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Why You Can’t Lose Weight on a Diet- New York Times Article- May 6, 2016

Susan2BHealthierSusan2BHealthier Posts: 125Member Member Posts: 125Member Member
http://www.nytimes.com/2016/05/08/opinion/sunday/why-you-cant-lose-weight-on-a-diet.html?hpw&rref=sunday-review&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well&_r=4

Why You Can’t Lose
Weight on a Diet
The problem isn’t willpower. It’s neuroscience.
You can’t — and shouldn’t — fight back.

SIX years after dropping an average of 129 pounds on the TV program “The Biggest Loser,” a new study reports, the participants were burning about 500 fewer calories a day than other people their age and size. This helps explain why they had regained 70 percent of their lost weight since the show’s finale. The diet industry reacted defensively, arguing that the participants had lost weight too fast or ate the wrong kinds of food — that diets do work, if you pick the right one.

But this study is just the latest example of research showing that in the long run dieting is rarely effective, doesn’t reliably improve health and does more harm than good. There is a better way to eat.

The root of the problem is not willpower but neuroscience. Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range, called the set point. The range, which varies from person to person, is determined by genes and life experience. When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.

The brain’s weight-regulation system considers your set point to be the correct weight for you, whether or not your doctor agrees. If someone starts at 120 pounds and drops to 80, her brain rightfully declares a starvation state of emergency, using every method available to get that weight back up to normal. The same thing happens to someone who starts at 300 pounds and diets down to 200, as the “Biggest Loser” participants discovered.

This coordinated brain response is a major reason that dieters find weight loss so hard to achieve and maintain. For example, men with severe obesity have only one chance in 1,290 of reaching the normal weight range within a year; severely obese women have one chance in 677. A vast majority of those who beat the odds are likely to end up gaining the weight back over the next five years. In private, even the diet industry agrees that weight loss is rarely sustained. A report for members of the industry stated: “In 2002, 231 million Europeans attempted some form of diet. Of these only 1 percent will achieve permanent weight loss.”

The specific “Biggest Loser” diet plan is probably not to blame. A previous study found similar metabolic suppression in people who had lost weight and kept it off for up to six years. Whether weight is lost slowly or quickly has no effect on later regain. Likewise — despite endless debate about the relative value of different approaches — in head-to-head comparisons, diet plans that provide the same calories through different types of food lead to similar weight loss and regain.

As a neuroscientist, I’ve read hundreds of studies on the brain’s ability to fight weight loss. I also know about it from experience. For three decades, starting at age 13, I lost and regained the same 10 or 15 pounds almost every year. On my most serious diet, in my late 20s, I got down to 125 pounds, 30 pounds below my normal weight. I wanted (unwisely) to lose more, but I got stuck. After several months of eating fewer than 800 calories a day and spending an hour at the gym every morning, I hadn’t lost another ounce. When I gave up on losing and switched my goal to maintaining that weight, I started gaining instead.

I was lucky to end up back at my starting weight instead of above it. After about five years, 41 percent of dieters gain back more weight than they lost. Long-term studies show dieters are more likely than non-dieters to become obese over the next one to 15 years. That’s true in men and women, across ethnic groups, from childhood through middle age. The effect is strongest in those who started in the normal weight range, a group that includes almost half of the female dieters in the United States.

Some experts argue that instead of dieting leading to long-term weight gain, the relationship goes in the other direction: People who are genetically prone to gain weight are more likely to diet. To test this idea, in a 2012 study, researchers followed over 4,000 twins aged 16 to 25. Dieters were more likely to gain weight than their non-dieting identical twins, suggesting that dieting does indeed increase weight gain even after accounting for genetic background. The difference in weight gain was even larger between fraternal twins, so dieters may also have a higher genetic tendency to gain. The study found that a single diet increased the odds of becoming overweight by a factor of two in men and three in women. Women who had gone on two or more diets during the study were five times as likely to become overweight.

The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Boxers and wrestlers who diet to qualify for their weight classes presumably have no particular genetic predisposition toward obesity. Yet a 2006 study found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports.

To test this idea rigorously, researchers could randomly assign people to worry about their weight, but that is hard to do. One program took the opposite approach, though, helping teenage girls who were unhappy with their bodies to become less concerned about their weight. In a randomized trial, the eBody Project, an online program to fight eating disorders by reducing girls’ desire to be thin, led to less dieting and also prevented future weight gain. Girls who participated in the program saw their weight remain stable over the next two years, while their peers without the intervention gained a few pounds.

WHY would dieting lead to weight gain? First, dieting is stressful. Calorie restriction produces stress hormones, which act on fat cells to increase the amount of abdominal fat. Such fat is associated with medical problems like diabetes and heart disease, regardless of overall weight.

Second, weight anxiety and dieting predict later binge eating, as well as weight gain. Girls who labeled themselves as dieters in early adolescence were three times more likely to become overweight over the next four years. Another study found that adolescent girls who dieted frequently were 12 times more likely than non-dieters to binge two years later.

My repeated dieting eventually caught up with me, as this research would predict. When I was in graduate school and under a lot of stress, I started binge eating. I would finish a carton of ice cream or a box of saltines with butter, usually at 3 a.m. The urge to keep eating was intense, even after I had made myself sick. Fortunately, when the stress eased, I was able to stop. At the time, I felt terrible about being out of control, but now I know that binge eating is a common mammalian response to starvation.

Much of what we understand about weight regulation comes from studies of rodents, whose eating habits resemble ours. Mice and rats enjoy the same wide range of foods that we do. When tasty food is plentiful, individual rodents gain different amounts of weight, and the genes that influence weight in people have similar effects in mice. Under stress, rodents eat more sweet and fatty foods. Like us, both laboratory and wild rodents have become fatter over the past few decades.

In the laboratory, rodents learn to binge when deprivation alternates with tasty food — a situation familiar to many dieters. Rats develop binge eating after several weeks consisting of five days of food restriction followed by two days of free access to Oreos. Four days later, a brief stressor leads them to eat almost twice as many Oreos as animals that received the stressor but did not have their diets restricted. A small taste of Oreos can induce deprived animals to binge on regular chow, if nothing else is available. Repeated food deprivation changes dopamine and other neurotransmitters in the brain that govern how animals respond to rewards, which increases their motivation to seek out and eat food. This may explain why the animals binge, especially as these brain changes can last long after the diet is over.

In people, dieting also reduces the influence of the brain’s weight-regulation system by teaching us to rely on rules rather than hunger to control eating. People who eat this way become more vulnerable to external cues telling them what to eat. In the modern environment, many of those cues were invented by marketers to make us eat more, like advertising, supersizing and the all-you-can-eat buffet. Studies show that long-term dieters are more likely to eat for emotional reasons or simply because food is available. When dieters who have long ignored their hunger finally exhaust their willpower, they tend to overeat for all these reasons, leading to weight gain.

Even people who understand the difficulty of long-term weight loss often turn to dieting because they are worried about health problems associated with obesity like heart disease and diabetes. But our culture’s view of obesity as uniquely deadly is mistaken. Low fitness, smoking, high blood pressure, low income and loneliness are all better predictors of early death than obesity. Exercise is especially important: Data from a 2009 study showed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out. Exercise reduces abdominal fat and improves health, even without weight loss. This suggests that overweight people should focus more on exercising than on calorie restriction.

In addition, the evidence that dieting improves people’s health is surprisingly poor. Part of the problem is that no one knows how to get more than a small fraction of people to sustain weight loss for years. The few studies that overcame that hurdle are not encouraging. In a 2013 study of obese and overweight people with diabetes, on average the dieters maintained a 6 percent weight loss for over nine years, but the dieters had a similar number of heart attacks, strokes and deaths from heart disease during that time as the control group. Earlier this year, researchers found that intentional weight loss had no effect on mortality in overweight diabetics followed for 19 years.

Diets often do improve cholesterol, blood sugar and other health markers in the short term, but these gains may result from changes in behavior like exercising and eating more vegetables. Obese people who exercise, eat enough vegetables and don’t smoke are no more likely to die young than normal-weight people with the same habits. A 2013 meta-analysis (which combines the results of multiple studies) found that health improvements in dieters have no relationship to the amount of weight they lose.

If dieting doesn’t work, what should we do instead? I recommend mindful eating — paying attention to signals of hunger and fullness, without judgment, to relearn how to eat only as much as the brain’s weight-regulation system commands.

Relative to chronic dieters, people who eat when they’re hungry and stop when they’re full are less likely to become overweight, maintain more stable weights over time and spend less time thinking about food. Mindful eating also helps people with eating disorders like binge eating learn to eat normally. Depending on the individual’s set point, mindful eating may reduce weight or it may not. Either way, it’s a powerful tool to maintain weight stability, without deprivation.

I finally gave up dieting six years ago, and I’m much happier. I redirected the energy I used to spend on dieting to establishing daily habits of exercise and meditation. I also enjoy food more while worrying about it less, now that it no longer comes with a side order of shame.

Sandra Aamodt, a neuroscientist, is the author of the forthcoming “Why Diets Make Us Fat: The Unintended Consequences of Our Obsession With Weight Loss.”

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Replies

  • BiggDaddy58BiggDaddy58 Posts: 406Member Member Posts: 406Member Member
    Dieting doesn't work...because a diet is a short term solution to a long term problem. Go on a diet..lose weight..done with the diet..go back to gaining weight. It has to be a lifestyle change. A combination of a healthy diet and exercise , staying active. IF you make it a lifestyle change, then it will stick.
  • RobertusRobertus Posts: 558Member Member Posts: 558Member Member
    I thought the article was pretty good at summarizing some important study results. Some studies do indeed show that losing weight quickly does not make you more likely to gain it back, and the great majority of people will very likely gain weight back after losing it. There are neurogenic and hormonal mechanisms that explain these issues. Fitness does have a much bigger impact on health and mortality than weight or even obesity. This is all good information. No good reason to deny or belittle the facts. But can people who maintain purposeful and effective attitudes and behaviors to take charge of their fitness and health succeed long term. Yes! But it isn't easy.
  • llbrixonllbrixon Posts: 1,203Member Member Posts: 1,203Member Member
    I really do believe the body has a weight set point. For the past 25 years my weight reaches it's set point of 198. I did not continue to exercise, but continued unhealthy eating habits. Every time i would lose the same 40 pounds, I would gain them back. It will take a life style change of "mindful" eating and continued exercise to keep the weight off.
  • CaptainJoyCaptainJoy Posts: 257Member Member Posts: 257Member Member
    @paulgads82 The author stated: "Whether weight is lost slowly or quickly has no effect on later regain."
    @Ws2016 "Calorie restriction..."

    I don't like how this 'neuroscientist' used personal experiences in her scientific article. It was opinionated and gave the impression that obesity is healthy and restricting calories is unhealthy. She states that we have no control over our metabolic functions so we should just follow mindful eating habits, exercise, and meditate. She's clearly had severe eating disorders her whole life, has never been obese, and would now like to enjoy her meals without a "side order of shame." Yup, sounds like bait to buy her book. No thank you.
  • lemurcat12lemurcat12 Posts: 30,886Member Member Posts: 30,886Member Member
    What the author may be trying to say, is that certain hyperpalatable but non-nutritious foods are too easy to overeat, and if we base our intake on old-fashioned foods made more from scratch, it will be easier to eat just the amount we need to lose, and then maintain, weight.

    I think she's talking more simply about restricting calories, and thus the example of wrestlers having issues with weight later in life.

    I never get the distinction between so-called old-fashioned foods and hyperpalatable ones, as IMO homemade foods are typically much more delicious than the super processed stuff. People overeat without problem at, say, Thanksgiving. The difference is availability, not that the store-bought stuff is harder to resist.
  • lemurcat12lemurcat12 Posts: 30,886Member Member Posts: 30,886Member Member
    llbrixon wrote: »
    I really do believe the body has a weight set point. For the past 25 years my weight reaches it's set point of 198. I did not continue to exercise, but continued unhealthy eating habits. Every time i would lose the same 40 pounds, I would gain them back. It will take a life style change of "mindful" eating and continued exercise to keep the weight off.

    The problem with this argument is that weight has increased societally--the obesity rate has increased a lot. It can't be a matter of set point.
  • kimny72kimny72 Posts: 14,065Member Member Posts: 14,065Member Member
    She seems to be conflating problems with long-term aggressive calorie restriction with all dieting. Probably to expand the target demographic of her upcoming book. And most likely fueled as well by her personal experiences with unnecessary VLCDs that led to her eating disorders.
  • kommodevarankommodevaran Posts: 17,960Member Member Posts: 17,960Member Member
    lemurcat12 wrote: »
    What the author may be trying to say, is that certain hyperpalatable but non-nutritious foods are too easy to overeat, and if we base our intake on old-fashioned foods made more from scratch, it will be easier to eat just the amount we need to lose, and then maintain, weight.

    I never get the distinction between so-called old-fashioned foods and hyperpalatable ones, as IMO homemade foods are typically much more delicious than the super processed stuff. People overeat without problem at, say, Thanksgiving. The difference is availability, not that the store-bought stuff is harder to resist.


    Yes, it's definitely the availability that is the problem. Paired with the ability to resist whatever one has problems resisting, if applicable. It's a problem only when and if it's a problem. Regularly overeating is a widespread problem, though. Regularly overeating broccoli is just as serious for those who do that, but it's not as common as overeating (what I call) hyperpalatable foods. Pica is also a serious problem for the sufferers of pica, but not for the society as a whole. I have no doubt your apple and rhubarb pies are delicious. But they aren't everywhere and pushed aggressively all the time.
  • Need2Exerc1seNeed2Exerc1se Posts: 13,589Member Member Posts: 13,589Member Member
    lemurcat12 wrote: »
    Right. I just hate the idea that highly processed stuff is more delicious/inherently harder to resist. It's just extremely available and requires no or little preparation.

    I agree. IMO it's inferior in taste. But there's no denying it's far superior in ease.
  • kayakerandbikerkayakerandbiker Posts: 28Member Member Posts: 28Member Member
    A neuroscientist trying to talk about metabolism, kay.

    And she spent "months" eating "below 800 calories a day."

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