Table of Contents
Introduction
In recent years, the global struggle against obesity and the quest for weight loss have become central health concerns, touching the lives of millions around the globe. Despite an abundance of information, ranging from diet plans to fitness regimes, a significant number of individuals find weight loss to be an elusive goal. The journey towards shedding pounds, for many, is fraught with setbacks, frustration, and confusion. This widespread challenge raises an important question: Why is weight loss so hard?
At the heart of this question lies the complex interplay of biological, psychological, environmental, and social factors that influence an individual’s weight. The simplistic view of weight loss, often boiled down to the mantra of “eat less, move more,” fails to account for the myriad of factors that determine one’s ability to lose weight and keep it off. Genetics, metabolism, lifestyle habits, and even the very environment we live in all play crucial roles in our weight management efforts.
From a biological standpoint, our bodies are hardwired to resist weight loss. Evolution has equipped us with mechanisms to conserve energy in times of scarcity, which in today’s world of abundant food supply, works against our weight loss goals. This biological predisposition means that for some, losing weight is not just a matter of willpower but a battle against their own physiology.
Psychologically, food is not merely a source of energy; it is deeply intertwined with emotions, traditions, and social interactions. Emotional eating, stress, and the use of food as a reward are common barriers to weight loss. These behaviors are often deeply ingrained, making them hard to change. Furthermore, the modern food environment, characterized by easy access to high-calorie, nutrient-poor foods, exacerbates the challenge, making healthy eating choices more difficult.
The influence of the environment extends beyond just the availability of food. Exposure to endocrine-disrupting chemicals (EDCs), found in everyday products from plastics to pesticides, has been linked to increased fat storage and weight gain. These chemicals interfere with hormonal balance, subtly influencing our weight in ways that are still being understood.
Social factors, too, play a significant role. Our social networks, family, and cultural practices can either support or undermine our weight loss efforts. Peer pressure, social gatherings, and even the expectations of those around us can make it challenging to stick to healthier choices.
Moreover, certain medical conditions and medications can significantly impact an individual’s weight, making weight loss even more challenging. Conditions like hypothyroidism, polycystic ovary syndrome (PCOS), and the side effects of medications such as antidepressants and antipsychotics can all contribute to weight gain or hinder weight loss. This article aims to delve into these complexities, offering a nuanced understanding of why weight loss is so hard. By exploring the top 10 questions asked about the difficulties of weight loss, we seek to provide insights grounded in scientific research, shedding light on the multifaceted nature of this challenge. Our goal is not only to inform but to empower readers with knowledge that transcends the oversimplified narratives surrounding weight loss. In doing so, we hope to offer a path forward that acknowledges the individual struggles and encourages a more compassionate, holistic approach to achieving and maintaining a healthy weight.
Biological Factors
Understanding weight loss requires exploring the biological elements that shape our bodies and influence weight. Genetics, metabolism, and physiological responses form the foundation of this complex process. This section delves into the crucial biological factors that make weight loss challenging.
The Role of Genetics in Weight Loss
Genetics significantly influence our body’s predisposition to store fat, our metabolic rate, and even our appetites. Specific genes, such as the FTO gene, are linked to a higher risk of obesity, making weight loss harder for some individuals. Genetic predisposition can determine how efficiently our bodies metabolize food, store fat, and experience hunger and satiety. This explains why two people on the same diet and exercise plan can have different weight loss results.
Metabolic Adaptation to Dieting
Metabolism, the process of converting food and drink into energy, is influenced by factors like age, sex, muscle mass, and activity level. When we cut calories to lose weight, our body adapts by becoming more efficient at using energy, known as metabolic adaptation. This survival mechanism slows down weight loss by reducing the calories burned at rest and during activities, leading to weight loss plateaus despite strict dieting and exercise.
Metabolism’s complexity extends to the thermic effect of food (TEF), where different nutrients require varying amounts of energy for digestion. Protein, for instance, has a higher TEF than fats and carbohydrates. Hormones like leptin and ghrelin, which regulate hunger and satiety, also change in response to weight loss, often increasing hunger and reducing fullness. These hormonal shifts make sustained weight loss more challenging.
Understanding these biological factors highlights the complexity of weight loss and the body’s natural resistance to change. Personalized approaches to weight loss, considering individual genetic, metabolic, and hormonal profiles, are essential. Recognizing and addressing these biological challenges allows individuals to navigate their weight loss journey with strategies tailored to their unique physiological makeup. Effective, sustainable weight management goes beyond “eat less, move more” and requires a deep understanding of the body’s biological intricacies.
The Influence of Environmental Chemicals
Recent research highlights a critical yet often overlooked factor in obesity: environmental chemicals, particularly endocrine-disrupting chemicals (EDCs). These substances, found in everyday products like plastics, pesticides, cosmetics, and furniture, disrupt hormonal functions, impacting fat storage, metabolism, and obesity risk.
EDCs and Their Impact on Weight
EDCs interfere with hormones that regulate metabolism, growth, and energy balance. This disruption can lead to weight gain and hinder weight loss efforts.
A key group of EDCs, known as obesogens, promotes weight gain by:
- Increasing Fat Cells: Some EDCs trigger precursor cells to become fat cells, increasing fat storage capacity.
- Disrupting Appetite Hormones: EDCs interfere with leptin and ghrelin, hormones that control hunger and fullness, leading to overeating.
- Altering Metabolic Rate: Certain EDCs lower the basal metabolic rate, reducing calorie burn at rest and complicating weight loss.
Examples include Bisphenol A (BPA) in plastic bottles and phthalates in personal care products and food packaging, both linked to obesity by altering fat storage and hormone levels.
The Challenge of Avoiding EDCs
Avoiding EDCs is difficult due to their pervasive presence in products and the environment, including canned food linings, thermal paper receipts, air, and dust. However, being aware of EDCs can lead to better choices:
- Opt for fresh or frozen foods instead of canned goods.
- Use glass or stainless steel containers over plastic.
- Choose phthalate- and paraben-free personal care products.
Advocating for policies to limit harmful chemicals in products and the environment is essential for public health.
Recognizing the role of EDCs in obesity adds a crucial layer to understanding weight loss. It emphasizes the need for comprehensive strategies that address environmental factors, moving beyond individual behavior changes. By tackling the influence of EDCs, we can develop more effective interventions and policies to support healthy weight management and overall well-being.
Psychological and Behavioral Aspects
Weight loss goes beyond diet and exercise, deeply involving psychological and behavioral elements. Understanding the mental struggle with food and the necessary lifestyle changes highlights why weight loss can be so challenging. This section delves into these complexities, underscoring the need for a holistic approach.
The Psychological Battle with Food
Food is more than nutrition; it’s comfort, celebration, and social connection. This emotional bond makes weight loss hard. Emotional eating—using food to cope with feelings rather than hunger—leads to overeating and weight gain. Breaking this habit means addressing deep-rooted behaviors and finding healthier stress management strategies.
Culturally, food often serves as a reward, complicating healthy eating. High-calorie treats given as rewards reinforce bad habits. Overcoming this requires awareness and alternative emotional regulation and reward strategies.
Habits and Lifestyle: The Challenge of Change
Lifestyle choices significantly impact weight. Sedentary habits, common in our tech-driven world, promote weight gain. Changing these requires effort and motivation. Our environment, geared toward convenience, often hinders physical activity. Adapting to a weight-loss-friendly lifestyle means altering daily routines and integrating more movement.
Dietary habits are equally challenging. Frequent fast food, high-calorie snacks, and large portions are tough to change. These patterns, influenced by family, culture, and personal preference, require more than willpower. Understanding nutrition and developing sustainable, enjoyable eating habits are crucial.
Integrated Approach
Psychological and behavioral aspects are intertwined—stress can lead to emotional eating and inactivity, while poor diet increases stress. Tackling these issues needs a multifaceted approach: psychological support, nutrition education, and habit-changing strategies.
Addressing these challenges demands support from healthcare professionals, family, and friends. Recognizing and overcoming psychological and behavioral barriers can lead to a healthier body and a better relationship with food and exercise.
Environmental and Social Influences
Weight loss is profoundly shaped by the environments and social contexts individuals navigate daily. These influences, ranging from food availability and urban planning to cultural norms and social networks, are pivotal in either supporting or hindering weight loss efforts.
The Food Environment
The food environment is crucial in determining dietary habits and weight outcomes. In urban areas, “food deserts” are common, where access to fresh, healthy food is scarce, while fast food and convenience stores are abundant. These environments push individuals toward high-calorie, processed foods that lead to weight gain.
Moreover, “food swamps” are areas where unhealthy food options far outnumber healthy ones, despite the presence of fresh food. Aggressive marketing of unhealthy foods, especially targeting children and vulnerable populations, exacerbates the problem. The lower cost and convenience of these foods make it challenging for individuals to choose nutritious options that promote weight loss.
Urban Planning and Physical Activity
Urban planning significantly impacts physical activity levels. Neighborhoods lacking safe, accessible recreational spaces or active transportation options (like walking and biking paths) contribute to sedentary lifestyles. Conversely, areas with parks, walking paths, and bike lanes encourage daily physical activity. Disparities in these resources, often linked to socioeconomic status and location, lead to varying obesity rates across populations.
Social Factors and Peer Influence
Social networks and cultural practices heavily influence eating habits and activity levels. Social gatherings often center around food, with cultural norms dictating large portions and calorie-dense foods, challenging those trying to maintain a healthy diet.
Peer influence also plays a critical role. Friends and family who prioritize physical fitness and healthy eating can motivate and support weight loss. Conversely, social circles that indulge in unhealthy eating and sedentary lifestyles make adopting healthy behaviors more difficult.
Additionally, social media and media portrayals of body image impact self-esteem and body satisfaction, influencing eating and exercise behaviors. The pressure to meet unrealistic beauty standards can lead to unhealthy dieting, eating disorders, or avoidance of physical activity due to body image concerns.
Action Steps
Addressing environmental and social influences on weight loss requires comprehensive strategies beyond individual behavior changes. Key actions include:
- Improving Food Access: Implement policies that enhance access to healthy foods in all communities.
- Urban Design: Create safe, accessible spaces that encourage physical activity.
- Social Support: Foster social networks that value health and wellness.
- Cultural Shifts: Promote societal changes that prioritize health over convenience and instant gratification.
By acknowledging and addressing these external influences, we can create environments that support sustainable weight loss and healthier lifestyles.
Medical and Health-Related Factors
The complexities of weight loss often involve medical and health-related factors that can significantly impact one’s ability to lose and maintain weight. This section explores underlying health conditions, medication impacts, and the effects of yo-yo dieting, offering insights into the medical challenges that complicate weight loss efforts.
Underlying Health Conditions
Certain medical conditions can hinder weight loss or contribute to weight gain through physiological mechanisms or by restricting physical activity. For instance, hypothyroidism slows metabolism, making weight loss difficult. Polycystic Ovary Syndrome (PCOS) affects hormone levels in women, leading to weight gain and challenges in losing weight due to insulin resistance and hormonal imbalances.
Other conditions like Cushing’s syndrome and insulin resistance cause weight gain through hormonal and metabolic changes. Mental health conditions such as depression and anxiety can also lead to weight gain through increased appetite and sedentary behavior. Addressing these conditions with healthcare professionals is crucial for effective weight management.
The Impact of Medications on Weight
Various medications can cause weight gain as a side effect, complicating weight loss efforts. Antidepressants, antipsychotics, and mood stabilizers affect appetite and metabolism, leading to weight gain. Diabetes medications, such as insulin and sulfonylureas, can increase weight by altering glucose processing and fat storage.
Corticosteroids, used for conditions like asthma and arthritis, promote fluid retention and increase appetite, causing weight gain. Even over-the-counter medications like antihistamines can contribute to weight gain. Consulting healthcare providers about managing these side effects and exploring alternative treatments is vital for weight management.
The Impact of Yo-Yo Dieting on Health
Yo-yo dieting, characterized by cycles of weight loss and regain, poses significant challenges to long-term weight management and health. Each cycle slows metabolism, making future weight loss harder as the body becomes more efficient at storing fat and conserving energy.
Yo-yo dieting leads to muscle mass loss and increased body fat percentage, further decreasing metabolic rate since muscle tissue burns more calories than fat. Psychologically, it can cause frustration, decreased motivation, and a sense of failure, undermining future weight loss efforts.
Additionally, yo-yo dieting increases long-term health risks, including heart disease, high blood pressure, and metabolic syndrome. Sustainable weight management strategies focusing on gradual, steady weight loss and maintenance are essential. Understanding the impact of health conditions, medication side effects, and yo-yo dieting is crucial for those navigating their weight loss journey. Working with healthcare professionals can help develop a comprehensive, effective approach to weight management that prioritizes long-term health and well-being.
The Impact of Medications on Weight
Medications essential for treating various health conditions can unintentionally affect weight. This section delves into how commonly prescribed drugs can lead to weight gain or hinder weight loss, emphasizing the importance of understanding these effects for effective weight management.
Antidepressants
Antidepressants, particularly SSRIs and tricyclics, often cause weight gain, likely due to changes in appetite and metabolism. Patients should monitor weight and discuss alternatives or adjunctive strategies with their healthcare providers to mitigate these effects.
Antipsychotics
Antipsychotics, especially second-generation ones, are linked to significant weight gain, increased appetite, and metabolic changes, raising the risk of diabetes and cardiovascular disease. Patients may need to explore different medications or lifestyle interventions to counteract these side effects.
Diabetes Medications
Certain diabetes medications like insulin, sulfonylureas, and thiazolidinediones can lead to weight gain by lowering blood sugar levels, increasing appetite, and promoting fat storage. However, drugs like metformin are associated with weight loss or neutrality. Discussing weight-conscious medication options with healthcare providers is vital for diabetes patients.
Corticosteroids
Corticosteroids can cause weight gain through fluid retention and increased appetite, leading to central obesity and a higher risk of metabolic conditions. Patients on long-term corticosteroid therapy should seek advice on dietary changes and physical activity to manage weight.
Beta Blockers
Beta blockers, used for high blood pressure and heart conditions, can slow metabolism and reduce physical activity tolerance, modestly contributing to weight gain. Patients should discuss alternative hypertension management strategies with their healthcare provider if concerned about weight gain.
Managing Medication-Related Weight Gain
- Discuss with Healthcare Providers: Open discussions about weight gain can lead to adjustments in medication type, dosage, or the addition of medications to counteract weight gain.
- Lifestyle Interventions: Adopting a healthy diet and increasing physical activity can help manage medication-induced weight gain. Healthcare providers can refer patients to dietitians or physical therapists for personalized advice.
- Monitoring and Adjustment: Regular weight and metabolic health monitoring can prompt timely adjustments to treatment plans, minimizing long-term weight impacts.
Understanding and proactively managing the weight effects of medications, in collaboration with healthcare providers, is crucial for achieving balanced health outcomes and maintaining a healthy weight.
Nutritional Complexities
Nutrition is fundamental to weight management, yet its complexities often challenge conventional wisdom. This section delves into the paradox of calorie counting, the role of macronutrient ratios in weight loss, and the significance of nutrient density, illustrating why simplistic dieting approaches often fail.
The Paradox of Calorie Counting
The calorie-in versus calorie-out model has long dominated weight loss strategies, based on the idea that a calorie deficit leads to weight loss. While scientifically valid, this model oversimplifies human metabolism and ignores the varied effects of different foods. Not all calories are equal; their source profoundly impacts metabolism, hunger, hormones, and overall metabolic health.
For example, 100 calories from a sugary snack affect the body differently than 100 calories from a protein-rich food. Proteins and fibers increase satiety and have a higher thermic effect, requiring more energy for digestion than fats and simple carbohydrates. This highlights the limitations of focusing solely on calorie counts without considering the nutritional quality and composition of foods.
Macronutrient Ratios and Weight Loss
The balance of carbohydrates, proteins, and fats in a diet significantly influences weight management and health. High-protein diets enhance satiety and increase metabolic rate more effectively than diets higher in carbohydrates or fats. Similarly, moderating carbohydrate intake, especially refined carbs and sugars, improves insulin sensitivity and promotes fat loss.
Optimal macronutrient ratios vary among individuals, influenced by genetics, activity levels, and health goals. This variability underscores the need for personalized nutrition rather than one-size-fits-all diets. It also emphasizes choosing high-quality macronutrients, favoring whole, unprocessed foods over refined options.
Nutrient Density and Weight Management
Nutrient density measures the vitamins, minerals, and fiber in food relative to its energy content. Focusing on nutrient-dense foods supports weight loss and health by providing essential nutrients without excessive calories. Vegetables, fruits, lean proteins, and whole grains, rich in nutrients, offer substantial health benefits beyond weight management, including reducing chronic disease risks.
Emphasizing nutrient density also addresses the issue of “empty calories” — high-energy foods low in nutritional value, like sugary drinks and processed snacks. These foods add calories without satisfying hunger or providing necessary nutrients, often leading to overeating and weight gain. Effective weight management requires moving beyond simplistic calorie counting to understanding food’s effects on the body. This means considering diet quality and composition, emphasizing macronutrient balance and nutrient density, and adopting a personalized nutrition approach. This comprehensive perspective is crucial for effective weight management and overall health, underscoring the importance of informed dietary choices in achieving a healthier lifestyle.
Conclusion
Weight loss is a multifaceted journey shaped by biological, psychological, environmental, and nutritional factors. This exploration underscores the complexity of weight management, emphasizing the need for a holistic approach tailored to individual needs.
Biologically, genetics and metabolic adaptations highlight the inherent challenges in weight loss. These factors reveal that weight management is not just about willpower but involves complex physiological mechanisms unique to each person. Environmental chemicals, especially endocrine disruptors, add another layer of difficulty, influencing weight gain beyond individual control.
Psychologically, food is deeply intertwined with emotions, culture, and social contexts, complicating efforts to adopt healthier eating and exercise habits. The food environment, urban planning, and social networks significantly impact diet and physical activity, either facilitating or hindering weight loss efforts.
Medical factors, including the effects of certain medications and the cycle of yo-yo dieting, further complicate sustainable weight loss. These challenges highlight the importance of medical guidance and personalized treatment plans that consider overall health, not just weight.
Nutritionally, the focus should extend beyond simple calorie counting. Understanding macronutrient ratios and nutrient density is crucial for a balanced diet that supports metabolism, satiety, and overall health.
A multifaceted strategy is essential for effective weight management, addressing the whole person—their biology, psychology, environment, and nutrition. Personalized, evidence-based approaches empower individuals to make informed health choices.
The journey to weight management requires patience, persistence, and support from healthcare providers, family, and friends. By acknowledging the complexity of weight loss and advocating for individualized strategies, we can foster a compassionate, understanding approach to health and wellness. This holistic perspective not only aids in weight loss but also promotes overall well-being. Click to learn more about the cost of semaglutide with BMI Doctors.
Research Citations
The complexities of weight loss and the multifactorial influences on weight management necessitate a robust understanding supported by scientific research. This section compiles a comprehensive list of citations from studies, reviews, and authoritative sources that have informed the insights presented throughout this article. These references serve as a foundation for the discussions on biological, psychological, environmental, nutritional, and medical aspects of weight loss, providing a base for further reading and exploration.
Biological Factors and Weight Loss
- Speakman, J.R., & O’Rahilly, S. (2012). Fat: An evolving issue. Disease Models & Mechanisms, 5(5), 569-573. This study discusses the genetic and evolutionary aspects of fat storage and metabolism, providing insight into the biological predispositions to obesity.
- Rosenbaum, M., & Leibel, R.L. (2010). Adaptive thermogenesis in humans. International Journal of Obesity, 34(S1), S47-S55. This review outlines the concept of metabolic adaptation to calorie restriction, highlighting its role in the plateauing of weight loss over time.
Environmental Chemicals and Weight
- Heindel, J.J., & Blumberg, B. (2019). Environmental Obesogens: Mechanisms and Controversies. Annual Review of Pharmacology and Toxicology, 59, 89-106. This article reviews the evidence for obesogens, environmental chemicals that may promote obesity by altering hormonal balance.
Psychological and Behavioral Aspects
- Kuijer, R.G., & Boyce, J.A. (2014). Chocolate cake. Guilt or celebration? Associations with healthy eating attitudes, perceived behavioural control, intentions and weight-loss. Appetite, 74, 48-54. This study explores the psychological relationship between food and emotions, particularly in the context of dieting and weight loss.
- James, P., et al. (2015). Built environment, physical activity, and obesity: What have we learned from reviewing the literature? Health & Place, 33, 198-207. This article discusses the impact of urban planning and community design on physical activity levels and obesity.
Medical and Health-Related Factors
- Bray, G.A., & Gallagher, T.F. (2016). Medications and obesity: Mechanisms and clinical implications. Obesity Reviews, 17(10), 956-969. This comprehensive review examines the effects of various medications on weight, offering insights into the mechanisms behind medication-induced weight gain.
- Field, A.E., et al. (2013). Association of weight change, weight control practices, and weight cycling among women in the Nurses’ Health Study II. International Journal of Obesity, 37(5), 683-689. This study investigates the health impacts of yo-yo dieting, highlighting the risks associated with repeated cycles of weight loss and gain.
Nutritional Complexities
- Halton, T.L., & Hu, F.B. (2004). The effects of high protein diets on thermogenesis, satiety and weight loss: A critical review. Journal of the American College of Nutrition, 23(5), 373-385. This review evaluates the role of high-protein diets in promoting weight loss through increased satiety and thermogenesis.
- Mozaffarian, D., Hao, T., Rimm, E.B., Willett, W.C., & Hu, F.B. (2011). Changes in diet and lifestyle and long-term weight gain in women and men. The New England Journal of Medicine, 364(25), 2392-2404. This longitudinal study assesses the impact of dietary quality, including nutrient density and macronutrient composition, on long-term weight gain.
The cited research articles and reviews provide a scientific basis for understanding the multifaceted nature of weight loss, underscoring the complexity of factors influencing weight management. These references are essential for those seeking to deepen their knowledge on the topic, offering pathways to explore the scientific underpinnings of the challenges and strategies associated with achieving and maintaining a healthy weight.
Questions and Answers: Why weight loss is so hard?
Weight loss challenges stem from a combination of factors including biological predispositions, such as genetic makeup and metabolic adaptation, that can make losing weight and keeping it off difficult. Psychological aspects like emotional eating, and environmental influences, including access to healthy foods and safe places for physical activity, also play significant roles. Additionally, certain medications and health conditions can impede weight loss efforts.
Genetics can influence several aspects of weight management, including metabolism speed, fat storage locations, and appetite. Some people may be genetically predisposed to store more fat or have a slower metabolism, making weight loss more challenging compared to others without these genetic traits.
Yes, environmental chemicals, particularly endocrine-disrupting chemicals (EDCs), can interfere with hormonal balance, potentially leading to weight gain. These chemicals, found in many everyday products, can mimic or block hormones that regulate appetite, fat storage, and metabolism.
Regaining weight after dieting, often referred to as yo-yo dieting, can be due to metabolic adaptation. When you reduce calorie intake, your body becomes more efficient at using energy, slowing down your metabolism. This, coupled with the return to previous eating habits and physical activity levels, can lead to weight regain.
Psychological factors, such as emotional connections to food, stress, and habits, play a significant role in weight management. Emotional eating, for instance, can lead to overeating, while stress can alter metabolism and promote fat storage. Changing these deep-seated habits requires not only awareness but also strategies for developing new, healthier coping mechanisms.
The food environment, including the availability and accessibility of healthy versus unhealthy food options, significantly impacts dietary choices and, subsequently, weight management. Living in areas with limited access to healthy foods or in “food swamps” where unhealthy options are prevalent can make it difficult to maintain a nutritious diet conducive to weight loss.
Certain medications, including some antidepressants, antipsychotics, diabetes medications, and corticosteroids, can contribute to weight gain as a side effect. These medications may affect appetite, metabolism, or fat storage, complicating efforts to lose weight.
The balance of carbohydrates, proteins, and fats in your diet can influence weight loss and overall health. Diets higher in protein and lower in refined carbohydrates can enhance satiety, improve metabolism, and support weight loss efforts, but the optimal ratio can vary among individuals.
Focusing on nutrient-dense foods is crucial for weight loss and health as these foods provide essential vitamins, minerals, and fiber without an excess of calories. They can improve satiety, support metabolic health, and reduce the risk of chronic diseases, making them a key component of a healthy weight loss diet.
Overcoming weight loss challenges requires a multifaceted approach that addresses biological, psychological, environmental, and nutritional factors. This includes seeking personalized advice from healthcare professionals, making sustainable lifestyle changes, focusing on nutrient-dense foods, managing stress, and being patient and persistent with your efforts. Additionally, understanding and addressing any medical conditions or medication side effects that may impact weight is important.
Dr. Jay Flottman
Dr. Jay Flottmann is a physician in Panama City, FL. He received his medical degree from University of Texas Medical Branch and has been in practice 21 years. He is experienced in military medicine, an FAA medical examiner, human performance expert, and fighter pilot.
Professionally, I am a medical doctor (M.D. from the University of Texas Medical Branch at Galveston), a fighter pilot (United States Air Force trained – F-15C/F-22/AT-38C), and entrepreneur.