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Book Excerpt: 'It’s Time to Reshape the Conversation Around Body Image'

"Fat shaming is often deceptive, steeped in misinformation and perpetuated by sources we trust."

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Book: The Book of Body Positivity

Author: Dr Rajeev Kurapati

Publisher: Penguin Random House

The author, Dr Rajeev Kurapati practices hospital medicine and holds the position of assistant professor of medicine at the University of Kentucky, USA. Triple-board certified, and specializing in obesity and lifestyle medicine, Rajeev is also the award-winning author of three books, and his writing has appeared in Slate, Cincinnati Enquirer, Journal of Medical Economics, Mind Body Green, Life Hack and Millennial Magazine.

Have you ever been bullied for being overweight? The reality of being a plus-sized person is that you’re trying to live a life just as complicated, exciting, fun and challenging as everyone else. But the problem is, at every turn, society sends the message that you should apologize for simply being in your own body. In his latest book, Dr Kurapati says, it’s time to reshape the conversation.

The Book of Body Positivity offers a fresh perspective on body image and weight management, and delves into why the measures aimed at controlling the so-called obesity epidemic have fallen short and presents solutions for a healthier future.

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Here's an excerpt from the book:

Inspirational weight-loss stories portrayed in reality shows like The Biggest Loser, and the ‘before’ and ‘after’ images featured in magazines are deceptive. They don’t reveal the big picture.

As many as 90 percent of people who have lost considerable weight will gain it back in one to five years, regardless of the method used. It is tempting to see this as a moral failing of the individual.

In this scenario, rather than shaming or, even worse, sympathizing with the person who struggles to maintain a healthy weight, the most logical thing to do is to ask the right questions: What makes our body regain excess weight every time we try to lose it and what can we do about it?

Set Point Theory

Numerous theories were proposed to explain our body’s perpetual drive to regain its lost weight.

One dominant theory explaining this phenomenon is the set point theory. According to this theory, our body has a ‘set point’, a weight at which it naturally tends to return to.

The set point theory actually applies to several parameters in our innards and is not exclusive to body weight. Consider body temperature. Our core temperature is maintained at around 36.5 – 37.5 °C. This is tightly regulated by various ‘thermostats’ spread throughout our body.

If the hypothalamus in our brain detects changes in the core temperature, it will send signals to the peripheral tissues to increase sweating or shivering, or moderate our body temperature through other mechanisms.

Similarly, our body has numerous mechanisms to tightly control its blood pressure, blood sugar, blood pH and electrolytes (like sodium, potassium, calcium, etc.) within a certain range for optimal functioning of its organs.

Our set point weight is orchestrated by multiple biological feedback control mechanisms coordinated between the central nervous system and peripheral tissues.

Unfortunately, this regulation is asymmetric, where our body is more responsive to weight loss than weight gain.

Tragically, our weight can increase without limit. We will burn more of our energy sources if we fast or expend lots of energy through high-intensity workouts, but the converse is not true; consuming more calories does not mean we will expend more of our energy reserves.

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When you decrease calorie intake by eating sparingly, the body adjusts by slowing down its metabolism, a process known as adaptive thermogenesis.

This ingenious metabolic compensation aims to reserve stored fats for any future energy expenditure. This preservation strategy allows even underweight people to function physiologically despite adopting an unbelievably lowcalorie diet.

This phenomenon also explains why underweight individuals tend to feel cold most of the time—because the body spends less energy warming itself to conserve energy.

Adaptive thermogenesis is lifesaving during a legitimate famine.4 In instances of food scarcity, the body will express gratitude for this survival mechanism.

Still, it is also inevitably more frustrating and depressing when the body actively resists one’s effort to lose weight. Besides slowing down your metabolism when you cut back on calories, your mind and body also fight to increase appetite, compelling you to eat.

The result is a rapid weight rebound the moment you return to a regular diet. This yo-yo-ing is frequently observed in those who follow the ketogenic (minimal carb, high fat) diet, which can be very effective in weight loss.

However, the minute they discontinue this diet, they gradually regain all the lost weight.5

Your body has a ‘set point’, a weight at which it naturally tends to return to.

On top of the body’s recoiling tendency to regain lost weight, it is also possible that a person will gain weight even if they exercise regularly. Physical training helps improve the strength and efficiency of your heart, lungs and muscles.

While this is priceless if you are trying to improve your heart–lung function, it causes sheer frustration in the long run if you are trying to lose weight.

With improved muscle efficiency, you might notice your morning jog getting easier over time, which seems like a good thing, but it also means you are burning less energy than before to do the same intensity of exercise—you won’t be burning as many calories as you were before unless you start jogging a little faster or increase the distance jogged.

(Excerpted with permission from The Book of Body Positivity, by Dr Rajeev Kurapati, published by Penguin Random House.)

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