Can a Drug or Surgery Solve Your Weight Problem?

06/09/2015 05:30 pm ET | Updated Jun 09, 2016

In a word, no. Can they help? Perhaps.

Last month I wrote an article that spoke somewhat favorably of the new weight loss drug, Saxenda. I said it was perhaps the most important weight loss medication ever developed.

Wow! Did I get lambasted! I got all sorts of email blasting me for going over to the dark side and becoming a drug pusher and lackey of Big Pharma. I even got an email from my favorite professor of counseling at the University of Massachusetts, now friend, Allen Ivey, Ph.D. Besides being a friend, he is a big shot in the counseling field, the father of Microcounseling and developer of "active listening". He said he was "sad" to see that I seemed to be pushing drugs. He is the last person on earth that I would want to be mistaken about my views on the solution to obesity. We've since gotten that misunderstanding corrected, but I want to make sure it is clear with everyone who reads my blogs.

I am still the world's staunchest advocate of the behavioral therapy I teach to reverse the condition of obesity. It works -like a miracle, some say. But not 100% of the time. For some, it is not enough.

After 30 years successfully helping people to lose weight permanently, I am convinced that a percentage of the population is dealing with a physiological condition that creates more persistent and intense degrees of craving and compulsion than the rest of us have to deal with. My approach teaches people how to overcome the habits and feelings that make them overweight but sometimes those cravings and compulsions are so strong that nothing on God's natural earth will quiet them.

If you've ever had a blister on your foot or a pebble in your shoe, you'll remember that your brain is getting the message loud and clear that you need to relieve that pressure and you need to relieve it right now. You will feel the drive to relieve it until you do. It won't go away until you do whatever it takes. There is no "will-powering" it away. Something is going on in the body, physiologically and chemically, that is triggering a response in your brain that will bother you until you satisfy it. It isn't exactly the same with the food cravings that some have, but it gives you an idea of what some people are dealing with. Hold your breath for as long as you can and see how powerful the urge to breathe becomes. This is the kind of relentless drive that a small percentage of the population is fighting in their attempts to stop eating too much.

For them, some sort of intervention or tool that would make it easier for them to eat less would be a Godsend. Then, perhaps what they learn in a good behavioral approach would be enough. Self-programming and cognitive techniques like I teach work like magic for many people, but they would be so much more productive for these folks with eating hyperdrive if we could reduce that drive, which the pharmaceuticals can do. Or in the case of surgery, an additional tool to use behaviorally.

Make no mistake about it, drugs or surgery will not by themselves solve your weight problem. To solve your weight problem, you need to make a permanent change in your behavior, made possible with behavioral therapy. Success comes with learning how to eat what you like in ways that keep you at your desired weight and it becoming habitual and a new "normal" for you. Now, with these new medical interventions, success may be possible even for those who have suffered from an abnormally intensive eating drive. Weight loss drugs or surgery may now enable them to overcome the obstacles that prevented them from being able to make those behavioral changes.

William Anderson is a Licensed Mental Health Counselor who specializes in weight loss, eating disorders and addictions. He is the author of The Anderson Method.