Shalini’s obesity problem 

Shalini*, a 61-year-old woman is at the pinnacle of her career. She immigrated from India when she was 26, and has climbed the ladder of success. She has a flourishing business in the SF Bay Area, in California. She is healthy and happily married to Vishal* who is a CFO at a multinational company. They have two adult children who live in Washington and Oregon.  All of them are successful. Yet despite all her achievements and stable life, Shalini is bothered by her inability to lose weight.  She approached us for some remedies.

During the consultation, after some routine health questions, I found out that Shaini has no family history of obesity and is only a social drinker. She tried things like human growth hormone injections and medications like Ozempic but was not successful in losing weight. However, she revealed that after she is finished with her work she sits and watches TV and rewards herself with countless snacks. She was not very conscious about this snacking habit until our discussion. Presented here are some excerpts from that discussion for the benefit of India Currents’ readers.

38 years of Indian American stories depend on what you do next. Stand with us today.

Question: What is causing me not to lose weight?

Dr. Sharma:  Shalini, what is leading up to your inability to lose weight is known as hedonic eating and this is coupled with a sedentary lifestyle. Hedonic eating refers to consuming food primarily for pleasure and not to maintain energy balance. In this condition, a person eats not because of bodily needs but to satisfy the urge of taste buds which in itself becomes rewarding.  This hedonic eating constantly adds to the body weight.  When it is coupled with a lack of physical activity or a sedentary lifestyle, losing weight becomes impossible. Unless these two behaviors are rectified, success in losing weight cannot be achieved.

Question: Why did Ozempic not work for me?

Dr. Sharma: Ozempic (or semaglutide) is a newer class of antidiabetic drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. Another one is Tirzepatide (Mounjaro or Zepbound) is a much more advanced drug and is more potent as it is both a gastric inhibitory polypeptide (GIP) receptor and a GLP-1 receptor agonist. These newer drugs are also sometimes called “nutrient-stimulated hormone-based therapies.” These are typically used for type 2 diabetes but have become popular as anti-obesity drugs as besides stimulating insulin secretion (which is needed for diabetes) they delay the emptying of the stomach. Shalini, you have tried Ozempic, but it did not work for you because the two causes that we discussed, hedonic eating and sedentary lifestyle, were not addressed.  Furthermore, once people stop taking these drugs it has been seen that they gain the weight back.

Question:  How can I control hedonic hunger?

Dr. Sharma:  You may have heard of the term “mindfulness.” It has recently gained popularity in the West but the concept has existed in Indian philosophy since ancient times. Mindfulness refers to the constant practice of becoming aware of the present moment without judgment. This is also the essence of meditation.  You can start by enhancing your awareness of the food that you are eating.  In a fast-paced modern life where food is so easily available, our brains do not find enough time to process signals of fullness and as a result, we consume more calories. You must pay close attention to when and what you are eating.  You can do that by using the following strategies:

  • Waiting to eat until hunger pangs are strong
  • Chewing the food thoroughly, eating slowly, and enjoying the taste of every bite
  • Paying attention to the texture, flavors, and smell of the food
  • Eating the food without any distractions and just focusing on enjoying the food in silence
  • Taking at least 25 minutes to finish the food with stopping in between for 5 minutes to check satiety
  • Remembering that it is okay to leave food unfinished (you may save the extras for later) 
  • Being cognizant of the effect food has on the feelings or mood
  • Being thankful for the food; appreciating it and all concerned in providing you with it. 

Question: Does stress play a role in hedonic hunger?

Dr. Sharma: Yes, Shalini, stress is one of the underlying causes of hedonic hunger. You need to be aware of your stressors or external events and how you perceive them. It is the perception that is very important. If you perceive that the stressor is uncontrollable then you will try to fix that through inappropriate hedonic eating. If you think you are in control of your stressor then practicing mindfulness will become easy. You need to remember that the judgment of control is entirely in your own hands and almost every situation is possible to be controlled by you. 

Question: Are there resources to learn more?

Dr. Sharma: Here are some additional resources from where you can find more information:

*Name changed upon request.



Manoj Sharma, MBBS, Ph.D., MCHES® is an Indian-American global public health expert, author, and educator who has written several books and publications on mental health and wellness. He answers queries...