Your question would make more sense if you forgot about weight. Obesity is defined as excessive body fat and even normal sized or thin people can have abnormal accumulation of body fat. You must also look at the difference between abdominal obesity and total body obesity.

After bariatric surgery patients tend to lose mostly lean body mass until they start eat more food. Then they start to slowly loss fat. For various reasons, these patients tend to eat differently after the surgery. They often eat less sugar and high glycemic carbohydrates because of dumping syndrome. Their brain also seems to change after the surgery and their strong cravings for sweet and starchy food seem to subside, at least for a while.

When they change the type of food they are eating (and to some extent the amount), they become metabolically healthy and their brain function improves. Over time their cravings can slowly start to come back and if they follow their cravings and eat more processed food, they start heading back in the wrong directions again. This accounts for the late failures of bariatric surgery.

We now believe that consumption of processed food can eventually trigger a form of food-induced brain dysfunction called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Most people with obesity seem to have this type of brain dysfunction that tends to drive more fat storage. Bariatric surgery temporarily reverses CARB syndrome.

The bottom line is if people avoided processed food in the first place, our obesity epidemic would virtually disappear.

I am not sure about the answer but I tend to agree with you that 10% weight loss always improves metabolic profile regardless of starting weight

Changing adipokine profiles accompanied with weight loss improves glucose sensitivity, cardiovascular function, and reduces inflammation; this is due to changing adipocyte volume.

Hi! We have seen significant improvements in FSL and glucose homeostasis at even 5% weight loss among subjects were just overweight or obese I. Some effects such as the improvement in insulin resistance that accompany weight loss are much more acute effects that are seen immediately after weight loss. A fraction of this improvement is lost during the weight regain or maintenance ( though it could still be better than at baseline). Improvements in HDL and TG are seen much more after weight loss has stabilized. There is an interesting paper by Johansson in AJCN (2012) that looks at gene changes during weight loss and weight maintenance, that he concludes are two biologically distinct events. The bottom line seems to be that any weight loss needs to be sustained in order to accrue clinical benefits.

The effect of acute weight loss and weight maintenance on inflammatory markers, BP and endothelial dysfunction needs further study. I wish we had more trials reporting their weight loss and weight maintenance results. Most weight loss trials have fantastic results in first 6 months or so when weight loss itself plateaus. Longer trials dont seem to have that kind of startling results. Would love to hear your experiences/ thoughts.

Your question would make more sense if you forgot about weight. Obesity is defined as excessive body fat and even normal sized or thin people can have abnormal accumulation of body fat. You must also look at the difference between abdominal obesity and total body obesity.

After bariatric surgery patients tend to lose mostly lean body mass until they start eat more food. Then they start to slowly loss fat. For various reasons, these patients tend to eat differently after the surgery. They often eat less sugar and high glycemic carbohydrates because of dumping syndrome. Their brain also seems to change after the surgery and their strong cravings for sweet and starchy food seem to subside, at least for a while.

When they change the type of food they are eating (and to some extent the amount), they become metabolically healthy and their brain function improves. Over time their cravings can slowly start to come back and if they follow their cravings and eat more processed food, they start heading back in the wrong directions again. This accounts for the late failures of bariatric surgery.

We now believe that consumption of processed food can eventually trigger a form of food-induced brain dysfunction called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Most people with obesity seem to have this type of brain dysfunction that tends to drive more fat storage. Bariatric surgery temporarily reverses CARB syndrome.

The bottom line is if people avoided processed food in the first place, our obesity epidemic would virtually disappear.

I agree with William Wilson that processed foods may be more indicative of poor biomarkers than weigh loss, particularly for persons on a medical regime. Directly after surgery, all tissue is lost, lean and fat, and the person has drastically reduced their caloric intake. This is not a permanent condition, so biomarkers should be measured when the person is on a regular diet plan (life-long). On the other hand, reduction of total body weight does have some protective effects, at least by indirect measure of biomarkers. The over-all damage done by obesity cannot be measured by lipid panel and glucose.