Hit plateau, thinking of increasing calories?

Unknown

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ndj1979

maillemaker wrote: »

7 weeks = metabolic slowdown? I don't think so. Metabolic slow down is something that takes longer than that...

I typically hit it within 5 days of caloric reduction.

You literally have no clue what you are talking about. Honestly. You don't.

Sorry, but you're wrong, and I have science to back me up.

http://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00009-1/abstract
http://videocast.nih.gov/summary.asp?live=2993&bhcp=20

do you have some literature on the five days for metabolic slowdown? Everything I have read is typically a year, but can be less depending on severity of deficit...

five days sounds like BS to me...

yopeeps025

http://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00009-1/abstract



Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations

Christopher N Ochneremail, Adam G Tsai, Robert F Kushner, Thomas A Wadden
Published Online: 11 February 2015
Article has an altmetric score of 124
DOI: http://dx.doi.org/10.1016/S2213-8587(15)00009-1
showArticle Info
Summary
Full Text
Tables and Figures
References
Many clinicians are not adequately aware of the reasons that individuals with obesity struggle to achieve and maintain weight loss,1 and this poor awareness precludes the provision of effective intervention.2 Irrespective of starting weight, caloric restriction triggers several biological adaptations designed to prevent starvation.3 These adaptations might be potent enough to undermine the long-term effectiveness of lifestyle modification in most individuals with obesity, particularly in an environment that promotes energy overconsumption. However, they are not the only biological pressures that must be overcome for successful treatment. Additional biological adaptations occur with the development of obesity and these function to preserve, or even increase, an individual's highest sustained lifetime bodyweight. For example, preadipocyte proliferation occurs, increasing fat storage capacity. In addition, habituation to rewarding neural dopamine signalling develops with the chronic overconsumption of palatable foods, leading to a perceived reward deficit and compensatory increases in consumption.4 Importantly, these latter adaptations are not typically observed in individuals who are overweight, but occur only after obesity has been maintained for some time.3 Thus, improved lifestyle choices might be sufficient for lasting reductions in bodyweight prior to sustained obesity. Once obesity is established, however, bodyweight seems to become biologically stamped in and defended. Therefore, the mere recommendation to avoid calorically dense foods might be no more effective for the typical patient seeking weight reduction than would be a recommendation to avoid sharp objects for someone bleeding profusely.

Evidence suggests that these biological adaptations often persist indefinitely, even when a person re-attains a healthy BMI via behaviourally induced weight loss.3 Further evidence indicates that biological pressure to restore bodyweight to the highest-sustained lifetime level gets stronger as weight loss increases.5 Thus, we suggest that few individuals ever truly recover from obesity; individuals who formerly had obesity but are able to re-attain a healthy bodyweight via diet and exercise still have ‘obesity in remission’ and are biologically very different from individuals of the same age, sex, and bodyweight who never had obesity.3, 5 For most individuals, these biological adaptations need to be addressed for weight loss to be sustained long-term. We believe these mechanisms largely explain the poor long-term success rates of lifestyle modification, and obligate clinicians to go beyond mere recommendations to eat less and move more.

Because sustained obesity is in large part a biologically mediated disease, more biologically based interventions are likely to be needed to counter the compensatory adaptations that maintain an individual's highest lifetime bodyweight. For example, leptin replacement therapy can normalise diet-induced reductions in energy expenditure and neural responsivity.6 However, commercialisation of leptin replacement therapy has not yet been successful. Current biologically based interventions comprise antiobesity drugs, bariatric surgery and, the most recent development, intermittent intra-abdominal vagal nerve blockade. Risk–benefit profiles of antiobesity drugs and bariatric procedures have improved in recent years; however, long-term (>2 year) data for recently approved drugs are still pending. Initial trials suggest that these new drugs might have either lower rates of side effects (lorcaserin) or improved effectiveness (phentermine/topiramate extended-release and bupropion/naltrexone) relative to previous drug treatments;7, 8 however, empirical comparisons have not been made. Liraglutide, an injectable glucagon-like peptide-1 receptor agonist, was also recently approved for long-term weight management. Finally, vagal nerve blockage uses an implanted pacemaker-like device to intermittently block signalling in the gut–brain axis via the abdominal vagus nerve. These interventions do not permanently correct the biological adaptations that undermine efforts for healthy weight loss but do, during use, alter the neural or hormonal signalling associated with appetite to reduce hunger and caloric intake, and can produce a 4–10% weight reduction. Data also suggest that combining antiobesity drugs with more intensive lifestyle modification would probably increase weight loss.9 The most common surgical options for extreme obesity include Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding. Substantial weight loss (roughly 25% initial bodyweight for Roux-en-Y gastric bypass) has been reported up to 20-year follow-up.10 Further, gastric bypass corrects obesity-induced changes in appetite-related hormone profiles11 and neural responsivity,12 which might explain why bariatric surgery is the only available treatment to show long-term effectiveness.

Although helpful, available biologically based interventions are not universally effective in countering the obesity-promoting interaction between a biological predisposition for energy storage and an environment that promotes high energy intake and low energy expenditure. Until substantial changes to the food and activity environment can be made, obesity should be treated as a chronic, and often treatment-resistant, medical disease with biological (and behavioural) underpinnings. Specifically, clinicians should be proactive in addressing obesity prevention with patients who are overweight and, for those who already have sustained obesity, clinicians should implement a multimodal treatment approach that includes biologically based interventions such as pharmacotherapy and surgery when appropriate.13 The risk–benefit ratio of these biologically based treatments should be established for each patient and weighed against potential risks posed by the patient's comorbid disorders. We recommend the use of lifestyle modification to treat individuals with sustained obesity, but it should be only one component of a multimodal treatment strategy. It is also important for clinicians to note that weight losses of only 5–10% of initial bodyweight are sufficient for clinically meaningful reductions in weight-related biomarkers, despite the fact that this level of weight loss might be disappointing to some patients with more aesthetically-driven goals. Finally, we encourage clinicians to monitor patients' weight-loss progress and adapt treatment strategies over time. Specific plans to maintain lost weight should be developed. For example, an individual might be initially successful in losing weight with lifestyle modification but need pharmacotherapy to sustain clinically meaningful weight loss. See panel for a summary of recommendations for the prevention and treatment of obesity, and the recently published NIH working group report14 for recommendations for weight loss maintenance. We urge individuals in the medical and scientific community to seek a better understanding of the biological factors that maintain obesity and to approach it as a disease that cannot be reliably prevented or cured with current frontline methods.

Panel
authors' clinical recommendations for obesity prevention and treatment*

*Based in part on recommendations from other sources.13, 14

Prevention
•Proactively address prevention with overweight patients. Obesity is far more challenging to address once established and, therefore, clinicians should address the importance of proper nutrition and physical activity prior to the development of obesity.
•Focus on lifestyle choices. Because several biological adaptations that preserve highest lifetime bodyweight do not seem to occur until obesity is sustained, validated behavioural interventions might be sufficient to regulate bodyweight.
•Continue to monitor progress and adjust strategy as necessary. Strategies should be ongoing and take into account the fact that weight-loss maintenance is more difficult than weight loss. Formulate a specific strategy and provide resources for weight-loss maintenance to patients who are overweight and able to achieve weight loss via lifestyle modification.
Treatment
•Encourage patients with obesity to consider treatment, even if not the primary complaint. Address the increased risk of serious medical conditions and offer treatment options.
•Consider biologically based interventions. Lifestyle modification alone is likely to be insufficient. Consider medication or surgery when appropriate.
•Implement a multifaceted treatment strategy. Construct an individualised treatment plan involving different treatments which can include highly structured diets, a high-protein diet, increases in physical activity, drugs, and bariatric surgery.
•Recommend surgery when appropriate, because bariatric surgery is the only effective long-term treatment for obesity available. Attempt highly structured lifestyle modification and discuss pharmacotherapy first. Patients for whom lifestyle change is not successful, particularly those with clinically severe obesity, should be informed about the risks and potential benefits of bariatric surgery.
•Continue to monitor progress and adjust treatment strategy as necessary. Formulate a specific strategy and provide resources for weight loss maintenance. Medication can be considered when behavioural weight-loss efforts wane.
•Inform patients of the challenges to weight-loss maintenance. Patients who achieve significant weight loss via lifestyle change are likely to become more metabolically efficient and will have to ingest up to 300 fewer (or burn up to 300 more) calories per day than someone of the same weight who never had obesity, just to maintain that weight. Inform patients that powerful biological mechanisms encourage weight regain and use of biologically based treatments (eg, drugs) is not a reflection of weak will.
CNO reports grants from Accera, and non-financial support from ProBar. AGT reports non-financial support from Nutrisystem. RFK reports personal fees from Vivus, Takeda, and Novo Nordisk and grants from Weight Watchers. TAW reports personal fees from Nutrisystem, Orexigen Pharmaceutical, Novo Nordisk, Boehringer Ingelheim, Guilford Press, and Shire Pharmaceutical and grants from Novo Nordisk, Weight Watchers, and NutriSystem.

yopeeps025

Second link is an hour+ long video.

Sued0nim

jacksonpt wrote: »

maillemaker wrote: »

. If I'm hungry and cold, I'm losing fat.

Or you need a sandwich and a sweatshirt?

You I like

maillemaker

What does you getting cold have to do with a metabolic slow down.

It's in the video. See the 35:12 mark.

So if these changes stymie weight loss why have so many of us here been able to lose the weight successfully. I already know the answer you're going to give but I just want to see it again, and for others to see it.

Most people who try to lose weight fail long term. I forget the exact numbers off the top of my head now, it's like 80%-95% failure rate.

For people who succeed, it could be a couple of things. First, they may have larger stores of willpower. But another thing that is starting to appear is that it may be that you [/i]might[/i] have to be obese for some period of time for your body to take a set to that body fat level. In other words, if you catch it in time, you might not be caught up in this defense mechanism. But the research is not clear on this yet. And of course it's also entirely possible that not everyone responds the same way.

What is clear is that there is increasing scientific evidence, from real doctors and real scientists, that being obese can cause real, permanent physiological changes to your body that can make weight loss very difficult, if not impossible for most people through willpower alone.

So it's been at least 2 years since you've been around here right? How much have you lost?

14 pounds, according to my doctor visit yesterday since my last visit which was probably six months or so ago. From 290 to 276.

Liftng4Lis

jacksonpt wrote: »

maillemaker wrote: »

. If I'm hungry and cold, I'm losing fat.

Or you need a sandwich and a sweatshirt?

PeachyCarol

maillemaker wrote: »

5 days? Yea okay. Believe that if you want.

I don't have to "believe" it, I can feel it. Just like in the video, I get cold. I can tell you when I am actively losing body fat without ever getting on a scale. If I'm hungry and cold, I'm losing fat. Typically hits me 5 days into a calorie deficit.

So is that the new reason why you are stuck?

I'm not stuck. I'm down 14 pounds since the last time I went to my doctor.

Your link, doesn't work. But I did see the title. "Obesity is a disease" so basically more excuses.

LOL. Talk about judging a book by its cover, eh?

Both links work fine.

One link is a link to a medical journal called The Lancet. You will need to register to read the Lancet article but is is free to do so. The other link is a link to something called the Grand Rounds and is a series of lectures hosted by the National Institute of Health. This particular one is Dr. Rudy Liebel of Columbia University Medical Center. He specializes in pediatrics and obesity.

Both of these links cover the actual scientific evidence behind the permanent biological changes that occur due to obesity that stymie weight loss.

Debating you really isn't going to be worth it I'll speak actual science without having to research and you'll look up links to support excuses. That's the way it usually works isn't it?

I just gave you the science. What you choose to do with it is up to you.

My jaw is hanging on the floor. 5 days and you go with "dem feels" because you're cold.

What book did you read that told you that you'd be a fat-burning furnace?

I have found that a lot of people doing this (trying to lose weight) end up "feeling" the latest malarkey they've read that they're "supposed" to be feeling, all in the name of placing blame anywhere but on themselves.

Your head's not in the game, mate.

sodakat

According to this ^^ research, "bariatric surgery is the only effective long-term treatment for obesity available".

Treatment would be something the patient undergoes, compared to say their own behavior modification, correct? So are these researchers saying this is the only thing they can do "to" or "for" patients, compared to what patients can do for themselves?

StacyMMo

I wasn't losing and I increased from 1200 to 1400 and then I started losing. I know the "starvation mode" is a dirty word around here but for me, my body wanted those extra calories. Plus, it makes me much happier to have the extra calories :-) I think you just have to experiment because no two people are the same.

PeachyCarol

@yopeeps025, thanks for posting the Lancet article.

OP, did you note that there's nothing in that Lancet article that would just have someone giving up and keeping the weight on? Did you also note that the front line attack suggestion against weight was behavior modification?

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ndj1979

StacyMMo wrote: »

I wasn't losing and I increased from 1200 to 1400 and then I started losing. I know the "starvation mode" is a dirty word around here but for me, my body wanted those extra calories. Plus, it makes me much happier to have the extra calories :-) I think you just have to experiment because no two people are the same.

if starvation mode were true then all the starving children in Africa would be obese...

SezxyStef

StacyMMo wrote: »

I wasn't losing and I increased from 1200 to 1400 and then I started losing. I know the "starvation mode" is a dirty word around here but for me, my body wanted those extra calories. Plus, it makes me much happier to have the extra calories :-) I think you just have to experiment because no two people are the same.

I couldn't pick a facial expression that suited this best so I went from teeheeing to WTH are you talking about....and see above about the African children.

girlviernes

I do believe the numbers about lots of regain over time, the truth is that managing your weight when you have been obese does mean that you are working against your body's mechanisms for regain...

which means you need to approach this seriously, with dedication, you need to be fairly vigilant, keeping track of your weight and addressing any regain quickly, being conscientious about your intake, and staying physically active. If you go back to the old ways and old way of being (the not paying attention way of being which might work perfectly well for a lot of people who've never had a weight problem) - you will regain.

yopeeps025

mamapeach910 wrote: »

@yopeeps025, thanks for posting the Lancet article.

OP, did you note that there's nothing in that Lancet article that would just have someone giving up and keeping the weight on? Did you also note that the front line attack suggestion against weight was behavior modification?

I had to take out the citations because it was over 1000+ characters to post.

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maillemaker

There it is!!!! I used to love when you would tell us that we were never fat enough or that we weren't fat enough for long enough. I told you I knew the answer, I just wanted to see it again. I guess the 75 lbs I was over for almost 10 years wasn't fat enough or long enough right? Why is it always the same excuses with you? Nothing changes with you.

As I have said before, I cannot explain why so few succeed, other than most people cannot tolerate the discomfort of hunger long-term. Perhaps there is something biologically different about a small number of people such as yourself.

They do, however over time the body will adapt to the new regular weight, just as it did to the old one.

Um, it said, "Evidence suggests that these biological adaptations often persist indefinitely", which is what the video also says.

It is possible that becoming obese causes permanent physiological damage to your body.

So it is still possible to maintain weight once lost. Obese people are not doomed to regain, they just have to be a lot more vigilant about calorie consumption for a number of years until their metabolism normalises.

No, they are not doomed to regain, they just have to be able to tolerate eating 15-20% less food than someone of their body mass would normally eat. So not only do they have to learn to eat normally, they have to learn to eat sub-normally. Most people can't sustain it. But yes, it can be done.

However, their metabolism may never normalize. It is possible that once you have become obese you have permanently damaged your metabolism.

maillemaker

Which is good reason why people that are always complaining and posting stuff how the are destined to fail never succeed. They sabotage themselves from the very beginning. What kind of success can you honestly expect to have?

I think it's important to understand the science behind weight loss and the science behind what causes failures to maintain it. When you understand the body's physiological response to fat loss you can take steps to mitigate it.

When you hit plateaus and you understand it is because your body now needs less calories to sustain itself and the answer is to simply eat less, that is important to understand.

It's all based on science.

PeachyCarol

maillemaker wrote: »

There it is!!!! I used to love when you would tell us that we were never fat enough or that we weren't fat enough for long enough. I told you I knew the answer, I just wanted to see it again. I guess the 75 lbs I was over for almost 10 years wasn't fat enough or long enough right? Why is it always the same excuses with you? Nothing changes with you.

As I have said before, I cannot explain why so few succeed, other than most people cannot tolerate the discomfort of hunger long-term. Perhaps there is something biologically different about a small number of people such as yourself.

They do, however over time the body will adapt to the new regular weight, just as it did to the old one.

I doubt that most overweight people know what real hunger is. Most of us, especially those of us who were raised on scheduled meal times to clean our plates regardless of what our bodies felt, don't have a clue how to listen to hunger signals. We eat because it's time, because it's a habit to do while certain activities are going on, and we eat in skewed quantities. Most of us have not addressed the issues behind these behaviors in any meaningful way during weight loss and revert to habit because we go back into a world with regimented eating times and out-sized portions.

Keep searching for the science behind what happens in your body in response to the behavior. You have control over your behavior and you can change it. Your body will adapt and follow suit. That's harder than making excuses, though.

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alanlmarshall

A refeed or intermittent fasting regimen works for some, but doing it to trick your scale is a poor reason. Just weigh yourself less often.

maillemaker

So you are saying that a 6'0 male that was 350 pounds for 10 years and got down to 180 lbs would have to eat 20% less than if he was 6'0 tall and 250 pounds for 10 years and got down to 180 lbs?

No, I'm saying that a person who is was obese and gets down to 180 pounds would have to eat 15-20% less than a person who was never obese and weight 180 pounds.

Rather, that is what Dr. Rudy Libel, Dr. Christopher Ochneremail, et al say.

How long are you going to continue posting stuff about why people fail, why people fail at keeping it off and how it's not the individuals fault they fail as opposed to maybe taking all that "knowlege" you have about the "science" of why we fail and actually apply it so you can have success?

That is exactly what I am doing! I'm taking appetite suppressants to mitigate the increased hunger and eliminate willpower issues.

Once you understand the science behind the problem, you can take steps to address it.

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jacksonpt

maillemaker wrote: »

So you are saying that a 6'0 male that was 350 pounds for 10 years and got down to 180 lbs would have to eat 20% less than if he was 6'0 tall and 250 pounds for 10 years and got down to 180 lbs?

No, I'm saying that a person who is was obese and gets down to 180 pounds would have to eat 15-20% less than a person who was never obese and weight 180 pounds.

I'm sure there are cases where that's true, just as I'm sure there are cases it isn't.

It is possible to diet off 100+ lbs and have it take a significant toll on your metabolism. You can also diet off 100+ lbs with relatively minimal impact on your metabolism.

jacksonpt

maillemaker wrote: »

Once you understand the science behind the problem, you can take steps to address it.

I don't think anyone is arguing that... People are arguing what the actual science is/says.

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PeachyCarol

jacksonpt wrote: »

maillemaker wrote: »

Once you understand the science behind the problem, you can take steps to address it.

I don't think anyone is arguing that... People are arguing what the actual science is/says.

Forgive me if I'm wrong here and for using your post as a jumping off point for my blathering, but isn't the current discussion "one scientist said" and just assuming it to be universal truth?

I thought none of this was hammered down to any scientific accuracy, that it was all a bunch of maybes. Saying that, it doesn't exempt anyone holding onto extra weight from the need to get rid of it nor the imperative to do their best, no matter the odds, to stay rid of it.

I can't fathom the mindset of someone finding excuses for not getting somewhere while they're still on the journey.

jacksonpt

mamapeach910 wrote: »

jacksonpt wrote: »

maillemaker wrote: »

Once you understand the science behind the problem, you can take steps to address it.

I don't think anyone is arguing that... People are arguing what the actual science is/says.

Forgive me if I'm wrong here and for using your post as a jumping off point for my blathering, but isn't the current discussion "one scientist said" and just assuming it to be universal truth?

I thought none of this was hammered down to any scientific accuracy, that it was all a bunch of maybes. Saying that, it doesn't exempt anyone holding onto extra weight from the need to get rid of it nor the imperative to do their best, no matter the odds, to stay rid of it.

I can't fathom the mindset of someone finding excuses for not getting somewhere while they're still on the journey.

I agree. I think the most fundamental aspects of the science are pretty universal. The problem is that people tend to speak in absolutes without acknowledging the array of variables that could impact how that science is applied, OR give any context to how they are using/discussing said science.

Add to all that someone who doesn't bother to actually read a post, or someone who argues semantics simply to be right rather than to be helpful, and you end up with circular threads of nonsense.

I've said it before... answering questions is easy. Being helpful is hard.

maillemaker

Forgive me if I'm wrong here and for using your post as a jumping off point for my blathering, but isn't the current discussion "one scientist said" and just assuming it to be universal truth?

Not at all. It is not just one scientist, and this is not all new information, though the picture is only slowly coming together, as is always the case with research.

The article from the medical journal The Lancet has four authors. The video is by Dr. Rudy Libel, who co-discovered the hormone Leptin with Dr. Jules Hirsch of Rockerfeller University Hospital. Another doctor who have spoken similarly on this topic are Dr. Sandra Aamodt.

These people are not hacks. Some of these people are heading up research departments at some of the most prestigious institutions in the country.

http://en.wikipedia.org/wiki/Rudolph_Leibel

I urge you to invest an hour this weekend and watch the video. There are lots of interesting counter-bro-science nuggets in there besides the idea that the body responds defensively to fat loss. For example they demonstrate that in a strictly controlled laboratory setting diet composition (carbs vs. protein) has virtually no impact on body composition (though it can have an impact on hunger).

It also drives home the message of how critical it is to head off obesity in children because if it is correct that obesity causes permanent physiological damage then it must be avoided at all costs or you are setting yourself up for a lifetime battle.

I can't fathom the mindset of someone finding excuses for not getting somewhere while they're still on the journey.

If you got a flat tire every 100 miles you drove, it would be very important to figure out why you were getting flat tires so you could do something about it. It's also important to figure out if it's only you getting flat tires every 100 miles or if 80-90% of drivers are suffering the same fate. And once you figure it out, you can either yell at the tire for not being good enough, or you can take steps to solve the problem. But it's important to understand both the scope and the cause of the problem.

I'm reasonably convinced, based on the evidence, that there is probably some truth here to the idea that something biologically changes in us when we get fat. It appears that this effect may be long-lasting, or even permanent, at least for some people. All of this is probably an evolutionary mechanism designed to create and preserve fat stores when food resources were plentiful for times when they were not, created in times when food resources were almost never plentiful.

Is the picture fully complete yet? No. In the video Dr. Liebel points out that there are likely dozens of genes and hormones and brain receptors at play here, and very few of them are understood yet. Leptin clearly plays an important signalling role, but it probably does not play the only role. But the overall defensive nature of body fat stores does seem to hold generally true for most people. It may not hold true for all people.