The body-weight set point. What can you tell your patients?

Body weight can be viewed as a physiologic variable that, like core temperature, is regulated at a specified level or set point. Adjustments in both food intake and energy expenditure are used to stabilize weight at the set-point level. Animal studies indicate that some forms of obesity can be regarded as instances of regulation at an elevated set point, while other forms seemingly result from a regulatory dysfunction. Possibly, a similar distinction between regulated and unregulated forms of obesity can be made in humans. Traditional weight-loss programs may be effective in treating unregulated forms. However, if obesity is the consequence of regulation at a high set point, a metabolic resistance to weight change will be encountered and weight loss will be difficult to achieve or maintain. Help for such patients will await development of safe and effective methods for altering the set point.