Weight Loss And Why It Fails


South Africa has the highest rate of obesity in Sub-Saharan Africa, with up to 70% of women and one third of men classified as overweight or obese1.


According to Dr Gary Hudson, a Johannesburg-based physician with a special interest in obesity and metabolic disorders, obesity is globally the number one non-communicable disease, responsible for approximately three million deaths per year. Obesity is associated with many health risks and diseases including Type 2 diabetes, heart disease, stroke, hypertension/high blood pressure, joint pain and certain cancers1.


Scientific research has concluded that even by losing as little as five to 10 percent of one’s body weight, a person can gain a host of health benefits2. According to Time Magazine, a 10% loss of weight  results in noticeable changes in blood pressure and blood sugar control, thereby lowering the risk of heart disease and Type 2 diabetes: “Two of the costliest diseases in terms of health care dollars and human life”3.


Yet even though more and more people globally know the risks of being overweight, and the benefits of losing weight, why does it prove so difficult for so many? We asked some healthcare practitioners with a special interest in weight management for their insights.


Although losing weight is one of the top resolutions made every year by millions of people around the world, only 20 percent of people are said to achieve successful weight-loss and maintenance4.


Dr Muller Smit, a General Practitioner from Durbanville in Cape Town, feels that the reason so many people fail in their attempts to either lose weight, or keep it off once they have lost it, are threefold:

  • There is a general lack of knowledge and commitment; people are looking for a quick fix and seasonal weight loss which can all lead to co-morbidities at a later stage.

  • People do not have access to or follow a proper healthy eating plan which can cause feelings of deprivation and lead to eating ‘bad food’

  • We are all under time constraints, living fast paced lives and do not make the time to prep for healthy eating lifestyles.


Furthermore, Dr Grant Fourie, a General Practitioner from Bellville in Cape Town, who is also a certified Functional Medicine Practitioner and certified Diabetes Educator, says that people do not address the underlying issues that caused their weight gain to begin with. “If you are tired, depressed, on lots of tablets, going through menopause, on a contraceptive, under extreme stress; then your problem isn’t food. Your body doesn’t get fat because you’re bad, it gets fat because it is a physiological response to some sort of stress,” he says. In other words, it does what it thinks is best for you. “If you don’t like it, then you have to convince it that it is not the best for you by changing the habits it is trying to protect you from,” he explains.


His advice to people who want to lose weight is to commit only to a program that is sustainable for a year or more, and not to fall for a fad. “Anything extreme or processed that makes promises of massive short term weight loss is a lie. Anything that uses the word “bikini” is only appealing to your desperate sense of vanity,” he says.


“Set realistic, achievable goals for yourself. Know how and why you want to lose weight. Then seek professional advice to ensure a follow through. Start small with your plan and make it realistic to your current lifestyle, this will ensure you lose weight at a healthy rate,” advises Dr Smit.


“I always start with a good history and general check-up, blood tests if indicated to determine the cause why my patients are overweight, then start them on a sugar free plant based diet, lower/no animal protein ratio with or without an appetite suppressant until they have reached their goal weight. This ensures the healthy balance ratio eating plan is in place,” says Dr Smit who does recommend the use of a medically approved weight loss treatment for some of his patients to help them “get over the release of dopamine which is stimulated by simple sugars in their diets and also helps them get over the cravings.”


For many, the thought of losing even five to 10 percent of their weight can be a very intimidating. Medical research has shown that there is strong and consistent evidence that overweight and obese patients in well-designed programmes can achieve a weight loss as much as ten percent of their baseline weight5.


Prescription medication, even though it cannot be used indefinitely, can safely kick start your weight loss and, together with long term lifestyle adjustments such as a healthy eating and exercise plan, can help you on your weight loss journey5.


Dr Fourie believes that weight loss can never be underpinned by exercise. Ideally, food must be eaten according to the true physical demand on the body. “So you shouldn’t need to exercise to lose weight. But if you’re sedentary, you hardly need to eat at all. Unfortunately, fit people seem to eat less than sedentary people. Boredom and “relaxation” are the major drivers for rubbish eating and drinking and general poor health choices” he says.


Reinforcing this is the fact that leading global researchers seem to have finally agreed that exercise, while critical to good health, is not an especially reliable way to keep off body fat over the long term3.


Dr Smit believes in getting his patients to understand and follow a tripod approach “Sleep followed by diet and assisted with exercise. These three work in synergy together to create homeostasis or an internal balance which will start the cycle of creating healthy internal functioning which will make sure their lifestyle changes become a way of life,” he says

According to Dr Jessica Bartfield who specializes in nutrition and weight management at the Loyola Centre for Metabolic Surgery & Bariatric Care in the United States of America, only twenty percent of people will lose weight and keep it off, despite two-thirds of Americans admit to being on a diet. She says that there are four main reasons where dieters go wrong, namely underestimating how much you actually eat every day, overestimating how many calories you burn through activity, poor timing of meals and inadequate sleep4.


Dr Smit says that it takes 66 days for an average person to learn a new habit or adopt a change in their lifestyles. “Losing weight is a lifetime change and depends on how much weight you need to lose. Having weight loss goals are important to ensure you lose the first five to10kg within three months. This also helps patients feel motivated to continue with their weight loss and ensures a sustained healthy lifestyle,” he says.


This opinion is backed by a study which was conducted to examine whether gradual initial weight loss was associated with greater weight reduction in the long-term when compared to quick initial weight loss6.


Researchers from the Department of Clinical and Health Psychology at the University of Florida in the United States found that there were both short- and long-term advantages to fast initial weight loss. “Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers,” the study concluded6.


Speak to your doctor about options for weight loss management or go to www.ilivelite.co.za for more information.

To contact Dr Grant Fourie, go to www.drgrantfourie.co.za and to contact Dr Muller Smit, go to http://www.drmsmit.co.za/

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. This editorial has content that includes independent comments and opinions from independent healthcare providers and are the opinions and experiences of that particular healthcare provider which are not necessarily that of iNova Pharmaceuticals.

Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.




1. National Obesity Week: South Africa’s weighty problem – The Heart and Stroke Foundation 2016 (http://www.heartfoundation.co.za/media-releases/national-obesity-week-south-africa%E2%80%99s-weighty-problem) (Accessed on 15 August 2017). Pietrzykowska, NB. MD, FACP. Benefits of 5-10 Percent Weight-loss. Obesity Action Coalition. (Accessed on 15 August 2017). 2. The Weight Loss Trap – Why Your Diet Isn’t Working. Time Magazine. 25 May 2017 (http://time.com/magazine/us/4793878/june-5th-2017-vol-189-no-21-u-s/). 3. Bartfield, J. Loyola Center for Metabolic Surgery & Bariatric Care. Top Four Reasons why Diets Fail. Science Daily. 3 January 2013. (https://www.sciencedaily.com/releases/2013/01/130103192352.htm). 4. Phelan S, Wadden TA. Combining Behavioural and Pharmacological Treatments for Obesity. Obes Res 2002;10(6):560-574. 5. Nackers L, Ross K and Perri M. The Association Between Rate of Initial Weight Loss and Long- Term Success in Obesity Treatment: Does Slow and Steady Win the Race? Int J Behav Med. 2010 September ; 17(3): 161–167. doi:10.1007/s12529-010-9092-y.