Set Point Theory

ddsb1111

Wait a second, I didn’t think this was a real thing. I came across 2 different articles that say otherwise:

https://www.ncbi.nlm.nih.gov/books/NBK576400/

And this one from the Cleveland Clinic https://health.clevelandclinic.org/weight-loss-plateau/amp/ (this second article reads like woo to me because of all the starvation mode talk).

For those in a hurry I pasted 2 excerpts below from ncbi from Oct 2022.

There are many theories as to why weight loss plateaus occur. One popular theory is the "set point" theory. This theory suggests biological control of body weight is regulated by feedback loops from peripheral organs and tissue, such as leptin secretion from adipose tissue, back to the central nervous system to rebalance and maintain homeostasis. Another theory is a "settling point," which reflects metabolic adaptations to energy imbalance without specific feedback control.[9]

Several studies confirm this phenomenon exists, and more research is needed to understand better why exactly on a micro-level.

On a metabolic level, a series of chemical reactions occur to derive ATP. This process involves uncoupling proteins (UCPs), where energy substrate oxidation occurs along with oxygen consumption. This process contributes to energy expenditure and is thought to be a considerable portion of BMR. Hormonally, anabolic, anorexigenic, and thermogenic hormones are decreased with decreased energy intake, while orexigenic and catabolic hormones are increased. Ultimately this leads to decreased energy expenditure and increased hunger.[8]

Does our body really provide these feedback loops after all? I’m having a HARD time believing this. I searched this topic on mfp and nothing showed up before 2019 and the consensus was it was a myth. Are we still blowing off this theory or are we changing our minds on the science after all?

cwolfman13

This doesn't seem to really address "set point theory", particularly as it is commonly described among the masses...ie you hit a certain weight and you can't lose any more no matter what you do because that is your bodies set point.

This seems to be talking about adaptive thermogenesis as it relates to plateaus and the like which are driven by hormonal responses from prolonged calorie restriction (particularly substantial calorie restriction). This doesn't say anything in the least about hitting a plateau and that's it...nothing you can do about it and that's your "set point". Plateaus are a period of hormonal adjustment which can be uncomfortable because you can be hungrier than normal (hormone driven), fatigued, etc which can cause you to eat more and/or conversely slow down your energy expenditure since fatigue will result in a decrease in involuntary movements like fidgeting and the like and you're more apt to laze about when fatigued than to get up and be busy. Your biology may also slow down expenditure related to things like growing hair...finger and tow nail health...loss of menstrual cycle, etc. Overall, the human body strives for homeostasis.

I don't think anyone here would find this debatable. It is one of the reasons why diet breaks are often recommended (there's a whole thread called "of refeeds and diet breaks"). It's one of the reasons why people recommend modest calorie deficits and not trying to lose weight too quickly or aggressively. It's one of the reasons why people caution against over exercising and recommend resistance training in addition to moderate cardio.

ddsb1111

This is how I understand it as well. Using those terms set point and settling point can be pretty misleading. That’s probably why articles run away with it as a headline on weight loss.

The second article was far more conflicting however. It was describing set point as your body fighting against you and trying to prevent starvation by hanging on to all your fat/weight, no matter how much you have to lose. If you click on the bolded “set point” term it will send you to yet another article defining set point in a way that is very different than your description.

At the end of the day if there’s no shocking research that came out proving we do in fact have this mythical set point keeping us at a certain weight (even if that weight is 200 lbs over weight), then I’ll just blow this off as using the words “set point” and “setting point” in a context very different than the tabloids do.

cwolfman13

The only time I've ever experienced anything like a "set point" was when I was around 12% BF and trying to get leaner. At that point I do believe your body really does fight against it on multiple fronts because from a biological/evolutionary standpoint being super lean or trying to be super lean is not really a natural phenomena and the body will fight to protect itself. I was ferociously hungry all of the time and always exhausted. I was also in my early to mid 40s...maintaining 10% BF or thereabouts when I was late teens and into my mid 20s or so was pretty easy.

ddsb1111

Same. I don’t know what my bf% was but I was about 20lbs underweight, not a good look, and then it stuck. I remember being there for quite awhile without dropping any lower thankfully. Oddly I wasn’t hungry anymore but I was absolutely exhausted and couldn’t think clearly. But when my health improved boy did I put the weight back on quickly.

cmriverside

I think maybe Dr. Avadhanula in that Cleveland Clinic article ought to stick to her specialty, endocrinology, and not try to explain exercise/exertion/weight loss and calories. That part of the article is all over the place and not in a good way.

Someone else can take that on point by point, but I find all those sites who do articles like this get a lot of stuff mixed up. Harvard makes some pretty big mistakes in their "articles" too.

Dr. Avadhanula - stay in your lane!

I did find this part to be true for me, though:

It can take between three and five years for your body to stabilize, to adapt to the weight loss and accept a new weight as a new set point, she adds. “You have to think about it as a journey more than a short-term experience.”

That first year post weight loss was really difficult for me. I lost about 70 pounds in less than a year. It was super easy for me to gain weight at the end of that weight loss, so I do think my body was in a bit of a panic and wanted to head back to the way it had been when I was obese and that the endocrine system had to play catch up (or, down-regulate?) It very well may be my genetically determined "set point" at 21-22 BMI, I've been at this level for most of my adult life fairly comfortably. I had just messed it up by being overweight for a few years. I just don't like that term because it gets so misused and used as a reason for someone to stay significantly over weight.

In that first year I had trouble finding a calorie level. Year two I had added more exercise, so same problem different angle. I would say in year three I felt stable and comfortable, but I had completely changed my entire life/food/eating schedule/activity/exercise/macros - it's a lot.

AnnPT77

In the Cleveland Clinic article, I think the exercise section is just literally wrong. Exercise feels easier as we get fitter, sure, but that doesn't mean the exercise (at the same bodyweight and objectively-measured intensity) burns fewer calories. That would require the laws of physics to be suspended, wouldn't it?

Yeah, for some activities there's some noodling around about literally getting more efficient at a movement, i.e., flopping around meaninglessly while doing some things (in ways that don't contribute to the objective intensity measure) is going to burn more calories than being direct about the activity, for example. But elite athletes burn massive numbers of calories even at (to them) moderate intensities, not diminished ones because they're "efficient".

Some of the stuff in there seems right-ish - the homeostasis mechanisms - but just oversimplified into mush.

It's amusing to me (in a sad way) that it says "“Exercising should be hard,” she says. Your body should feel some discomfort" but "“One of the big misconceptions about weight loss is that there should be some sort of deprivation element to it,” so the bottom line is you should change your exercise, but not change what you eat to break a plateau.

I wonder how much of it is the doctor vs. the writer, TBH.

The Sarwan/Rehman article seems pretty reasonable to me. They keep underscoring the importance of a reasonable weight loss rate to avoid or short-circuit the downregulation of activity and upregulation of appetite that will be occurring at a physiological level. They mention diet breaks as another intervention to counter those effects.

It's interesting to me that they recommend increasing interprofessional interventions ("including a physician, a dietitian, and a psychologist") to help people through plateaus, and mention the mismatch between common expectations of weight loss linearity, and the more likely actual uneven scale progress that's often what happens in practice.

In some sense, I wonder if the "set point" or "settling point" ideas are trying to bridge conceptually between the very real and measurable physiological aspects (appetite upregulation and activity downregulation via hormones, for example) and the human behavior as observed by an external researcher (stalls, regain, yo-yos). To me, set/settling points do make sense as descriptive theories of what occurs in real life because people do the things we see so often here: Extreme (unsustainable) tactics, unrealistic expectations, etc., so people become discouraged when consistent fast weight loss doesn't happen (and weight stalls do happen), plus they feel hungry/deprived and maybe fatigued (subtly or otherwise) so they give up and 'go back to normal'.

Personally, I do feel that there are different sets of habits that I can sustain well as an integrative whole way of living . . . total "lifestyles" - if you will - that will lead to different body weight outcomes. But (subjectively) I experience those not so much as biological destiny "settling points" but a reasonably happy habits "settling points". I'm not insisting that's true for everyone, though.

neanderthin

From what I've understood about human physiology is that the body has numerous set points within the body's attempts at our overall homeostasis. Body fat is just one of them, an evolutionary adaption, pretty simple I've always thought. We have positive and negative feedback loops along with hormones that effect mechanisms that influence our homeostasis but I certainly wouldn't say that "set point theory" doesn't exist but I haven't done a lot or research on set point specifically, just to get that out there, just my opinion at this point. Cheers

paperpudding

People in famines and in POW camps kept losing weight as their calories decreased.

How come set point didn't keep them at their prior weights?

neanderthin

paperpudding wrote: »

People in famines and in POW camps kept losing weight as their calories decreased.

How come set point didn't keep them at their prior weights?

Do you really need an answer to that?

paperpudding

Yes - would like those who believe in set point theory to explain how it seemingly does not apply in real life scenarios of decreased calories

neanderthin

Those examples you gave, people were starving, the end game for those scenario's, is death.

paperpudding

No - many people did survive the scenarios I mentioned

Of course the step further in massively reduced calories long term would be death - but not sure how that negates the query of how such scenarios did not result in people staying at their so called set point regardless of eating less calories - which is what the theory espouses.

neanderthin

Set point isn't staying at a particular weight regardless of the calorie input and don't know where you got that idea, otherwise people would never lose or gain weight, it's about the body recovering to where is feels is the best place based on the individual traits for a particular person for a homeostasis the body feels it performs it's best.

Like I said, I haven't researched set point specifically, but I think it's much like a thermostat that will and can have minor adjustment based on certain criteria, but to stray too far off will be challenging. I suspect those starving people and concentration camp survivors more than likely went back to close to the weight they were.

Can I get down to 6 or 8% body fat without starving myself, sure but that is very hard work based on a grueling schedule that will probably take 1 or 2 years to achieve and if I stop or don't maintain that regime, I'll start to put weight (fat) back on, which I've experienced. Can we adapt to a new set point would probably be on my more important check list when researching though. Cheers

lynn_glenmont

There are many theories as to why weight loss plateaus occur. One popular theory is the "set point" theory. This theory suggests biological control of body weight is regulated by feedback loops from peripheral organs and tissue, such as leptin secretion from adipose tissue, back to the central nervous system to rebalance and maintain homeostasis. Another theory is a "settling point," which reflects metabolic adaptations to energy imbalance without specific feedback control.[9]

Several studies confirm this phenomenon exists, and more research is needed to understand better why exactly on a micro-level.


Theories aren't phenomena. I believe this is referring back to the study's overall subject of weigh loss plateaus, which are phenomena. I think it is a misreading to take these paragraphs as saying that studies have confirmed the theories discussed in the previous paragraph.

cwolfman13

paperpudding wrote: »

No - many people did survive the scenarios I mentioned

Of course the step further in massively reduced calories long term would be death - but not sure how that negates the query of how such scenarios did not result in people staying at their so called set point regardless of eating less calories - which is what the theory espouses.

I think it's a bit like laymen discussing "starvation mode" vs the scientific community discussing adaptive thermogenesis. The laymen theory of set point isn't really a thing, but observationally as well as my own experiences and research would indicate that there is something to hitting certain "set points" along the way while the body strives for homeostasis. I've always thought of them as "sticky points" when I'm losing weight, and the leaner I get, the stickier they get to the point that at a certain threshold (around 12% for me) it becomes almost impossible because I can't physically cope with what I necessarily have to do to push past that point and the effort becomes not worth it.

Lietchi

I find it curious how it's usually in the context of weight loss when talking about set/settling points. But rarely when talking about weight gain?

I've never had a stable weight throughout my adult life. Gain, gain, gain, lose a little when dieting, gain, gain, gain, lose a little... I lost a lot eventually, but even then not really reached homeostasis, since I only managed 6 months at a certain weight before it started creeping up again (currently bending the trend downwards again).

And, anecdotally again of course, I didn't have settling points while losing weight either. But it guess it depends on what duration we choose as a criterion, I just noticed weight fluctuations that seemed normal to me.

If there are physical mechanisms at work, I must be an exception or perhaps the mechanisms aren't very strong and easily overcome by other factors.

cwolfman13

Lietchi wrote: »

I find it curious how it's usually in the context of weight loss when talking about set/settling points. But rarely when talking about weight gain?

I've never had a stable weight throughout my adult life. Gain, gain, gain, lose a little when dieting, gain, gain, gain, lose a little... I lost a lot eventually, but even then not really reached homeostasis, since I only managed 6 months at a certain weight before it started creeping up again (currently bending the trend downwards again).

And, anecdotally again of course, I didn't have settling points while losing weight either. But it guess it depends on what duration we choose as a criterion, I just noticed weight fluctuations that seemed normal to me.

If there are physical mechanisms at work, I must be an exception or perhaps the mechanisms aren't very strong and easily overcome by other factors.

I have the same experiences gaining weight that I do losing. Sticky points...180 is my preferred maintenance and I can maintain that pretty easily (below that and the associated BF% is a much trickier matter). In 2020 during the pandemic my weight rose slowly to 190 and then just stopped without me doing anything deliberate to halt it. I stayed there for about a year. Weight eventually started creeping up again and I hit 200 Lbs give or take in the summer of 2022 and I've been at that weight ever since (about a year) without doing anything in particular to stop it from increasing.

200ishLbs, 190ish, and 180ish are my sticky points losing and they're my sticky points gaining. I'm trying to cut right now down to at least 190 and it's a chore because I'm trying to cut down food but I'm friggin' hungry and hormonal so I end up eating to maintenance despite the fact that I cut out alcohol over a month ago completely, which was over 1,000 calories per day in booze and beer. On paper I'm not consuming an additional 1000 calories in food to make up for the alcohol, so there must be something else going on...which I also presume has something to do with alcohol calories and the way they are metabolized and that they can't be stored. What I do know is that if I persist, things will move and once they do, they'll move pretty steadily until I hit 190ish again and hit that wall.

AnnPT77

In myself, I don't really perceive set points, settling points, or sticky points that feel independent of psychological factors - maybe with the exception of my class 1 obese starting weight here (mid-180s pounds) which I'd been within 5 pounds or so of for some years before losing (at my then-current activity level and ad libitum eating).

Lately, though I'd prefer intellectually to be maintaining around 125, I've been meandering up and down around 130 since the holidays. To me, it seems like a psychological thing . . . I go up a little then decide I've got to cut back a little, then get tired of that and indulge some, maybe creep up a couple of pounds, and so forth. Maybe the mechanism is some kind of temporary "settling point" for biological or physiological reasons, but it feels more like an outgrowth of habits and attitude, subjectively - a set of decisions I'm making somewhat consciously.

I suspect I'll drop back down a little over the summer, because I do more spontaneous outdoor NEAT stuff during the nicer weather, get crave-y in the Fall as the days get short and the weather cold, hibernate indoors a bit in Winter, maybe add a pound or so over the holidays, then repeat that cycle more or less annually.

ddsb1111

As I see it the original article was really just talking about homeostasis, whether physically, hormonally, or psychologically. I actually appreciated how the author encouraged using a doctor, psychologist, and dietitian to reach goals and learn maintenance. I think where it gets twisted is when magazines and fitness gurus get their hands on terms and bend them for financial gain. Seeing articles like the second 😒 so annoying. They should know and do better than echo myths that keep people feeling defeated or rationalizing their choices.

I guess what surprised me is that the terms “set point” and “settling point” are actual terms that CAN make sense. Just not the way I expected.

AnnPT77

ddsb1111 wrote: »

As I see it the original article was really just talking about homeostasis, whether physically, hormonally, or psychologically. I actually appreciated how the author encouraged using a doctor, psychologist, and dietitian to reach goals and learn maintenance. I think where it gets twisted is when magazines and fitness gurus get their hands on terms and bend them for financial gain. Seeing articles like the second 😒 so annoying. They should know and do better than echo myths that keep people feeling defeated or rationalizing their choices.

I guess what surprised me is that the terms “set point” and “settling point” are actual terms that CAN make sense. Just not the way I expected.

Maybe just "meeting people where they live", i.e., using the common terminology as a way to get into what the underlying mechanism is? It'd be a step up from clickbait if so, but maybe in the same neighborhood.