DOCTOR: OBESITY NOT SIMPLY A MATTER OF `WEAKNESS'

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, March 22, 1993                   TAG: 9303220046
SECTION: VIRGINIA                    PAGE: A-6   EDITION: METRO 
SOURCE: By CAROLYN CLICK STAFF WRITER
DATELINE:                                 LENGTH: Medium
DOCTOR: OBESITY NOT SIMPLY A MATTER OF `WEAKNESS'
People who are overweight generally overeat, but they may also be missing the kind of body signals that tell their slimmer colleagues to pull back from the table.
"I don't like the concept that it is the fault of these people, ' said Dr. John Grant, associate professor of surgery at the Duke University Medical Center. "There are too many people like this to say it is just a weakness of the personality."
Since he began working with the super obese, Grant is more convinced than ever that genetics and the hypothalamus, the part of the brain that controls appetite, contribute to huge weight gains in certain segments of the population.
"I don't think they have the same feedback mechanisms that you and I have," Grant said. While the average person receives signals from the brain that let them know when the stomach is full, "these people don't get that feedback."
For a number of years, scientists have speculated that people have a certain "set point" system within the body that regulates metabolism. Obese people may have a higher set point and thus have a harder time removing the excess poundage.
Grant has spent the last five years researching ways to aid the super obese, developing a surgical therapy that includes a combination intestinal bypass operation, called a jejunocolostomy with intravenous nutrition. So far, he has operated on eight people and all eight have returned to normal weights, about 140 pounds for women and 200 pounds for men.
Grant said he hopes medical breakthroughs can eventually reduce the need for such dramatic intervention.
But he also acknowledges that while some people are predisposed to obesity, all of his super obese patients have a history of overeating.
"They tell me they eat like birds," he said. Some are chronic snackers, never eating a regular meal, while others simply do not realize how many calories they ingest.
Before he agrees to consider them for the operation, he counsels them about the importance of seeing the process through.
"The fear of God is in them," said Grant. "I tell them you have an obligation in the future to do well."
Nevertheless, he plans to monitor them for many years.
"It's a lifelong problem," he said. "Like alcoholism, you have to keep supporting them."

by Archana Subramaniam by CNB