Thoughts, Epiphanies, Insights, & Quotables
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Don't disagree re that in the end we can manage!!!
Be aware that there is some re-gigging of what chat-bots say in response to prompts. You can see me fighting with the thing to eliminate refeeding syndrome it latched itself to; and to also not take as gospel some things I threw at it unless they had support from the literature.
Set point theory is based on biological (physiological) resistance. Settling point theory is more based on environmental, socioeconomic, behavioral, social factors. Slowly it is looking like a hybrid dual intervention point model is evolving which will incorporate both biological and environmental factors.
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Oh, haha, chatbot telling you how/what to reframe so it can report - hysterical.
Pav, so was reading more of 1st report - and the recognition of exercise important to have a higher calorie burn - and, I think that reflects what 'Anne- who rows' often reports.
2nd, reading about 'TEF' - thermogenic effect of food' - that must be what the RD was talking about bmr + digestion of food theoretically would burn about 200cals/hr, so spread food out and eat 200 cals/hr - which just has not worked well for me - it's similar to the diabetes food approach they put mom on in the 80's - snacks between meals, mid-evening, and bedtime to keep her blood glucose stable (theory).
- Compared to now, eat 5-6 hrs between meals to give pancreas a rest
- Or IF or OMAD to help body heal.
Or.… then there's things like intuitive eating to learn real hunger signals - but honestly, how would that realistically work if hunger signals are quite broken related to metabolic adaptation post-weight loss and the body increases leptin, ghrelin and stress spikes cortisol?
3rd, I would agree with the idea/concept that the systems are NOT static, and the adaptation post-weightloss may actually be temporary (despite 6yrs for Biggest Losers people who really were super loss super fast.)
Like Yooly mentioned, it is not simple physical mechanics. There are significant emotional/behavioral things - hence HAES considerations as well.
Consequently, similar but confoundingly complex/unique considerations specific to the individual — combined with non-static adjustments by the physical body
==⇒ a variable time and variable habit/behavioral strategies needed different/vary for each person.
— fwiw disclosure, on a personal experience, i have not yet reached weight-loss maintenance, nor kept lost weight off, so speaking from other observation/ experience.
I know no one in real life who lost and kept off weight, so my experience is that regain/recidivism is acutely high.
I find it profoundly encouraging to meet people on MFP who are tackling maintenance and talking about it. Find it profoundly hopeful. Can't say that enough.
I find quitting longterm smoking similar but weightloss much harder.
- It was roughest first year after quitting. Took 5 years for the habitual part to extinguish.
- This gives me hope the weightloss is possible too…
- And that... there is a point a person reaches where they are unlikely to go back.
- Think Prochaska stages of change theoretical model - i think the weightloss - and maintenance - path can be messy like that...
- Not linear, different for everyone.
- Profoundly possibly - we just have to keep at it. I refuse to quit.
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Mfp burped! Lol
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Snippet - Pav also wrote/concluded: "Set point theory is based on biological (physiological) resistance. Settling point theory is more based on environmental, socioeconomic, behavioral, social factors. Slowly it is looking like a hybrid dual intervention point model is evolving which will incorporate both biological and environmental factors."
/end snippet
— have caught up! We come to a similar conclusion :))
— settling point? Hmmm, missed that - not doubling back. Lol
— so completely agree with evolving consensus and possible future approach…
— worthy topic to post in debate - would be intetesting.
I do not have a chatbot beyond what is generally starting to be offered in search functions. I did not think I would like it, at all, however, my few uses have yielded info I was unable to pull from general search which curates the answer it thinks I want and is often completely wrong.
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MFP often eats my homework.
I tried to leave intuitive eating and haes out not because of hate but because there is little evidence for them either in terms of helping create weight loss or assisting with post weight loss maintenance.
HOWEVER, as far as I can tell, both have a LOT of evidence / substantial anecdotal support in terms of improving participant psychological states and improving problem eating behaviors. And some modest weight loss in many cases as a result. So, if we consider that anything that builds us up is good… they're good!
But do remember that the original questions and direction of the evidence based over-view of available literature that I asked for was evaluating the vehemently advanced contention that exercise and increasing one's TDEE are the only way to maintain a weight loss and that this is established scientific consensus—both positions that I do not agree with.
The initial question then had to do with maintenance after weight loss and reasons as to why it is a problem as well as on options to counteract the issues.
actually now that I think about it, the whole review is a very light in terms of ways of eating for example.
I will admit that I got a lot of push-back (more than I expected) from the AI in terms of the long term hormonal adaptations issue. I was expecting some evidence for recovery in the longer term and I didn't manage to get it to find me any. I got more support than I expected about longer term resolution to metabolic adaptation even though gemini was initially presenting it the same way as horomes. I was aware of support for my position via Minnesota which gemini did eventually find. And when I pushed back against it being valid it held to the validity of both minnesota supporting this AND found a newer study I wasn't aware off discussing even faster resolution to metabolic adaptation.
Got more pushback than expected in trying to exclude the larger loser study results and replace them with something else. One of the criticisms of the study that I am personally aware off that I couldn't get the AI to consider is that it is very likely that at the six year follow up point the participants were not testing after a time period of six years of stable weight but were instead tested in the middle of a crash diet to make themselves look less bad in terms of how much weight they had re-gained. Which would make the results invalid as we already know that there is metabolic adaptation during loss and it is to be expected that someone who has lost rapidly would be prone to faster adaptation in subsequent attempts (making it harder and harder to lose with each yo-yo unless sufficient time has passed / sufficient regain taken place)
In any case, though, I think it gives a more full overview and if nothing else the references can be followed individually!!! And hint: extra activity and exercise are good. But so are a whole whack of other things!
And remember the bit about following some of the references? Now why didn't the AI that found this paper not surface it when I was asking about hormones resolving?
https://pmc.ncbi.nlm.nih.gov/articles/PMC7250208/
Individuals with obesity should expect to feel hungrier in the fasting state after they lose weight, but also more full after a meal. In summary, their appetite control system becomes more attuned to their lower body weight and sensing the reduction in fat mass. This likely represents a normalization toward what would be expected as fat mass reduces and, as we have previously shown, does not predict long-term relapse.
This concept needs, of course, to be tested and further validated because it represents a paradigm shift in thinking about relapse in obesity management, and that it is no longer an inevitable scenario resulting from increased orexigenic drive following diet-induced WL.
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A bit of a long day, tuckered, stream of consciousness reply... making a case for the behavioral aspects of weight management.
Ok... here we go...
Nods...
Learns a new word there 'orexigenic' - ha! I have a 4 letter explanation word - 'life!' Lol
Understand the intent of the question you posed to AI, and, in the past and in a methodical clinical, physical sense, physical drivers have NOT been well understood,
and all too often, moral values have been inappropriately assigned to the person - values of good, bad, failure/blame type values assigned when the person stops or regains - which a significant portion/majority of people seem to regain... or truncated even earlier... when they fail to lose.
So although the question at hand is narrowed to physical dynamics within the body, neither weightloss nor maintenance occurs in a vacumn.
Social, cultural mores, beliefs/attitudes, habits and problematic behaviors can controvert the physical dynamics of the process at any point during weight loss or maintenance -
and there seems to be increasing evidence that those hormonal dynamics in the body along with adaptation can drive physical hunger ==⇒ dealing with that trigger/appetite might necessate both a physical response (such as add exercise) and a 'thinking/behavioral/emotional' response to recognize and not feed hormone driven hunger.
In other words? I think understanding the physical hormones and adaptation process in the body ==⇒ can lead to strategies to cope with, maybe even devolve the appetite; questions like type & duration & timing of exercise or quantity and types of foods that might have an 'orexigenic' or 'anorectic' impact, such as some medications do, like the glp'1s do.
Occurs to me, medicine induced impact would be an 'external' intervention/manipulation such as exercise factors would be an external intervention...,
so yes, i would agree with you - exercise is not, can not be, the sole solution, eh? Part, but not all of the effective therapeutic options one can choose to use… or not - which I would proffer, ongoing emotional, behavioral factors are equally important to address.
For some people, speaking of significant disordered eating type matters - behavioral matters sometimes needs significant work before the person can sustain weight loss.
And in all of this, it gets totally entwined for some. I almost think it's a relatively rare person who can wake up, decide to change and do it from a CiCo technical perspective? Not sure there is any research to support this idea either!
But, it seems to me MFP is outsized with people who find CiCo & calorie counting helpful - so perhaps the sample population here is skewed (lacking a significant representation of people who find success more on the other end of options.)
Lol
Pav, I appreciate the conversation and mulling the ideas. Thank you!
Personally speaking, I'm not a science/technical kind of person - more of a marketing, understand the trends & social thinking kinds of 'rah rah, pump you up - you can do it, Eye of the Tiger' kind of person/dieter.
But when I read the posts of trauma & emotional pain, and dis-empowered hopelessness in posts like those, I increasingly feel it is both. Physical & emotional multifaceted factors must be addressed for many to actually succeed in the weight loss phase and then in maintenance - I desire to believe both are possible!
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Ps - I do see/understand that 'all the rest' is beyond/unrelated to a narrow scope/question to understanding the post-weightloss physical mechanics and aspects within the body re the changes in hormones and metabolic adaptation.
It is good to know the adaptations and effects may not endure as long as previously thought because it is not static nor permanent, and, I would agree, there surely may be more ways to physically impact the duration perhaps even intensity.
Some that come to mind
- Exercise in terms of duration, intensity, timing, frequency (whereas it has been demonstrated to impact blood glucose levels and metabolic sensitivity to insulin - then perhaps it has impact on other hormones & systems?)
- Types & quantity of foods eaten and frequency particularly on appetite and the physical drive to eat
- Again on food that provides essential nutrition to support body functions
- On sleep, rest and recovery allowing the body to repair
- Of stress and cortisol and the physical and emotional ways a person can help the body release stress and tension, calm cardiovascular system in ways other than exercise.
Don't mean to overshoot or shoot wide, it's fine to look at a specific function - I just would agree that adding/increasing exercise is not the only way to regulate the body, hormones and metabolic adaptations, post-weight loss.
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I’m likely missing the whole point of the study…..
Okay - some thoughts on a more pedestrian level. Researchers/scientists tend to waaaay overthink and often complicate stuff.
Maybe people who are successful in maintenance by upping exercise are the ones who stay AWARE and active in the process. If I up my exercise after weight loss it’s because at some level I know it’s necessary? The “intuitive” eaters are also in the game at some level.
A lot of regain is often the result of letting go. Tired of the daily struggles? Whether consciously or unconsciously like during life crises? My new meds and weight are manageable if I really work at it. Unfortunately right now my brain/emotions are not giving a damn and asking for comfort.
I think of my obesity as a lifelong medical condition that I need to manage. Sometimes well and sometimes poorly (lately!). Normal people- like my husband- do not suffer from that condition.1 -
I find very little (at first blush nothing) wrong with yakky's train of thought.
My only disagreement with Rah Rah and social is that I've seen too many rah rah / social milieu failure.
Rah Rah can work for 10 months (maybe) but cannot work for 10 years. And if you don't respect the physical during the 10 months and trigger too many changes without being somewhat aware then you're not setup for later.
Social milieu / team is a good concept for support maybe but a hard fail for me in terms of depending on it.
We are in a low % of success game and setup the condition of having multiple simultaneous successes in order to win either. So we take our 10% independent probability of success and turn it into a 1% joint probability.
That said: I started improving my health in part because my friend J was in the successful middle of a 3 year yo-yo. Seeing me lose and continue as he had reverted he recommitted (and also started logging and also I'm going to giggle but discovered rowing and the social group found there). So J is, frankly, in way better shape than myself and normal weight with a maybe a couple of years less maintenance. And his cousin seeing both of us has not applied quite as much of a loss but the past couple of years is more than 10% down from Max. So there is an effect. Most important there both J and myself made major changes in our daily lives/associations to support.
But yes. I think of it as an onion with many layers and the more layers of tools and defense you can have between where you were and where you are.... the better.
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Yooly: sometimes treading water is the win. In the middle of medication induced and health problems just slowing things down is a win. Viewing them as non wins doesn't help you appreciate the fact that they are.
Bend - bide - pounce.
Bend = slow down the negative
Re feeling down. Wish I had an answer. I joke with a friend that we need to start the 1 900 therapy line (900 not 800 😂) as most of everyone we know needs some--legitimately esp as evidenced by some of our decision making!🤔🤯
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Agree
Anecdotal musings, with mom/grams/auntie, we went to rw focus weight loss groups & programs such as TOPS, weight watchers, weigh down - paid type Jenny Craig, Doctors/hospital group education & support groups... and even in those, it is often a superficial support, isn't it?
- Sometimes there is a dysfunctional dynamic to 'cheat together' with large potlucks or ginormous cheat meals out after weigh-ins
With family/friends & acquaintenances, I don't know anyone who has
- managed to lose and keep off any significant amount,
- always yo-yo with some practical diets but more often with crash diets - always out of deep desire desperation to lose
- in hand with the flip side, no one wants to change feasts/treat foods or nature of getogethers.
Q - do you think the 95% failure rate is accurate?
- On the tv show 'my 600 lb life', I think an expert mentioned it is 99% failure for that group.
Re quitting smoking, there is quoted a 95% failure rate to stop cold turkey for the hard core, long term, addicted/resistant group, especially if they started as a teen.
- I wonder if this is a dynamic for people with long term incremental weight gain over years,
- reaching back to childhood - with yoyo patterns?
- Afterall a 5 lb gain averaged per year with persistent yoyo dieting for 40 yr is 200 lbs - if the person never gets a grip! [Or 5 lbs/year x 10 yrs = 50 lbs; x20 yrs = 100 lbs.]
My thought - overcoming this dynamic is essential if a person is to actually lose and maintain any significant amount of weight… or even just stop the gain/maintain, or prevent relapse/regain.
2 things seem essential
- The physical dynamics, understanding CiCo, hormones, metabolic factors
- The brain work - attitudes, core beliefs, habits, choices, unraveling the unhealthy/disordered thinking/actions and replacing with helpful going forward.
Think it is is way more complicated than what is being argued in the forums to have/increase exercise - I do agree regular exercise is a significant, beneficial helpful thing - and agree also that exercise is not the only path fortunately especially if there are confounding factors like illness or limited mobility or just a 'don't enjoy it' factor.
- I think 'food choice & amount' is likely equally essential, if not actually a more critical, top level factor above exercise even.
Online socials - agree… hmmm, could be good or bad, certainly not reliable for support, but can be thought provoking but analytical thinking by the reader is essential - crucially important to assess and if appropriate to use. Have observed some hairbrained posts, and too many outright nutso...
- I find a practicality with peeps in this group that is helpful for me (beyond the short term visit to do tracking for the RDs review. Glad to have found this group.)
- Helpful here for talking about some issues - like the stuff the RD is walking us through
- It is hard to resist a 'professionals recommendation' and express our POV/issues/why's to their satisfaction - some professionals are very confident in their recs (why they charge us big bucks, huh? Lol)
- But we have had opposing/changing recommendations pushed out -
- interesting to see things evolve for ex eat breakfast... nope do IF or Omad
- Oh wait, go vegan, nope go keto, nope 3months keto then low carb mediteranean.
- Mostly now, keto, wls and glp1s. A home health NP said, 'Just eat less' as she walked out the door...
- (when I was about 18, my doctor said very same thing along with 'move more and you'll be fine' --- I wish!)
- I have heard that advice as a top line recommendation since I was a child. Grams would crash diet before her annuals, said her doctor always chewed her out... )
All of which (points up) address symptoms but do not resolve the persistent weight gain from physical overeating and squirelly thinking/habits factors.
I suspect the solution is more nuanced and indivdualistic — somehow, tailored for the individual — either provided by advisors or for the individual to seek solutions, tackle, implement and resolve their own particulars at any problematic point... Hopefully in healthy ways. With support.
- Medical support, government policies, corporate advertising and product offered/pricing could be so much better
- At present it remains a tangled mess for individuals to tackle.
How are we supposed to do that??? How can we be a 5% success (or 1%)
- I want that…
Stopping now. I can't see the end. Focused on now, exploring what helps now. Will tackle more as I get there.
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I could go for a 900 #, !! ;)
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