I am one of those who have constantly increased weight, year on year, for decades. Genetic testing a few years ago (for other issues) identified that I have inherited a gene variant, that controls the amount of serotonin released via the gut - brain axis… so I don’t release as much serotonin (a ‘feel good’ hormone) after I eat, compared to the majority (maybe 99 per cent?) of the population. This gene / its role in hormone regulation has only been established in biomedical research, and mainstream medical consultants know nothing about it.
I need to look into it more, but I suspect that serotonin somehow counteracts cortisol (the stress hormone).. as part of these health investigations a few years ago, with a different consultant at a different hospital, I was told I have high cortisol levels, but no explanation was given (they ruled out the typical reasons).
I live permanently with high stress / anxiety, and have this gnawing / overwhelming urge to eat, that has been with me for decades, but has worsened as I have got older (and coincidentally this faulty gene variant tends to get worse with age). eating does help me feel calmer. WLIs do help reduce this gnawing feeling - and I can see that I am likely to be on them for life. I have to pay for them privately; despite meeting BMI / cormorbodity criteria, my gp practice says they don’t prescribe them.
Obesity is a huge problem in modern society (forgive the pun!) and I feel deep sadness that it is considered a ‘lifestyle choice’ - that obese people are ‘just’ lazy / lacking in motivation. Why is there not a greater understanding of what physiological factors / differences are driving this, and more of an emphasis on treatment for what is clearly a metabolic disorder, probably with a multitude of different possible genetic / physiological factors? For me, I think obesity is primarily a symptom of a genetic / inherited hormonal dysregulation - my body is driving me to eat (especially when cortisol levels are high) to increase serotonin. This will never go away, so I am genetically programmed to increase weight if not on WLIs…