Neuroscientist says lasting weight loss requires ‘identity shifts,’ not just willpower

Neuroscientist says lasting weight loss requires ‘identity shifts

Losing weight — and keeping it off — can feel like an uphill battle, even with the growing popularity of weight-loss medications.

OAKLAND, Calif. - Losing weight — and keeping it off — can feel like an uphill battle, even with the growing popularity of weight-loss medications.

A study from the National Institutes of Health found that 80% of Americans who lose a significant amount of weight regain it within five years. 

That pattern, according to neuroscientist Susan Pierce Thompson, is not about motivation. It’s about biology.

What they're saying:

"Our fat cells remember the weight they used to be at, and so does the brain," said Thompson, author of the book "Maintain: The Three Identity Shifts that Turn Temporary Weight Loss into Lasting Freedom. "

"The brain toggles dials hormonally to force us back up the scale once we’ve lost weight."

Thompson argues that long-term weight maintenance requires what she calls three "identity shifts" — changes that go beyond diet plans and daily habits.

"Fundamentally, you’ve got to become a different person," she said. "The same person will eat again and regain the weight."

What you can do:

The first shift, she said, is devotion to a chosen eating plan. 

Thompson compares it to the way a vegetarian adopts a firm identity around not eating meat.

"A lot of people think they’re going to lose weight one way and then go back to the way they used to eat and keep it off," she said. "It doesn’t work that way. Whatever you’re doing to lose the weight, you’ve got to be devoted to that system to keep it off."

The second shift involves becoming "resourced," meaning developing alternatives to cope with stress besides food. That might include starting a meditation practice, building a support network of friends on a similar health journey or finding other outlets to manage daily pressures.

Finally, Thompson said people must allow themselves to be "liberated" from the long-standing struggle with food and weight — and be prepared to fill that mental space with something new.

"For many people, dieting has taken up a huge amount of headspace for most of their lives," she said. "Once that problem is solved, you’ve got to be willing to fill that vacuum with other pursuits."

Big picture view:

The conversation around weight loss has shifted dramatically in recent years with the rise of GLP-1 medications, originally developed to treat diabetes and now widely prescribed for obesity. 

Thompson said those drugs have changed the landscape — but not necessarily the long-term outcomes.

"Right now, people are using them as a diet," she said. "They’re getting on them and then getting off them, and that doesn’t work."

Research shows that most people who stop taking GLP-1 medications regain the weight, she said. If patients choose to use them, Thompson argues they should be prepared to view them as a long-term tool.

"If they’re going to be effective long term to really turn the tide on the obesity epidemic, people need to accept that they’re going to be on them for life," she said.

As for calorie-counting apps and macro trackers, Thompson said technology can help — if used consistently.

"What gets measured gets managed," she said. "You’ve got to find something that works for you and then be devoted to it for the long term."

Ultimately, Thompson said, lasting weight loss is less about a temporary change in habits and more about a permanent shift in identity — one rooted in understanding the brain and body’s powerful drive to return to a previous weight.