Extreme Weight Loss Drops Metabolism - Long Term?
Replies
-
auntstephie321 wrote: »does it say how they measured their current metabolic rate? I can understand that while on the show they would've been highly supervised and tested continually, but how are they checking that now? I admit I didn't read the study but read most of the article. it felt like it skewed toward sounding like they were making excuses for the contestants that regained as if it had nothing to do with the highly unsustainable low calorie, high calorie burn diet they were on, and are no longer following.
They retested at the same center they used while on the show.0 -
auntstephie321 wrote: »it felt like it skewed toward sounding like they were making excuses for the contestants that regained as if it had nothing to do with the highly unsustainable low calorie, high calorie burn diet they were on, and are no longer following.
It could be making excuses but this issue of weight regain is what happens to most everyone who does any diet program. The paper below that highlights the National Weight Control Registry finds that only ~20% of subjects maintain a 10% weight loss after 5 years. Keeping weight off is more than simple will power.
Wing and Phelan. 2005. Long-term weight loss maintenance. Am J Clin Nutr.1 -
Muscle loss is definitely part of it. The way I addressed the maintenance issue was to look at SUCCESSFUL long-term maintainers. Ignore the ones who regain.
90% of successful long-term maintainers exercise a LOT. The average was an hour a day.
http://www.nwcr.ws/research/
That will help maintain/increase muscle mass, which not only helps with BMR, but muscle is also a major glucose sink, so it'll help with BG control.
Extreme exercise is the only thing that has ever allowed me to maintain my large losses. Every time life has gotten in the way of my exercise, all of the weight has come back, and then some. I know now that if I want to lose weight permanently, exercise is not optional. I'm not exercising much now, but I still have a long way to go before I'm anywhere near maintenance and I am currently losing sufficiently. I'm slowly incorporating more fitness into my life, but the more I lose, the more focused I will become on the exercise side of things.
At 19 I lost 50 lbs (220 to 170) and kept it off by walking 2 hours a day. 2 years after the loss, when I started working 3 jobs and stopped walking, I gained it all back and then some (a lot more).
At 24, I was laid off from work and I walked the hills of San Francisco all day, every day for 3 months, literally from one side of the city to the next and lost 80 lbs (280 to 200). For the next 2 years, I exercised my *kitten* off for 10-15 hours a week at the gym and I maintained my loss, though I never lost any more.
At 28 I was diagnosed with cerebral venous thrombosis, the entire venous system of my brain was filled with clots. It took me 2 years to fully heal from that and I no longer had the strength or energy to workout anymore, I made it up to 300 lbs. I was diagnosed as a diabetic at that time and when I was eventually put on insulin, I made it all the way up to 380. I managed to lose 30lbs quickly, but I've spent the last 8 years bouncing between 325 and 350.
So I'm on my third big weight loss journey now, my dream is to get to 140-150, but I'd be very happy to be 180 and fit. I've gone from 340 to 280 since 11th December. My weight stalled a lot in April, but I know stress affects me a lot, hormones suck. I'm back on track now with a goal of at least 100 lbs more.
I know many people here have said that they can eat a lot of calories as long as they keep it LCHF, not me. But then when you look at my history in reflection of the article shared, it may make a little more sense. Like all of those people on Biggest Loser, as soon as I'm no longer exercising at those weight loss levels, all of the weight has come back on. I've always just attributed it to exercise fueling my metabolism and when I stop exercising, my metabolism implodes, but it sounds like there may be more to it.
I'm hopeful (because I have to be, I'm not going to give up on myself again) that with the new tools in my belt now - some behavioral changes, the benefits of low carb appetite suppression and the fact that I can nearly control my diabetes solely with diet - that this time I'll be able to maintain long-term. Being a little older and wiser, I'm prepared to fight for enough time in my life to exercise, no matter what my employer expects of me. And I finally have my husband on my side and he's been such an amazing cheerleader and he's so excited to see me happy and feeling hopeful again.
It's not new news that most dieters regain and many regain more than they lost. We've seen countless studies and articles that attest to that over the years. The whole metabolism issue addressed in this article is certainly disheartening, but to me, knowledge is power. The more I understand my body, the better I can fight for for it.5 -
anthophora wrote: »Figure 4 shows that RMR increased for 5 subjects from 30 weeks to 6 years but all were below baseline (all negative numbers on the Y axis).
Well, 30 weeks is how long they were losing weight. You'd expect a reduction in RMR with weight loss. You wouldn't expect it with a weight regain.
So 11 of the 16 clearly had a "broken" metabolism. That is something to fear.
But 5 of them, almost 1/3 had a pretty normal response -- RMR went up with increased weight, suggesting that it wasn't a "metabolic adaptation" that was driving the gain.
I view that as not-so-bad news. If 95% regain weight, we have 5% to help guide us.
This study suggests that 68% or so may be doomed, but maybe 32% of us have a path forward. That's better than 5%.
3 -
anthophora wrote: »auntstephie321 wrote: »it felt like it skewed toward sounding like they were making excuses for the contestants that regained as if it had nothing to do with the highly unsustainable low calorie, high calorie burn diet they were on, and are no longer following.
It could be making excuses but this issue of weight regain is what happens to most everyone who does any diet program. The paper below that highlights the National Weight Control Registry finds that only ~20% of subjects maintain a 10% weight loss after 5 years. Keeping weight off is more than simple will power.
Wing and Phelan. 2005. Long-term weight loss maintenance. Am J Clin Nutr.
oh I know I'm very familiar with weight regain, I just know that my regain had everything to do with no longer tracking my food intake and freely munching on whatever I wanted and less to do with any supposed metabolic rate reduction. I'm not saying that their metabolic rate didn't change, I just think there are a lot more factors at play than just that, and the article seems to want to steer people towards worrying about not being able to have any control over whether they regain or not1 -
PaleoInScotland wrote: »
At 24, I was laid off from work and I walked the hills of San Francisco all day, every day for 3 months, literally from one side of the city to the next and lost 80 lbs (280 to 200). For the next 2 years, I exercised my *kitten* off for 10-15 hours a week at the gym and I maintained my loss, though I never lost any more.Muscle loss is definitely part of it. The way I addressed the maintenance issue was to look at SUCCESSFUL long-term maintainers. Ignore the ones who regain.
90% of successful long-term maintainers exercise a LOT. The average was an hour a day.
http://www.nwcr.ws/research/
That will help maintain/increase muscle mass, which not only helps with BMR, but muscle is also a major glucose sink, so it'll help with BG control.
lol that may be a little tmi
0 -
auntstephie321 wrote: »PaleoInScotland wrote: »
At 24, I was laid off from work and I walked the hills of San Francisco all day, every day for 3 months, literally from one side of the city to the next and lost 80 lbs (280 to 200). For the next 2 years, I exercised my *kitten* off for 10-15 hours a week at the gym and I maintained my loss, though I never lost any more.Muscle loss is definitely part of it. The way I addressed the maintenance issue was to look at SUCCESSFUL long-term maintainers. Ignore the ones who regain.
90% of successful long-term maintainers exercise a LOT. The average was an hour a day.
http://www.nwcr.ws/research/
That will help maintain/increase muscle mass, which not only helps with BMR, but muscle is also a major glucose sink, so it'll help with BG control.
lol that may be a little tmi
OMG MFP's censor just made that sound really bad!! That was supposed to be a s s not the replacement word MFP used. I kept seeing *kitten* in people's threads and though it was just some new internet thing people were intentionally doing to self-censor. Geez, I didn't think the three letter word for your behind was a bad word
4 -
Well, 30 weeks is how long they were losing weight. You'd expect a reduction in RMR with weight loss. You wouldn't expect it with a weight regain.
Again, what is so interesting to me is that NONE of the contestants were back at their basal RMR after 6 years. That is astonishing. Also, Fig 5C is a bit scary.But 5 of them, almost 1/3 had a pretty normal response -- RMR went up with increased weight, suggesting that it wasn't a "metabolic adaptation" that was driving the gain.
Sure but we have no idea as to which subjects these were and the degree of weight loss (at least I didn't see it in the paper). It would have been nice if they provided the data. I could probably get it from Figure 5 but I should get back to my real job...I view that as not-so-bad news. If 95% regain weight, we have 5% to help guide us.
I agree with this and I like the approach as each of us has only body to test this. However, we can't ignore the ones who fail. In general, we have to have a control group to see what is actually working and what behaviors are leading to weight control.0 -
auntstephie321 wrote: »I'm not saying that their metabolic rate didn't change, I just think there are a lot more factors at play than just that, and the article seems to want to steer people towards worrying about not being able to have any control over whether they regain or not
Agree. I do hope researchers and nutritionists see this as a major major issue in weight loss programs. In fact, I think it may be the biggest. We need better tools and strategies for this if we want to deal with the obesity epidemic.
3 -
One really does have to wonder if the speed and aggressiveness of the weight loss factors in.
As well as the psychological factors.0 -
Let's put another perspective on it. How much did they regain in 6 years? Was it only slightly over 6 kg/year ? That doesn't sound like permanently reduced RMR. It sounds like unsustainable diet program in the first place and loss of muscle fiber. Did they continue the same extreme program after or did they start relapsing to old ways?
Edit: I regained about 6 kg in 6 months. I don't have any RMR to blame...I've already relost 1.5 kg. The point is, the regain they did wasn't very big spread on 6 years.0 -
Sabine_Stroehm wrote: »One really does have to wonder if the speed and aggressiveness of the weight loss factors in.
As well as the psychological factors.
I feel like it has to, that kind of loss in a year or less has got to be completely shocking to your system. the body probably feels like its recovering from a trauma.1 -
Foamroller wrote: »Let's put another perspective on it. How much did they regain in 6 years?
It seems like the BL competitors did better than most. From the paper: 57% of the BL competitors maintained at least a 10% weight loss after 6 years. While according the the National Weight Control Registry ~20% of dieters maintained at least a 10% weight loss. Yes - these are a bit of an apples and oranges comparison but it doesn't seem like BL is all that bad of a weight loss method.Foamroller wrote: »That doesn't sound like permanently reduced RMR.
All BL competitors experienced reduced RMR after 6 years.
1 -
Table 1 is very informative.
A lot of numbers to sift through and think about. Seems to me to be a fairly big loss in BF% (~40% loss at 30 weeks). BW weight loss was also ~40%.
Edited...just saw the FM vs FFM comparison.
It looks like they didn't lose all that much fat-free mass at 30 weeks (Confidence intervals overlap although there isn't much power in a sample of 16 subjects). So the idea that they lost too much muscle doesn't seem to add up.
The big loses were in the FM (fat mass category).
1 -
-
FFM = fat-free mass (mostly muscle). With weight loss (end of 30 weeks), you'd expect both FM and FFM to decline as it did. But FFM actually went WAY up as a % of body weight, so that's a Good Thing.
RQ went up a bit as they gained weight. Like I said earlier, just another sign that they're eating high-carb and burning more carbs.
The important part is the difference between predicted and measured RMR (adaptation). Kevin Hall models this stuff for a living -- the expectations come from his (pretty good) models. So the surprising finding here is that difference in RMR. That's the data that suggests these subjects have a "broken" metabolism, and it wasn't even fixed by regaining a bunch of weight.
Interestingly, TEE is pretty high -- almost back to baseline. That group stayed very active even after the show.0 -
I thought this article in NYT by Gina Kolata (who I have always found lite on nutrition/exercise science) was really lacking. There was nothing about muscle mass and weight loss, lifting weights vs. aerobic exercise, type of diets (carb heavy vs. carb lite), insulin resistence, etc. My experience with maintenance (sample size of 1) is that if I don't lift weights and exercise most days, and if I go back to eating my binge foods (sugary carby things) I will always gain the weight back. Also sugary carby things triggers my hunger.
Also fast weight loss has never worked for me (always slow is better). I think nutrition/weight loss research is very sucky. I have studied epidemiology/research design in grad school, and most "research" is pretty pathetic when it comes to weight loss.
In her book on Diet & Exercise, Gina Kolata had the same message: might as well give up because you were born to be fat. I just don't buy it. I think we may need to really work hard to find what works for us, and may need a lot of support, but it is doable for most.4 -
But fat free mass is everything in the body except fat, including skin, blood and bones. It's a misconception LBM is only muscle fiber.
Anyway. According to Wikipedia (yeah I know) the most surprising things contributes to higher BMR, including bigger bodies cause more skin demands heat control. They probably lost some skin too, during their weight loss.
https://en.m.wikipedia.org/wiki/Basal_metabolic_rate
Thx for the explanation above. Poor people. Sounds to me they kept exercising madly but couldn't outrun their diet.1 -
anthophora wrote: »it was a really small sample size.
16 subjects. All of them regained weight. 11 had a decrease in RMR even after weight gain. 5 of them had an increase in RMR, suggesting the weight gain was appetite driven rather than a metabolic adaptation.
Pretty clear most of them were high carb during the regain. Big increase in insulin, insulin resistance, and blood glucose.
Actually one woman - Amanda Arlauskas - lost 87 lbs and after 6 yrs is only up 14 lbs or an average of 2.3 lbs a year. I think psych factors are huge in this as well as very low fat food choices on maintenance which cause satiety issues. We all know the hunger blunting effects of a higher fat diet. They are not getting any of that. So although it is sad that they get to eat less than someone who hasn't lost all that weight it really is all about the cravings/hunger because the one fellow lost weight again with bariatric surgery which only means he cannot eat more food or he will puke. (gross simplification - I know) It doesn't mean he has less cravings, just that he can't act on them.
1
