Maintaining Weight Loss and Leptin Deficiency

Adah_m

So please don't get nasty with me for the re-post as there are a lot of people talking about the NY Times article about the biggest loser contestants, and I have read SEVERAL of these threads, but NONE of them answer any of the questions that are in my head. It also appears that a lot of the people discussing it did not read the whole article (it's long so I understand) but please do not respond unless you have read the entire thing and understand the science in it. http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

1. Most people are responding that they don't care if their bodies burn less calories than another person their size because it's only their personal experience that matters- but this is hardly what I'm concerned about. What I'm concerned about is that if you have extremely low leptin levels and constantly feel hungry after losing significant weight. Eating fewer calories isn't that hard- it's eating fewer calories when your body is screaming at you that it's hungry- all the time. This has been my experience since losing 150 lbs years ago. I am always hungry- painfully so, sometimes. I've had many episodes of sitting on the floor in front of the fridge crying- because I know I shouldn't eat but my stomach is growling and I feel weak and awful. Has anyone experienced the problem of being constantly hungry after losing weight? Do you feel hungrier than the people around you?

2. Has anyone ate at a deficit (while weighing their food, counting everything, and not overestimating exercise calories, et cetera) and still gained weight? While pregnant (which meant I should have been burning 300-500 extra calories per day) I ate at 1600 cals every day (should have been a decent sized deficit) while logging religiously and carefully, and I still gained 90 lbs by the time I delivered. Please do not try to call BS- because it is 100% true and I was really angry about it, but now I'm starting to think this article just explained why. I want to know if anyone else has had something similar happen.

3. A lot of people are chiming in that have lost <50 lbs. I'm interested in the experience of people who have lost over 100 lbs and have kept it off, or failed to keep it off (even with diet and exercise) for 5-10 years or more. Extreme weight loss is a different ballgame than losing 25 lbs and keeping it off for a few years. Of course, every success is worth celebrating, and generally I wouldn't minimize, but losing less than 50% of your body weight just doesn't contribute anything to this conversation. Based on what I read in the article it appears that the metabolic damage and leptin issues that occurred for the participants were proportional to the amount of weight they lost, so if you lose 30 lbs you're not going to be suffering from having almost no leptin in your body and feeling constantly hungry as a result.

4. If you DID manage to lose 100 lbs or more and keep it off for many years- how long did it take you to lose the weight to begin with? I'm curious to know whether it's the extremely fast nature of the weight loss that sent these contestant's bodies into shock and created all of the metabolic issues. I'm wondering if losing a few lbs a month will go unnoticed by the body or if it will produce the same issues.

5. I'm interested in whether anyone had liposuction after or in conjunction with losing significant weight through diet. I have seen people speculating that once you have fat cells in your body, once you shrink them, they are still prone to store fatty tissue again more easily, so a person who has been obese once can gain the weight back easier because they don't have to create new fat cells. If that's the case, if anyone has had lipo and a huge amount of these cells were actually removed from your body as a result, I'm wondering if you found it harder or just as easy to gain back the weight.

6. Just a few disclaimers- please do not chime in just to talk about how it's all CICO and anyone who thinks gaining weight is more or less than that is wrong. We know it's about CICO- but if you don't think that a lack of leptin making you constantly insatiably hungry or a body that burns 800 calories less than the MFP calculations tell you that you're supposed to be burning isn't an issue, than you're oversimplifying things and you're being grossly insensitive to those of us who are following the rules of the mathematics and who understand the science and still aren't getting results. If you have ever lost 100-150 lbs and then found that NOTHING worked for you after that, then you know what I mean. I have lost significant weight and then followed the MFP calculations religiously in an attempt to get the final 30-50 lbs off and nothing happened. I was maintaining when I was supposed to have a daily 500 calorie deficit. Some weeks I would even gain. I kept lowering my deficit and getting angry that the math was betraying me, and I had to get all the way down to 550 cals a day before I was losing again- which was absolute torture and isn't healthy. I am desperate to know if there's just going to be a number that's so low that you can't lose any more weight without exercising to excess to create deficits.

7. Did anyone lose their significant weight with an alternate diet (not strictly CICO) like keto, and did you struggle with regaining weight? Did anyone lose weight in conjunction with body building or lose weight and then bulk up with muscle and have a difficult time keeping the weight off? (There is some promising research on a ketogenic diet and metabolism issues, and I'm also wondering if bulking muscle mass would fix the slow metabolism since muscle has a higher resting metabolic need than other tissue.) The whole time I was reading the article, when the contestants were describing their methods to create 3500 calorie deficits daily- of course I was thinking that's just not healthy. It makes sense that it would do some damage- and we know that spending 7 hours a day on cardio is not the best approach to begin with- (catabolism, adrenal stress, et cetera) and that HIIT and weight lifting are far more valuable ways to spend your gym time.

Thanks all. I hate to be so honest about the types of answers I'm looking for but I just spent 45 minutes scouring other threads and haven't really seen many credible answers to these questions from people who might be actually experiencing these issues (people that have lost extreme amounts of weight.)

afatpersonwholikesfood

I'm 11 pounds from being classified as overweight and 45 pounds from being normal weight. I'm not sure that normal weight is my goal at the moment, but I wanted to throw that out there. I'm down about 170 pounds (didn't have a scale at first, so I freely admit that there's a 5 pound margin of error with my total weight lost, and I wanted to see a higher total so I went with the higher margin on my profile ), and May 6 will mark one year of weight loss. That means I've lost quickly, though perhaps not Biggest Loser-style fast.

I have lost 125 pounds and regained 7 years ago, and I lost 80+ pounds a couple of years before that and regained (as well as added on 100 more). There have been plenty of other -50's or -25's along the way as well that were regained. Just to give a bit of history. I have definitely been a yo-yo.

As for my body composition, I can tell you that I am most likely a bit leaner than another woman my height who has gotten to my current weight by perhaps gaining instead of losing. I say this because I have visible collarbones, a defined jaw line, and a hip-to-waist ratio of 0.7ish. I'm still fat; don't misunderstand, but I know I didn't lose all of my muscle along the way.

In any case, my contribution to this discussion is that I am continuing to lose. I'm not losing as consistently each week, but I am losing. I've averaged 9 pounds per month for the last 3 months. That's a pretty decent rate considering I have been eating in a deficit for a year. I also eat more now than I did when I was over 300 pounds - I just wanted to get that initial weight off quickly.

I do have a fear in the back of my mind sometimes that it will just stop. I've had that fear for quite a while. It has yet to happen. I may not lose every week, but after a few weeks, I am showing a loss.

As for maintenance and the future and leptin, sure, that scares me. Absolutely. How could it not? There's got to be a grain of truth in it somewhere. My goal is to make high levels of enjoyable activity my safeguard (it's not essential for loss, but over and over and over, it's shown to be essential for maintenance) and to stop at a weight that I feel comfortable maintaining - meaning, for example, that weighing 160 pounds is probably not realistic for me. I also hope to perhaps have body contouring done down the road when I have reached my final goal.

I do have to say that I have the most hope now that I have had in years. I'm not suffering, and things are working. There's no burnout. I feel like I can continue to log and carry on each day for the rest of my life. In the past, even though I understood CICO, I always had some sort of mental fatigue by now. Something has clicked this time.

lemurcat12

If this is about the BL study, PLEASE post in the correct thread: http://community.myfitnesspal.com/en/discussion/10382754/nytimes-reports-that-biggest-losers-have-decreased-metabolism#latest

If you don't like what people are talking about, bring up whatever.

Adah_m

lemurcat12 wrote: »

If this is about the BL study, PLEASE post in the correct thread: http://community.myfitnesspal.com/en/discussion/10382754/nytimes-reports-that-biggest-losers-have-decreased-metabolism#latest

If you don't like what people are talking about, bring up whatever.

I ask for no trolls complaining that I opened a new thread because the other threads are 20+ pages of no one talking about science, and then that's exactly what I get. The existing threads were taking way too long to read and they were just a hundred people chiming in with opinion about the biggest loser and not a whole lot of people talking who actually had read the study/understood the science.

ilex70

There was a recent thread in the General section re:is BMR testing worth it? People pretty much all said no, it isn't worth it because it is just a snapshot and you can calculate your personal TDEE through trial and error.

But I feel that if it is weighing on your mind that it is worth spending some money just to relieve the stress of wondering if nothing else. Find a testing center near you that isn't a weight loss clinic...prices range from $50 to $150 from the thread. The university near me is $150. Then you will have more information and if your BMR isn't crazy low then you know to look elsewhere for answers.

A lot of questions listed, but FWIW, I lost 100 pounds quickly w/VLCD (800 calories a day; then 1,000) Took around 9 months and I did lots of walking, cardio, minimal resistance exercise. Felt pretty lousy after...cold, hair falling out, fatigued. I regained 15 pounds within about 8 months. Then had some personal stress stuff and gained back more.

Started back here this past December and I've been losing fairly steadily eating more than I was on the VLCD. It isn't as quick, but I have been losing. And I'm doing cardio again...started just walking, but have increased as I've gone along. Increased my calories too.

The leptin issue has been a known thing for awhile I believe. And the lower BMR/RMR, but the thing is that the studies up to now found at worst maybe 100-200 calories less than average post weight loss, and some studies found that the effect went away over time.

And also you might do better to break these questions up into separate threads or take them to google; like: study lipo weight maintenance, or some such.

queenliz99

I'm lost. How do you know if your leptin is messed up? Is there a blood test for this? If you are not losing weight, it is because you are not in a calorie deficit.

MelodyandBarbells

queenliz99 wrote: »

I'm lost. How do you know if your leptin is messed up? Is there a blood test for this? If you are not losing weight, it is because you are not in a calorie deficit.

From what I understand she's wondering if her painful hunger pangs might have been explained why extremely low leptin levels due to prolonged calorie deficit

90 lbs gained while eating 1600 cals per day?

snikkins

JaneiR36 wrote: »

queenliz99 wrote: »

I'm lost. How do you know if your leptin is messed up? Is there a blood test for this? If you are not losing weight, it is because you are not in a calorie deficit.

From what I understand she's wondering if her painful hunger pangs might have been explained why extremely low leptin levels due to prolonged calorie deficit

90 lbs gained while eating 1600 cals per day?

And pregnant. All sorts of hormonal things could have been happening. OP also may have been overestimating extra pregnancy calories as well.

OP, if you're truly only losing at 550 calories per day, it's time to go see a doctor. MFP can't help you there.

EvgeniZyntx

Adah_m wrote: »

So please don't get nasty with me for the re-post as there are a lot of people talking about the NY Times article about the biggest loser contestants, and I have read SEVERAL of these threads, but NONE of them answer any of the questions that are in my head. It also appears that a lot of the people discussing it did not read the whole article (it's long so I understand) but please do not respond unless you have read the entire thing and understand the science in it. http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

This is the debate section, expect debate. It also seems to have become a free for all, so I can't really say your questions don't belong here. But being mostly of a personal nature - they'd probably be better suited for one of the other forums.

Still, I'll try to address your questions.

1.Has anyone experienced the problem of being constantly hungry after losing weight? Do you feel hungrier than the people around you?

Yes, some people report huge hunger issues, but if you are feeling that to such an extent that you are crying on the floor. Something is wrong. The culprit is one of various possibilities: under eating (which you seem to have eliminated as a possibility), macronutrient issues (are you getting enough protein and fat?), neuro, hormonal issues or other medical problems.

Personally, I do not generally have these hunger issues but even when I see a little too much hunger, it is usually 4-5 days of poor macros that set me up for hunger. Look at that first.

2. Has anyone ate at a deficit (while weighing their food, counting everything, and not overestimating exercise calories, et cetera) and still gained weight? While pregnant (which meant I should have been burning 300-500 extra calories per day) I ate at 1600 cals every day (should have been a decent sized deficit) while logging religiously and carefully, and I still gained 90 lbs by the time I delivered. Please do not try to call BS- because it is 100% true and I was really angry about it, but now I'm starting to think this article just explained why. I want to know if anyone else has had something similar happen.

If you gained 90 lbs while eating 1600 cals then something is medically wrong. This article does not explain that (and trust me, I've read it froward, backwards, the references and prior articles.) See a doctor. You should exclude fibromas and all other issues first.

Imagine that your metabolism is somehow set to 1100 cals TDEE at one point (which means that your BMR is sub 900, which by the way, would mean you are smaller than 4 ft 5 and completely inactive). And you eat 1600. That would be a 500 cal surplus resulting in a pound a week gain. 40 weeks later, you give birth. That means that for this tiny woman, the max fat weight possible would have been 40 lbs. Yet you gained 2x that.

So clearly a large weight gain like that isn't fat. It means that your weight gain was related to something else. A medical condition. There are a whole bunch of them that can result in important non-fat gains from water retention, edema, etc... We won't play the guessing game - this is an area to discuss with a doctor.

3. A lot of people are chiming in that have lost <50 lbs. I'm interested in the experience of people who have lost over 100 lbs and have kept it off, or failed to keep it off (even with diet and exercise) for 5-10 years or more. Extreme weight loss is a different ballgame than losing 25 lbs and keeping it off for a few years. Of course, every success is worth celebrating, and generally I wouldn't minimize, but losing less than 50% of your body weight just doesn't contribute anything to this conversation. Based on what I read in the article it appears that the metabolic damage and leptin issues that occurred for the participants were proportional to the amount of weight they lost, so if you lose 30 lbs you're not going to be suffering from having almost no leptin in your body and feeling constantly hungry as a result.

Quite incorrect. Leptin issues occur at various weight and weight losses. And also may not occur at large loss. The variance on the leptin measured in the study was quite high. The authors recognise that it might be a factor but do not report it as a certainty. Also, evidence of extreme hunger was not reported in the article.
The article focuses more on the possibility of adrenal-thyroidal issues related to hormonal balance.

If all you are looking for is personal stories of people that lost a lot of weight - might want to use the other sections of the forum and ask that specific question.

If you believe that the hunger issues you are seeing are driven by hormonal issues - get these tested with your doctor.

5. I'm interested in whether anyone had liposuction after or in conjunction with losing significant weight through diet. I have seen people speculating that once you have fat cells in your body, once you shrink them, they are still prone to store fatty tissue again more easily, so a person who has been obese once can gain the weight back easier because they don't have to create new fat cells. If that's the case, if anyone has had lips and a huge amount of these cells were actually removed from your body as a result, I'm wondering if you found it harder or just as easy to gain back the weight.

Lipo only touches some of the subcutaneous fat cells is small regions. "Huge" amounts are never removed - it is an aesthetic and remodelling technique - not a fat loss technique. Once someone goes back to eating at surplus fat will come right back.

6. Just a few disclaimers- please do not chime in just to talk about how it's all CICO and anyone who thinks gaining weight is more or less than that is wrong. We know it's about CICO- but if you don't think that a lack of leptin making you constantly insatiably hungry or a body that burns 800 calories less than the MFP calculations tell you that you're supposed to be burning isn't an issue, than you're oversimplifying things and you're being grossly insensitive to those of us who are following the rules of the mathematics and who understand the science and still aren't getting results.

Leptin is not the only hormone involved in hunger signaling and leptin therapy has only been shown to be effective is a small number of types of deficiencies.

Weight gain and loss isn't just about CICO, there can be medical conditions that result in radical weigh changes.
CICO is about metabolic weight gain based on energy input and output and the equations used here assume that long term that is related to fat gain or loss, not other physiological possibilities.

I am desperate to know if there's just going to be a number that's so low that you can't lose any more weight without exercising to excess to create deficits.

For some individuals it will be extremely difficult to lose weight without exercise. And at one point, weight loss without exercise, in the face of hunger signaling, etc. is just harder. Furthermore, important weight loss without exercise means that you've lost metabolically active LBM and have not seen the positive metabolic changes (improved mitochondrial response, etc.)

While I don't support the Biggest Losers method, at least the fact that they exercised heavily created physiological pressures to retain muscle, connective tissue and bone health. Without that, these people would have seen further metabolic issues and faster weight regain.

Hope that helps, I suspect you are looking for personal stories from people that have lost large amounts - which is not my case - but some of the answers might be food for thought.

Adah_m

EvgeniZyntx I was looking for exactly the answers you provided. Thank you so much. What I did not want to see were a ton of personal stories, I wanted real information with as much science as possible. I've been doing as much research as I can on my own by reading the actual studies and trying to understand more of how the body's metabolic processes work (what you were talking about- the additional mechanisms besides leptin). I only have limited time right now but learning the real underlying information is my goal and kind of a hobby to tell you the truth. Unfortunately it takes a lot of time just to weed through the bull and find credible sources online. MFP forums can be helpful sometimes but I'd kind of given up on them- too many trolls who post just to tell you the reason why you shouldn't be posting, too many personal stories and anecdotal information, too much repeating information, too much opinion (and conflicting opinions). Combing threads seems even more time consuming and less helpful than just doing the research outside of MFP.

To address the concerns about eating at 1600 cals pregnant- I'm 5'8'' and began my pregnancy in a size 14, weighing 210 ish. When I went into labor I weighed 299 and was in a size 18 maternity jeans. Give or take 90 lb gain. Of course, it wasn't 90 lbs of fat though because I gave birth to a 10 lb baby and I was ENORMOUS for having only one baby. I think I had a large amount of amniotic fluid and things. After delivery I was down around 275, and I had extreme edema for a while too, I remember because the high swelling interfered with nursing. I think I gained around 50 lbs of fat and the rest was baby, fluid, and breast tissue. The point though is that I was eating very carefully to avoid excessive gain (the doctor only recommends gaining 15 lbs if you're already overweight) and I still gained a ton. As an aside though- besides all the weight gain I had an extremely good pregnancy. I never developed any complications (gestational diabetes or pre-eclampsia) or even had a lot of pain or difficulty with anything. I didn't even have morning sickness. Everything was extremely smooth and I delivered at 2AM on my due date with a big healthy baby boy. It never occurred to me that there could be a hormone issue when I didn't have any fertility issues and my pregnancy was so smooth.

At the advice though of several of you, I am going to see a doctor because the numbers rarely add up for me and I had never really considered before that there were other factors at play than simply fat and muscle losses and gains. I have been looking at the math over and over and getting really upset when maybe the math isn't working for me because there is something else up. I guess I assumed that if I had a thyroid issue or something that it would have become apparent during the pregnancy but maybe not. There is a history of extreme obesity in my family though and I'm doing everything I can to fight it.

Also regarding the person who seemed shocked that the hunger pains can be bad enough to leave one in tears- it's not so much the pain/hunger, part of it is the sheer frustration of knowing that I SHOULDN'T be hungry, yet being hungry anyway, and feeling like my body is betraying me or wanting to stay fat of its own accord. That is a very defeating feeling.

I did notice, and I will mention this to the doctor when I go- that since I started a keto diet (at the advice of my friend) the extreme hunger has reduced DRASTICALLY. I lost 8 lbs in the first week keto, and that's without really cutting calories (getting around 1600-1800 and getting most of that from protein and fat). I'm assuming that I had some water retention going on because it's not possible to lose 8lbs of fat like that, but I think maybe by avoiding insulin spikes and the subsequent crashes, I'm getting the hunger under control. I used to feel weak, get headaches, get extremely tired, even feel nauseated when hungry and I haven't felt that in weeks. Right now I'm only logging to keep track of my carb intake and I've been losing week over week without a calorie decrease. Maybe the insulin levels had something to do with it, I don't know. I can say I feel 10x better though, and I'm performing WAY better when I train too. I wasn't making any gains for a long time, and in three weeks keto I jumped from squatting 45 lbs to 115 and increased my deadlift from 95lbs to 165. I thought I was getting enough protein before (75-125 g/day) but maybe I wasn't getting enough fat. Either way I'm training better and feeling better so maybe there's something to keto.

Adah_m

If it helps, here's what I looked like at 299 lbs (5'8'') the day before going into labor. Needless to say my son is a chunk.


This was at 5 months pregnant, probably around 245 or 250.


Here was pre-pregnancy (around 210) and please excuse the outfit, haha. I had very few pictures to choose from. I was around a 14-16 here.



Here I was a few weeks ago- roughly 250, size 16-18, 6 months post partum and after getting back to heavy lifting for about 2-3 months.

RalfLott

queenliz99 wrote: »

I'm lost. How do you know if your leptin is messed up? Is there a blood test for this? If you are not losing weight, it is because you are not in a calorie deficit.

@queenliz99 - Yes, there is a leptin test, but there are relatively few labs around able to run it. (My sample was sent to Mayo and took 2 weeks to come back.)

Oddly, the male and female standard ranges are quite diffetent (females needing higher levels to fall within the normal range).