By Laurel Mellin

As a native Marin resident (from a family that moved to Greenbrae back when cows still grazed on the hill) who spent 42 years as a professor at the University of California at San Francisco studying the root causes of obesity, I am surprised at the demand in the county for GLP-1 drugs to treat weight issues.

Even if the bulk of the nation buys into “a pill for every ill” doctrines, I thought our county — the birthplace of the mountain bike where yoga studios abound — would solve a problem that science has shown to be caused by stress with more natural treatments.

These weight-loss drugs have a bright side, providing relief to some people with serious metabolic problems and, even more importantly, increasing awareness that obesity is driven not by lack of willpower but by biochemistry. The fly in the ointment of the weight loss drug frenzy is that a deficiency of this 30-amino acid peptide hormone does not cause obesity, so injecting GLP-1 drugs does not “solve” the problem.

Instead, it distracts people from seeking a solution and creates dependency. Initially, obesity was viewed as lack of willpower, then there was “fat shaming” and, now, an apparent dependency on drugs that put the body in “starvation mode,” but do not rewire the neural root cause of the problem. When will the 70% of people with weight issues get a fair shake?

For the pharmaceutical industry, these weight-loss drugs deliver a perfect trifecta: the desperation of dieters, a drug that wipes out appetites in the short-term and the data that dissuade users from going off the drugs and facing weight regain. The side effects of hacking the system to produce starvation are an issue for many, but as Americans the financial fragility of our nation may factor in.

The estimated $1 trillion per year cost to the federal government may cause us to dig deeper into debt and steal from funds for childhood education, social services and climate change-related initiatives.

Based on medical research, the root cause of obesity is stress, specifically the activation of a few faulty stress circuits stored in the amygdala, the stress center. These wires unleash dysregulation in all eight of the major chemicals that cause obesity: cortisol, dopamine, insulin, leptin, ghrelin, PYY, serotonin and GLP-1.

With advances in neuroplasticity, the logical target for obesity treatment is to rewire these circuits. However, they are emotional circuits and rewiring them requires emotional processing. Our standard of positive thinking and mindfulness do not switch off those wires, so we cannot cognate our way out of the obesity crisis.

When these circuits fire, the prefrontal cortex goes offline and the “emotional steam” from the stress chemical cascade is so powerful that most of us hit an emotional wall, scuttling our healthy impulses and the unscathed stress chemical cascade sends us to the fridge.

At UCSF, my colleagues and I developed “emotional brain training,” a physiologically-based way of using emotions not for psychological purposes alone but to switch off and “rewire” stress. The method is the only intervention other than weight-loss surgery shown in research published in peer-reviewed journals to produce lasting weight loss after treatment ends.

EBT allows people to take control of their biochemistry with an app and support group as a pathway to lasting weight loss. The method has shown similar beneficial effects on emotional health problems and chronic disease.

In an age of excessive dependence on external solutions to our health problems, the idea that the solution is within is reassuring. Our emotional brain has beautiful resilience pathways that take us from stress to joyous states and make us feel better as we rewire our brains to get better. EBT is homegrown in Marin. As it becomes more broadly used, the method may become known as yet another product of our marvelous county. However, in the meanwhile, the availability of the method, now backed by a dozen studies, gives us a pathway to finding more natural solutions to losing weight and keeping it off.

Health psychologist Laurel Mellin, of San Anselmo, is a former faculty member in family and community medicine and pediatrics at UCSF.