1. Habit of excess calorie intake; A lot of people have developed the habit of excess food intake, and given that habits are difficult to break, it makes managing obesity problematic.
2. Defective fat regulating hormone (leptin) by resistance and transport failure:
As previously stated the fat regulating hormone (leptin) acts by inducing loss of appetite when the level of body fat is high. In some individuals this hormone that regulates appetite can become ineffective either due to resistance often caused by large calorie, high fat food intake or failure of transport of the hormone leptin to the brain to stimulate the appetite regulating centre of the brain. Occasionally there may be a structural defect in the hormone hence unable to work efficiently. Under these circumstances the body loses it ability to control appetite and help control weight.
3. Set point for leptin /adiposity: Each individual has a set point for the fat regulating hormone leptin determined by a certain level of body fat at which there is a trigger for the hormone leptin to be released to act and reduce appetite. In leptin resistance the set point is elevated and makes control of obesity difficult. Thus the more you eat high calories / high fat diets the more you induce leptin resistance and the more to compound your ability to control your weight.
4. Drastic weight reduction not effective: It is documented that 95% of people who lose weight regain it because most obese people employ drastic measures to lose weight. Obesity is a chronic disease and successful management cannot be achieved over a short time, but rather through an effective long-term management programme involving full participation of individuals who must accept long term lifestyle changes if meaningful success is desired.
5. A decrease in calorie intake is often results in a reduction in the basal metabolic
rate. Any extra calories taken over and above this new reduced basal metabolic rate is then stored as fat.
6. Diet or Exercise alone doesn’t work, but must involve a combination of appropriate physical activity status and appropriate dietary control. Dieting alone causes the brain to give the interpretation of the presence of famine and hence manipulates the Voluntary utilization of stored fat is similar to the temptation to spend purposeful money savings for a specific ‘big project’ energy equation. Additionally increased physical activity would demand supply of extra energy supply. In view of the reluctance to utilize stored energy, the brain would modify basal metabolism especially cutting energy supply to less important cells/tissues in an effort to try not to utilize the stored fat. It appears that unless the physical activity and its demand for energy supply hits a critical high threshold stored fat will not be utilized.
7. Wrong type of exercise / wrong diet. Some dietary regimes proposed for weight management involve either restricted carbohydrate or fat intake. Long-term use of such regimes would result in malnutrition because the diet is not balanced. Such practices are unhealthy generally.
8. Lack of emotional support. The obese woman needs the support of family and friends to achieve success. Words of encouragement are key to keep the level of motivation high to keep up working on weight management.