Losing weight can be an arduous process, with many individuals finding it difficult to maintain their weight loss over time. This phenomenon, known as the “yo-yo effect,” has long perplexed researchers. A new study from ETH Zurich in Switzerland offers a molecular explanation for why keeping weight off can be so challenging.

Published in the journal Nature, the study highlights how the body’s fat cells retain a “memory” of obesity, even after significant weight loss. This memory is linked to epigenetics, a process where changes in gene activity occur due to environmental factors like diet and lifestyle.

The study suggests that when a person is overweight, their fat cells may develop lasting epigenetic markers that remain even after weight loss. These markers disrupt the normal function of fat cells, making them more likely to store fat and respond to dietary changes in ways similar to when the person was obese. As a result, despite losing weight, the body behaves as though it is still in an overweight state, which could contribute to the difficulty in maintaining weight loss.

To reach these conclusions, the researchers studied fat tissue samples from individuals who had undergone weight-loss surgeries, such as gastric bypass or stomach reduction. They found that even two years after surgery, the fat cells of these individuals continued to behave as if they were still overweight.

In addition, the team conducted an experiment with mice to observe similar effects. After making the mice obese by feeding them a high-fat diet, the researchers switched them to a standard diet to induce weight loss. The mice showed that their fat cells retained markers of obesity even after losing weight. When reintroduced to a high-fat diet, these mice regained weight more quickly, and it was easier for them to become obese again.

While the researchers did not investigate how long this “cell memory” lasts, co-author Laura Hinte noted that fat cells are long-lived and can persist for up to ten years before being replaced by new ones.

Ferdinand von Meyenn, a professor of nutrition and metabolic epigenetics at ETH Zurich, emphasized the importance of preventing obesity in the first place. He explained, “It’s precisely because of this memory effect that it’s so important to avoid being overweight in the first place. Because that’s the simplest way to combat the yo-yo phenomenon.”

This groundbreaking study provides new insight into the biological factors behind weight loss struggles, offering hope for more effective strategies to combat the yo-yo effect in the future.

European healthcare systems are witnessing a significant decline in hospital bed numbers, raising questions about their preparedness for future health crises. Experts attribute the trend to shifting healthcare priorities, technological advancements, and differences in national health policies.

Declining Numbers Highlight Disparities

Data from Eurostat reveals that the average number of hospital beds in the European Union (EU) fell from 563 per 100,000 people in 2012 to 516 in 2022—a drop of more than 8%. Some nations experienced declines exceeding 15%, including Finland (-51%) and the Netherlands (-39%).

The trend underscores disparities in healthcare systems. Bulgaria boasts the highest ratio, with 823 beds per 100,000 people, followed by Germany (766) and Romania (728). At the other end of the spectrum, Sweden recorded the lowest figure, with only 190 beds per 100,000 people, trailed by the UK (242), the Netherlands (245), and Spain (294).

Key Factors Behind the Decline

According to experts, the reduction in hospital beds reflects efforts to improve efficiency. “Eastern European systems traditionally focused on bed and doctor ratios, while Western Europe invested in advanced healthcare technologies,” explained Dr. Elmer Diána of Hungary’s University of Pécs.

Technological advancements and shorter inpatient stays have also reduced the need for hospital beds. The Organisation for Economic Co-operation and Development (OECD) cites a shift toward outpatient care as a primary driver of this decline.

Liina-Kaisa Tynkkynen from Finland’s Institute for Health and Welfare noted that Finland has centralized healthcare services and replaced hospital beds with elderly residential care facilities. Sweden adopted similar reforms, reorganizing specialized care services.

Growth in Some Nations

While most European countries saw declines, some bucked the trend. Bulgaria reported a 25% increase in hospital bed numbers, attributed to the rapid expansion of private hospitals. Ireland and Turkey also expanded their capacities due to population growth, increasing their hospital beds by 14% and 16%, respectively.

Concerns Over Future Readiness

Experts warn that declining hospital bed numbers could pose risks during health emergencies, as seen during the COVID-19 pandemic. Tynkkynen cautioned that the pandemic highlighted the importance of maintaining sufficient inpatient care capacity, particularly in crisis scenarios.

Dr. Rodney Jones, a healthcare statistical advisor, argued that bed numbers alone may not fully reflect readiness. “Deaths per population and resource allocation to community-based care are equally critical metrics,” he said.

A study in Value in Health Regional Issues emphasized the need to balance bed reductions with investments in human resources and primary care. “Developing robust healthcare infrastructure is essential to tackle future crises effectively,” concluded Diána.

Despite the decline, the debate continues over whether fewer hospital beds signal greater efficiency or vulnerability in Europe’s healthcare systems.