Rewards and Punishments

A brief article we saw today via CNN described a Mayo Clinic study which indicated that people who were given a fairly modest cash prize tended to do better on their weight loss regimen than those who were not. It seems pretty obvious that, for a person with severe obesity, it will take more than a $20.00 reward to take the place of a well thought out approach that includes bariatric surgery. It did, however, get us thinking about the way we humans are motivated when it comes to such issues as food and exercise.

A old friend of ours had a mother with a serious weight problem that had caused her to have fairly severe high blood pressure and type 2 diabetes. Even so, she invariably come back from the store with a wide selection of just the kind of fat-laden foods that had caused her condition. When her son asked her why she'd kept buying such large amounts of this kind of food, she's start talking about how inexpensive it was (usually, a coupon was involved). Her son told her to think of the doctor bills. In fact, her later-life health problems, including a stroke and kidney failure, did eventually cause her a great deal of suffering while also requiring extremely expensive 24-hour care that wiped out a very large portion of her life savings-- but that was all far in the future at the time.

We don't have to tell anyone reading this how strong the body's drive to eat really is. One reason we believe that gastric sleeve surgery may be so efficacious is that it removes the part of the stomach that produces a hormone called ghrelin which appears to be at the root of that drive, which often tells overweight that they "need" to eat more despite the fact that they've consumed more than enough calories. In this way, the gastric sleeve appears to short circuit the means by which we become too overwhelmed with faux hunger to actually consider the real rewards and punishments of eating the right amount of the right foods or eating too much of the wrong foods. Since hormones like ghrelin basically work on the human brain, it really seems to us that the the chemistry of the mind may be the last great frontier when it comes to battling obesity.