Medicine: Turn Down the Appestat

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Why do people overeat and get fat? Why, after reducing, do so many of them quickly regain the weight they have lost? In both cases, says Dr. Norman Jolliffe in Reduce and Stay Reduced, published last week (Simon & Schuster; $2.95), the answer lies in the individual's appetite-regulating mechanism—or, as he calls it, the "appestat." People get so used to overeating that they cannot feel satisfied with the right amount of food.

Long the top nutritionist in New York City's Health Department, Dr. Jolliffe believes that people may overeat for one of three main reasons: 1) simple habit,which may be the result of growing up with obese, gluttonous parents; 2) on purpose, as when a child tucks away gobs of food because then his nagging mother stops nagging; 3) psychosomatic urges, to compensate for some social, financial or sexual problem. The second and third causes eventually harden into habits.

Whatever the cause of excess weight, says Dr. Jolliffe, the only way to take it off is by cutting down the intake of calories for a while below the body's actual needs, so that stored fat will be burned. When the ideal weight is reached, intake and consumption of fuel can be equalized. The main thing, he insists, is for the dieter to realize that his appestat has been set too high and has to be set lower.

Dr. Jolliffe locates the appestat in the hypothalamus, site of the body's temperature-control, water balance and sleep-control mechanisms. It may be thrown out of kilter by injury or disease. But where there is no physical explanation for the appestat's demanding too much fuel, Dr. Jolliffe believes that the answer must be found in habit or conditioning. And it takes "time for habits to be overcome. "Eventually, however," he says, "if the reducer is conscientious, exerts his will power, and is, above all, a good sport, the appestat will usually return to a lower level, so that a smaller intake of food will give satisfaction."