We're gonna move wanna live under discussion about it and good luck to allele on -- -- planets I just think -- the hearts. Com about weight loss and and positive or negative feedback we've already heard from Daniel Callahan who was. Interviewed on -- WL 1937. By Henry du pre he's a proud prominent bio atlantis' he talks about that she aiming. I don't know that negative reinforcement really worrisome. Unless it's. You know lot of pain involved -- and -- as good as the loans loans subject there and it's a story for another David Patrick O'Neil joins us right now from. Patrick got -- on good morning doctor Patrick -- where do you join us from. Good morning I'm in Charleston south Carolina at the Medical University of South Carolina. And immediate past president of the obesity society. I'd end just -- -- -- knows it'd go into the region history of -- WL we found out the doctor O'Neill grew up into the -- listening to -- W I was wells so. We what I dubbed W Ralph Stanley is is -- far reaching an extended a tell us what -- obesity society was that doctor. It's -- primary professional and scientific associations or people who lower. Working in the area of obesity both doing the search in the area as well as -- working publicly that help people. Deal individually the thereupon problems with -- obesity. Mom I didn't doctor edited and done of these doctor Callahan and -- Daniel Callahan they're very thin man idea if I might ask any ideas from people who are wondering are you yourself (%expletive) -- -- ever struggled with a weight problem or not. I met them pretty healthy weight right now I've been about. Forty pounds heavier in the past. Was the beneficiary of good genes from my parents but I still have to work to an attendant. If -- it is much is that like two and exercises little like two -- gain weight. And days sub if if time were T it would be an interesting science experiment disease especially living your new loans. If I already go buck wild crazy and eat whatever I wanted and like you know you're -- exercises little as I could. I'll bet she you'd have to come get him a forklift and now mean that disrespectfully that's how that's how -- -- again I think the point is. It goes to discipline and I don't think any animal kingdom. Things -- that much differently is that much different rather because they think if you look at the mild. And animal and is just my opinion I'm not trying to solid Fred Willard and Christopher Guest movies anything but he Gilligan a wild and animal will will hunt only as much as it has to but if you look at a pet that's kept. If the food's available. And you see so many people that if have animals that are obese I mean up pet it's captain dale pretty much is on foods there yes and I'll. Well I think is true for many pets and it's certainly tougher for us humans. To resist the siren song of the very fattening and the rich environment will let -- get better. That's why I brought it up because a pet is eating for the most part you know pet food and NN. All of us I think at some point or maybe not have tested dog food on a bad or as a kid just did goof around and taste and -- -- you know Abbas is not very tasty. But I -- dog is not bombarded with. You know I mean just if you've ever tried to lose weight put the TV on and watch how many commercials come on for. For this ice cream or that don't matter this cookie or or their candy bar. So the pet doesn't handle all of that they don't handle these goods fried foods over the delicious things we have in Louisiana but yet. If the food's available later read it because they don't have to god in the hunt for days and meet its basic needs and go ahead guys and get that out. Well no I mean you're right elbow is hardly crawfish it is. But we. You know we're all faced with a lot attempting from everywhere and we've got bodies that were designed. To bring our ancestors through times the uncertain food availability. Periods of time went -- was not a bills so the program. To overeat when we have -- -- particularly its its very palatable or tasting food that doesn't mean we have to religious means that we all have. Something of a drawn -- to do that and it does take. Call it discipline -- different -- patterns whatever. Two deal with the environment that now has to go around all the time. And in a variety of form recently for. Really -- As for some people would stop for another -- that's a lot of folks still recognizable and obesity. It's tougher for some people pushed away from the table and wrote but the want a number of interest in studies have been done recently. Where using imaging techniques. Researchers have looked at the brain activity -- people when they're presented with pictures of food. And what they find is that there's different patterns of activity often in the brains of people who are obese compared to people or not. I've lost about forty pounds and 85 times in my life seems like goes away then. If I don't stay with the exercise and say what I and keep watching one AD keeps. Common bag and then getting worse and yankees coming back the same forty pounds and and I've heard talk of this bodies set point but what is a researcher on that. Well a lot of research to show that once you have been overweight that your body tries to defend that higher weight. For various reasons and in various ways so before you gain that -- down the first time. You your body was -- one condition after you've gained and lost affords country a little different shape. And I don't mean -- out of shape but I just mean that. The system and your body that are trying to get you back to that higher weight so it's a challenge to legislate and that's another challenge is different -- to keep at all. On the topic at hand -- Daniel Callahan the bio ethicists talking about. That she gaming and positive and negative reinforcement. -- in terms of motivation. Is there any data that indicates. One works better than the other in terms of motivating people lose weight. Well shaming does not work we certainly know that from clinical experience and from. Looking at studies we panel also on the fact that obesity is so widely statement size and our society as a business. So if if we're going to work we would not have been increasing rates of obesity that we had. Another thing is that it -- the people who are obese don't know and my experience is that just about all of these people are aware. That they -- more dimension from a health standpoint. And if you engage in conversations they can tell you a lot of ways in which could cause them discomfort. And and pain at various kinds it's physical or psychological. So tell somebody -- obese is not necessarily gonna contribute to a zone problem. You draw the analogy of smoking but there's a huge difference there and that smoking is the behavior and obesity is not obesity as a condition. We -- shame smokers as individuals. The behavior smoking less socialist statement to. But -- to -- further statement size the condition of obesity is not going to help. To any extent. What we can't do effect on society wide basis that maybe change some of our norms about what's acceptable. In terms of portion sizes what's acceptable consumed for everybody regardless of their weight. And what are what's acceptable on the part of people selling them in terms of promoting. Excessively lower -- can also try to make it more positive and more appealing. To get more active. And you're seeing and that's a lot of places as were paying more attention and making sure that we have sidewalks of new developments. On making sure that bridges. When possible have pedestrian. Lanes -- sidewalks on them and I'll I'll ignore the prior discussion about the other issue -- -- but if we can have an environment that. Allows and encourages us to be more active then guess what everybody becomes more active. He has so much of it in my life seems like habit and I was evident discussion. With somebody about this the other day when it -- in -- good handed mode. The year eaten right. Your exercise in years stain on the program you know that yet yeah you gotta pay for what you put your mouth by. I'd burn and it off with the exercise and you don't crave the foods that seems like -- you do when you're not working out. And it's Obama handed both good and pants -- keep yourself on and on it the right side on the good side the the Nat -- did the angels' side of of eating properly and -- the -- side of criminally garbage in your mouth and coming out. But you know I courage our patients to get out of the rectory and give them a bit rot. Because you're right -- that is very very important if you can get some better patterns of automatic. A lot better off we find that when people adopting healthier eating plan. And lose in some way don't even have been maintaining their weight. The overtime they actually have fewer cravings for the old. More fattening and unhealthy. -- and so I think that's especially important. And you need to remember also that you didn't put the weight on all of a sudden so to go crash diets. And all of a sudden go from meeting anything you want to eating cracker entering and some water in a lot of ways it it doesn't your body shut down and and and an essence your metabolism slows and that hurts the process. But your metabolism -- somewhat when you go on a reduced calorie diet when your body senses that you're taking in fewer calories than it's burning. But that's the condition you have to get to the lose weight however. The example you mention of that going on an extreme -- is certainly not helpful. You wind up -- in the wrong way to lose a lot of water weight Jerusalem muscle weight and the problem is not the border way to the most awaited -- And to lose a pound body fat. There -- rules from Asia got burned about 3500 calories more than you take him over that period of time. So that's a lot of exercise that's a lot of hours surprise that takes a while. -- so it does require a certain amount patients. Any thought he'd leave his let's before we we say goodbye to the efforts -- money that is is motivated now on up positive. Angle and they they decide you know what and we try to get healthy -- trying to lose weight. Sure a couple of things one does make a commitment to yourself that you're going to start making some changes as you can stick with. Another is to for a few days keep track of everything that you eat and drink with calories in it. To see where you're really getting the most calories and -- If there's some items that you could more easily dispense with. Well we encourage people to -- themselves regularly about once today people -- That and that way you concede despite the daily ups and downs is just reflect changes in water which you considered -- overall trend this. -- a few changes which you can make focus on those and then let that success built helped you build on build some other successes that you dodger we appreciate your time. -- pleasure.