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By the end of the film, the 300-pound 18-year-old had his bariatric surgery and, to his delight, lost 147 pounds. "I’m a whole human less in weight," he exulted.
Indeed, he had lost the equivalent of his skinny twin’s total weight. (It’s worth noting that this surgery is recommended only as a last resort. And even then, a patient should make sure that his physician is an experienced bariatric surgeon who has performed many operations. The risks are real -- and harrowing. Nevertheless, for this young man, the procedure was a huge success.)
What about the former tomboy who gained 125 pounds after becoming an executive at Microsoft? Humiliated when she spilled out of her airplane seat and onto her fellow passengers, and frustrated that she could no longer participate in the sports she loved, she became even more depressed when she had difficulty getting pregnant.
That’s when she and her oversized husband signed up for a comprehensive program that includes doctors, nutritionists and trainers.
By the time the film was completed, they were still exercising and dieting, though they hadn’t lost much weight. Many obese people find it all but impossible to lose weight and keep it off. Their body fights every attempt to shed pounds as neurological signals flowing from their gut to their brain overrides their conscious will. Thanks to genes that we are only beginning to understand, they are hardwired to maintain a certain weight.
This is what makes obesity a chronic disease -- and a lifelong struggle. Nevertheless, this couple wasn’t giving up.
"You just have to keep on falling off the horse, and getting back on," said the former athlete. And recognizing this fact is half the battle.
The good news is that, by the end of the film, the couple were finally pregnant. The delighted mother-to-be expressed her determination to try to remain as healthy as possible. Having a child will, no doubt, motivate her to keep on exercising.
And when it comes to better health, exercise may well be much more important than trying to achieve the svelte figure that society holds in such high esteem. A U.K. study presented at the Society of Behavioral Medicine Scientific Meeting in Cambridge in 2006 tells the tale.
The yearlong study of 62 women ages 24 to 55 encouraged them not to diet but to take part in exercise classes. They were required to do four hours a week of exercise such as tai chi, aqua aerobics or circuit classes. The program also included educational sessions teaching the women how to read food labels as well as behavioral therapy to help the women respond to body cues such as hunger and feeling full. But the women were encouraged to eat whatever they wanted, in moderation.
The women who took part in the study all had a body mass index over 30, which is classed as clinically obese. After a year, the average participant had lost very little weight. But the women were significantly fitter and happier with themselves. Blood pressure, heart rate and cholesterol fell, and respiratory fitness increased. The women also felt better in terms of general well-being, body image, self-perception and stress.
"People of all sizes and shapes can reduce the risk of poor health by adopting a healthier lifestyle," Dr. Erika Borkoles, exercise psychologist at Leeds Metropolitan University told the BBC. "Health care professionals need to shift their focus from weight loss to helping their patients improve their health."
Borkoles said the program, which has been set up with Leeds City Council, gave the women discounts to continue exercise classes after the 12-month project finished.
Dr. David Haslam, clinical director of the National Obesity Forum, confirmed the study’s findings: "It is quite well known that you can improve your lifestyle and reduce your risk of cancer, stroke and heart disease. You can improve fitness without losing weight, as you can gain muscle and lose fat and weigh the same or even gain weight."
But he disagreed about shifting focus from weight loss to exercise. "It's important to think across the board."
Nevertheless, for those who cannot lose weight, "Exercise without weight loss is an effective strategy for obesity reduction" according to a study published in the Journal of Applied Physiology in 2005.
