The current estimates are that about 80 per cent of people who lose weight will regain it about 20 per cent of people can successfully keep it off, he says.
Professor Cowley believes this is partly due to a set point, which he says is our bodies tendency to stick to a certain minimum weight, which drifts upwards with time.
Libby Oakes-Ash pictured before the surgery.
Its not a hard-coded set point ... but you have an innate tendency towards a weight thats determined by your genes and your epigenome, he says.
Then you have environmental pressures, whether thats how much activity youve got in your life and how much food you eat. Those three factors weigh against each other and create a point of balance that you go back to.
A major factor is the fact that as we age, we lose muscle which means we burn less energy, leading to weight gain if activity doesn't increase, Professor Cowley says.
While we generally can't change our body's "set point", we can of course alter how much we eat and move, he says.
"Its really clear people can successfully change their weight up and down. You cant change the set point, but what we can do is change the things that push against it."
And while you might assume that surgery would lower the body's "set point", that isn't the case, says Professor Cowley. However the surgery will likely decrease your hunger, and the amount of food you eat, leading to successful weight loss if food intake can be controlled.
He believes that gastric sleeve surgery surgery in which about two-thirds of the stomach is cut out, leaving just a narrow tube can be a very effective solution for many individuals, but only if a surgeon has a strong patient engagement program with adequate support
Professor Amanda Salis, of the University of Sydney, agrees that almost everyone regains weight, contributing to the fact that about two-thirds of Australians are obese or overweight. But Professor Salis says there are still tangible health benefits in losing weight, however temporarily.
Theres relief from the joints. Theres relief from arthritis. Even long term, theres a reduced risk of cardio metabolic disease if a person has lost weight even if theyve regained it all.
Oakes-Ash is now trying to lose weight again slowly through a healthy diet, counselling and exercise.
She believes psychological support is crucial for anyone battling extreme weight gain particularly for those who choose surgery.
As with many overweight people, her path shows the reasons for obesity are rarely just as simple as eating too much.
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I was always very fit, very slim, very active but I married a man who had an addiction problem," she says.
Over the years I developed what they call co-dependent behaviours which happens to a lot of people that live with alcoholics or drug addicts, they develop their own addictions to something else to cope. For me it was food.
The tipping point for surgery was when she fell over her grandson and couldn't get off the floor. "I was just miserable really, very depressed."
Now Oakes-Ash's main focus is on being able to do the things she enjoys, such as cycling or playing with her grandchildren.
"I dont do those things to make me thin I do those things because they give me joy and I cant do those if Im 50 kilos overweight," she says.
Insight airs on SBS on Tuesday at 8.30pm
Larissa is a reporter and producer
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The 'set point': Why it can be so hard to maintain weight loss - Sydney Morning Herald
