Weight is regulated, not simply chosen.
Dr. Chris Thompson has spent two decades studying how the body defends its weight, and developing ways to influence that defense from the inside.
Professor of Medicine, Harvard Medical School · Chief of Interventional Gastroenterology, Mass General Brigham · Pioneer of endoscopic sleeve gastroplasty · Co-founder, EverselfC-BIO-01
Most people think of weight as something they choose. In reality, the body regulates it, much as it regulates temperature or blood sugar, and it defends the weight it has settled on. Twenty years of treating patients have persuaded me that weight regain is biology, not behavior. The hunger that returns after a diet is not a failure of willpower; it is the system doing what it evolved to do, working against you in an environment of abundance. That shifts the conversation from self-blame to biology, and toward the more useful question of what can take the pressure off.
The ideas he keeps coming back to
Your body defends a range
The body regulates weight around a range rather than a single number, and it resists loss far more strongly than gain, which is why the range tends to drift upward over a lifetime.
ReadThe gut is a metabolic organ
It senses what arrives and signals the brain how to respond. It is also where Dr. Thompson has spent most of his career.
ReadThe environment outran the biology
The systems that kept our ancestors alive through scarcity were never tuned for an environment of abundance.
ReadWhat comes after the drugs
The treatments now under study beyond today's medications, and what the evidence shows for each of them so far.
ReadRead it in order
The argument runs in four parts and is best read in order, though you can also begin with a question on the science page.
- Part I Ancient biology in a modern world Why the ability to store energy and conserve it was an advantage for almost all of human history.
- Part II How weight is regulated Leptin, ghrelin, and the signals that pass between the gut and the brain.
- Part III When regulation becomes dysregulation What happens when those systems run for decades in an environment they were not built for.
- Part IV Reengineering metabolism Medication, procedures, and what the evidence shows each one does.
The procedure he pioneered
Endoscopic sleeve gastroplasty
Bariatric surgery had long been the gold standard for durable weight loss. Dr. Thompson began with a simple question: Why cut away part of the stomach when it could be made smaller from the inside with no cuts?
In 2012, he performed the world's first ESGC-BIO-01, bringing the stomach-reducing principle of bariatric surgery to a non-surgical procedure. Using sutures placed through the mouth, ESG reshapes the stomach with no incisions and nothing removed, allowing for a quicker recoveryC-IV-05. Patients lose an average of 20% of their body weight.
Dr. Thompson co-founded Everself to bring the procedure to patients nationwide and continues to perform it today.
Harvard
Professor of Medicine
2012
First ESG cases, current technique C-BIO-01
300+
Peer-reviewed publications
6,000+
Endoscopic procedures
The clinic he co-founded
Everself
Dr. Thompson co-founded Everself, which offers endoscopic sleeve gastroplasty, the procedure he pioneered (he performed the first cases with the current technique in 2012C-BIO-01). The clinic owns and pays for this site.
everself.com