understand the root cause of their obesity.
Here is a brief overview of 5 areas of the brain that can affect your weight loss and an explanation of why.
The Hypothalamus
Our hypothalamus is like the conductor of a symphony, making sure our energy input and output are perfectly in balance. However, damage to this crucial brain region can have devastating consequences: rapid weight gain due to increased calorie intake or decreased burning abilities. On top of that, there’s also The Amygdala – our emotional center responsible for ‘tempting’ us with food cues we’ve grown accustomed to even when not hungry. It has been found that those struggling with excess weight seem particularly influenced by its power!
The Amygdala
We know that our environment can have a major impact on our eating habits, and it may be the cause of weight gain even if metabolic processes are operating normally. In fact, research shows how certain external cues can make us crave unhealthy foods despite already feeling full! But did you know elevated insulin levels also play into this? That’s why maintaining healthy blood sugar is so important – to avoid an urge for high-calorie goodies!
The Prefrontal Cortex
The brain plays a bigger role in sustainable weight loss than we ever imagined. Research shows the key to successful dieting is having control over yourself – and that’s where your prefrontal cortex comes into play! In one study, those who lost the most weight had stronger activity in their lateral prefrontal cortices – which is associated with self-control. Even getting bariatric surgery can improve these functions by expanding white matter in this area of the brain!
In their research, Alain Dagher of the Neuro Institute and Hospital showed that the prefrontal cortex has a ‘self-control’ area that can help us make healthier decisions. FMRI studies found activity increased in this region when participants underwent bariatric surgery as well as others who have lost weight and a decreased signal in the “desire” area of our brain, resulting in better long-term health outcomes as well! So it’s truly possible for people to change their brains.
The Mesolimbic System
The mesolimbic center in our brain, also known as the reward pathway, is responsible for transporting dopamine to areas related to desire and emotion. This system helps us learn rewards-based responses. Have you ever wondered what drives us to repeat certain behaviors? The answer lies in our brain’s reward pathway. This powerful network is responsible for producing dopamine when we experience pleasure, which then motivates us towards a desired goal or habit. To put it simply: the nucleus accumbens and amygdala tell your other brain areas how best to act according to associated rewards – just like training Fido with treats so they learn where they’re supposed to go outside!
“The brain plays a bigger role in sustainable weight loss than we ever imagined. Research shows the key to successful dieting is having control over yourself – and that’s where your prefrontal cortex comes into play!”
Studies have revealed that our dopamine pathways are at the heart of how we regulate motivated and habitual behavior. This includes when it comes to food – if something signals a reward, like palatable food, this pathway makes us more likely to repeat the behavior in the future. Unfortunately, with diets often involving restriction, what can happen is actually an increased drive for junk foods due to heightened levels of dopamine response! Additionally, as high-calorie/palatable goods become chronically consumed, they also mess around with natural body signaling mechanisms such as insulin or leptin production which ultimately creates an unending cycle where you just want more and cannot stop yourself from eating these unhealthy items again.
The Lateral Habenula
Life throws us curve balls all the time, requiring us to think fast and act accordingly. From instinctive responses to learned behaviors that use past experiences as a guide; our interactions with different events shape how we respond in the present moment. By connecting environmental factors with external sensory stimuli, neutral cues become associated with either positive or negative outcomes – providing indicators for what’s ahead and this in turn plays a role in your weight loss or gain behaviors.
It’s amazing how our brain is hardwired to keep us safe and help us pursue experiences that make life meaningful but sometimes, this protection can work against us. There is an area in our brain called the lateral habenula (LHb) that plays an important role in protecting us based on potential negative interactions with our environment. The LHb plays a major role in determining how we behave, both instinctively and based on our past experiences. It’s responsible for alerting us to unexpected rewards or punishments as well as making sense of external cues that predict what may lie ahead. In this way, the LHb can help determine whether it would be wiser to seek out rewarding sensations or stay away from potential danger!
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Have you ever started going to the gym for a new years resolution or tried that juice-only diet and then just stopped? The lateral habenula (LHB) plays a big role in this – it helps us determine if something external is rewarding or punishing and suppresses a motor activity when it’s going to have negative consequences. It’s what stops certain habits from becoming too automatic. This can be great for things that may really hurt us such as the juice-only diet but not so great when we are trying to establish healthier habits that can help us in the long term and may often be the reason that gym routine has not become an automatic behavior for you.
These instinctual behaviors result from a special kind of cognitive processing, so how do you get around it? By thinking differently and using curiosity, how can you switch up that gym routine to still get in exercise but perhaps not at the gym, or to eat healthier but make it enjoyable? This is how you get around that sneaky protective habenula and stop yourself from losing motivation.
And all of this brain stuff by the way is also influenced by our genes which is why learning what makes you uniquely you is the most important to any health journey ecs in weight loss. So in summary there are multiple areas in the brain that contribute to your weight gain and two main pathways that influence our actions – one is dopamine-activated when we’re presented with something rewarding or expectant, while the other pathway involves neurons in an area called lateral habenula (LHB) responds to negative outcomes and cues telling us not to do something.
As you can see the brain plays a powerful role in your weight loss journey and has several areas that can help or hurt your progress and can be very complex. So no need to blame yourself on why your previous regimens have not worked long term, instead understand your brain and its role in your weight loss journey by taking the NeuroSwitch Method program. Understanding this and being able to change your brain is key because believe it or not your brain is your most powerful tool for sustainable weight loss.
1) Flegal, K. M., Kruszon-Moran, D., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2016). Trends in Obesity Among Adults in the United States, 2005 to 2014. JAMA, 315(21), 2284–2291. https://doi.org/10.1001/jama.2016.6458
2) De Lorenzo, A., Gratteri, S., Gualtieri, P., Cammarano, A., Bertucci, P., & Di Renzo, L. (2019). Why is primary obesity a disease?. Journal of translational medicine, 17(1), 169. https://doi.org/10.1186/s12967-019-1919-y
3) Velapati, S.R., Shah, M., Kuchkuntla, A.R. et al. Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment. Curr Nutr Rep 7, 329–334 (2018). https://doi.org/10.1007/s13668-018-0243-0
4) https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity
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6) Cell Press. (2018, October 18). Weight loss success linked with active self-control regions of the brain. ScienceDaily. Retrieved January 10, 2023 from www.sciencedaily.com/releases/2018/10/181018141126.htm
7) Song M, Jo YS, Lee YK, Choi JS. Lesions of the lateral habenula facilitate active avoidance learning and threat extinction. Behav Brain Res. 2017 Feb 1;318:12-17. doi: 10.1016/j.bbr.2016.10.013. Epub 2016 Oct 11. PMID: 27732891.
8) Mondoloni S, Mameli M, Congiu M. Reward and aversion encoding in the lateral habenula for innate and learned behaviours. Transl Psychiatry. 2022 Jan 10;12(1):3. doi: 10.1038/s41398-021-01774-0. Erratum in: Transl Psychiatry. 2022 Feb 28;12(1):86. PMID: 35013094; PMCID: PMC8748902.
