I think we know less about a lot of metabolic processes than we need to. It’s obvious that obesity is correlated, especially since losing weight often makes sy

I think we know less about a lot of metabolic processes than we need to. It’s obvious that obesity is correlated, especially since losing weight often makes symptoms disappear. I think we need to better understand precisely what the metabolic pathway is. Losing weight obviously is the best intervention, but the statistics I’ve seen indicate that for people needing to lose in excess of 30 lbs the success rate of keeping the weight off is <10%. So while it’s the best intervention, it’s not a particularly effective one. An interesting note, bariatric procedures have had mixed results in this arena, laparoscopic banding has basically been abandoned as ineffective over the long term, in favor of vertical sleeve gastrectomy (restrictive) and gastric bypass (restrictive and malabsorptive). Paired feeding research indicates that the greater weight loss from bypass vs. sleeve does not just come from malabsorption, but from an as yet unknown metabolic change.