Firstly, though, I have one small quibble with Dr. Sharma to put out of the way. When one is 250 pounds, (female and 5' 5"), and one remains at that weight for several months: is there something wrong with the body's "energy homeostasis'? Dr. Sharma assumes there is--
one can look at excess body fat simply as a sign or symptom of the fact that there is a something “wrong” with energy homeostasis.
But I thought homeostasis refers to whether or not one's weight is stable, not how much body fat is being stored. There is absolutely nothing wrong with one's "energy homeostasis" if one's weight is stable--even if it is "too high" by some measure.
To say what Dr. Sharma said is to assume that there is a "correct" or proper amount of fat to be stored on each and every body and that it is the job of whatever it is that contributes to "energy homeostasis" to achieve it. If body weight is in excess of this "correct" amount, then something is broken. I agree there is something broken, however, if someone is carrying too much weight--and it could be my marriage as much as confused satiety signals.
What exactly is not working to produce this "correct" or proper amount of body fat in each person's body could be any number of things, as Sharma says:
Only when we find what is causing the excessive intake will we have made a diagnosis of what is causing the problem - a few specific examples could include: poor meal planning, peer pressure, hedonic overeating, depression, obesogenic medications, binge eating disorder, defective satiety signaling, etc. The point is that till we know what is causing the overeating, we can’t fix it, which means we will have little success in treating the weight problem and will be limited to a “symptomatic” approach - just eat less! (emphasis mine)
On the other side of the "energy equation"
when the problem appears to be lack of activity, again the question is what exactly is causing the problem. Obviously if the problem is lack of time our approach will hopefully be very different than if the problem is back pain or lack of motivation (a possible symptom of sleep apnea, exhaustion or depression). A “symptomatic” but useless approach would be to simply recommend 10,000 steps. No better than offering an ice-pack to someone with a fever.(emphasis mine)
So, here's a check list for periodic review:
1. Do I have a food plan?
2. Is there anyone "pressuring" me to eat other than what is on my plan?
3. Am I eating for the rewards it brings me? Do I have a plan to cope with that?
4. Am I using food to treat my emotions, specifically, depression?
5. Am I on any medication which causes weight gain?
6. Do I have binge-eating disorder? If so, am I getting effective treatment for it?
7. Do I find myself unable to feel full after I eat? If I do feel full, do I continue to eat anyway? Do I want to continue eating?
As for exercise:
1. Have a scheduled time for a workout--or do I just hope to make it a part of my day, some where?
2. Is my back pain an impediment? Do I have a treatment plan for it?
3. If I'm not motivated to exercise, what are some of the ways I can motivate myself?
I am having trouble getting in my planned exercise: so I think I may make up a list of advantages for that and read that 2x a day!