Once you tip the overweight scales you are unlikely to ever get off again. Chronic weight losers are the big time losers. They end up stuck in the middle of cycles of weight gain and loss. Part of the problem has been the focus on energy input and output through dieting and physical activity. A neglected component is what is eliminated from the body. It’s about time to take a closer look at lean bowels and how to maintain them.

What we eliminate from our bodies is important. Weight maintenance doesn’t stop at our middles.

Weight vigilance lasts forever and requires regular disruption to a wide variety of bodily functions. We now know that nearly all weight loss programs work – but only in the short term. Most can achieve a healthy weight loss of between 5-10% of body weight – usually in the early phases of the program and most of the loss is maintained for between six and 12 months.

Losing weight is not a problem – keeping it off is.  Fifty percent of people who lose weight will put it back on within five years. Even worse for those people who are significantly overweight – the greater the weight loss the higher the likelihood to regain it.

Fortunately, the excretory processes offer new hope of an additional strategy. In the intestines there are millions of organisms (microbiome) that assist absorbing or excreting what passes through. Even though we don’t really understand yet how, these organisms can work to either absorb more or less nutrients. So building up organisms that are less energy efficient and so allow more to be expelled has the potential to maintain weight loss.

Evidence is now growing on how obesity microorganisms ie the ones that promote absorption, can be replaced by other “lean” ones that encourage less absorption. One strategy is through extreme dieting.

However, once these diets are stopped the old microorganisms come back. Using probiotics has similar effect and results.

A variety of other approaches to elimination are needed to support the urge to purge. Researchers are now looking at fecal transplants. Stools of lean people have lean stool microorganisms and when implanted into overweight and obese people they reduce unnecessary food absorption.

It’s early days and like all new obesity initiatives, it probably should form part of a range of strategies.