You May Not Be Doing Anything Wrong

RobynC79

I thought this was a fascinating article. Regarding the criticism of the rapid rate of weightloss and the strict calorie restriction, I think it's worth keeping in mind that there is a practical consideration here from a research point-of-view - they are trying to get the weight off their subjects as rapidly as possible to begin the maintaining stage as soon as they can - since that is the focus of the study, the sooner it can begin, the longer they have to obtain data. Research projects are expensive, high-stakes and have limited funding runs. And subjects are more likely to drop out over time, so the faster they can get their data, the better. That is most likely not the sole reason the study was conducted this way, but it's probably a contributing factor.

Note that the article does mention that the prolonged metabolic alterations do seem to be independent of the rate of loss. So while it's a possibility that behaviourally, taking longer to lose might permit better consolidation of new eating patterns, physiologically it seems pretty much the same irrespective of loss rate. Whether loss or retention of muscle would make a difference is not the focus here, but it is likely to be among follow-up studies. Certainly an interesting question.

For the criticism that 34 patients is too few for the results to be broadly applicable: Actually clear results with a small sample size indicate a very strong effect - that is, to show that there is a statistically significant difference between the weight-losers and the always-been-that-weight groups with a small sample size indicates a very pronounced, very consistent difference in the two groups. So assuming (as is reasonable) that the starting groups were fairly representative of the general population, this study indicates that the effect observed is likely to be consistently present in many other people, the opposite of the criticism that the study is too small to be broadly applicable.

This report was published in a highly regarded medical journal (NEJM) with fairly exacting standards, so its reasonable (although not irrefutable) to assume that the study was of a high standard.

k7n2w3

thanks for sharing this article. I have been on maintenance for a few months and can relate... i feel as long as you still record it all you can fight the urges. I definitely believe there is some imbalance after on maintenance of that Leptin horomone but also believe there is no excuse to gaining it back... LOTs of will-power and accountability and everything will be fine :-) but yes leptin or some other imbalance is definitely there cuz the hunger you sometimes feel is not from habit, seeing food, being hungry, etc, its just unexplainable other than knowing the body is trying to trick you and just can't give in!


SW 155.1
GW and CW 112.0

agthorn

I thought this was a fascinating article. Regarding the criticism of the rapid rate of weightloss and the strict calorie restriction, I think it's worth keeping in mind that there is a practical consideration here from a research point-of-view - they are trying to get the weight off their subjects as rapidly as possible to begin the maintaining stage as soon as they can - since that is the focus of the study, the sooner it can begin, the longer they have to obtain data. Research projects are expensive, high-stakes and have limited funding runs. And subjects are more likely to drop out over time, so the faster they can get their data, the better. That is most likely not the sole reason the study was conducted this way, but it's probably a contributing factor.

Note that the article does mention that the prolonged metabolic alterations do seem to be independent of the rate of loss. So while it's a possibility that behaviourally, taking longer to lose might permit better consolidation of new eating patterns, physiologically it seems pretty much the same irrespective of loss rate. Whether loss or retention of muscle would make a difference is not the focus here, but it is likely to be among follow-up studies. Certainly an interesting question.

For the criticism that 34 patients is too few for the results to be broadly applicable: Actually clear results with a small sample size indicate a very strong effect - that is, to show that there is a statistically significant difference between the weight-losers and the always-been-that-weight groups with a small sample size indicates a very pronounced, very consistent difference in the two groups. So assuming (as is reasonable) that the starting groups were fairly representative of the general population, this study indicates that the effect observed is likely to be consistently present in many other people, the opposite of the criticism that the study is too small to be broadly applicable.

This report was published in a highly regarded medical journal (NEJM) with fairly exacting standards, so its reasonable (although not irrefutable) to assume that the study was of a high standard.

Oh, I have a PhD in the sciences...so I know all about the costs of research and sample sizes and all that jazz. I'm not knocking the study itself *for the specific question it asked* - I'm just saying that the specific question it asked is probably not the best way to go about attaining long term success. Yes, it's easier and more cost-efficient and more accurate from a compliance standpoint to get the data quickly, but in doing so I think they set themselves up for their own conclusion (that maintaining weight loss is challenging). They created less than optimal conditions for maintaining weight loss through the trade-offs of the study.

They *hypothesize* that the body's response is independent of weight loss rate and is only determined by amount. But they haven't tested it yet. I think it was buried well within the article that a longer-term (3-year?) study is being planned. I don't remember seeing weight training mentioned anywhere in the article.

RobynC79

Oh, I have a PhD in the sciences...

Yep, me too What area of science are you in?

so I know all about the costs of research and sample sizes and all that jazz. I'm not knocking the study itself *for the specific question it asked* - I'm just saying that the specific question it asked is probably not the best way to go about attaining long term success. Yes, it's easier and more cost-efficient and more accurate from a compliance standpoint to get the data quickly, but in doing so I think they set themselves up for their own conclusion (that maintaining weight loss is challenging). They created less than optimal conditions for maintaining weight loss through the trade-offs of the study.

They *hypothesize* that the body's response is independent of weight loss rate and is only determined by amount. But they haven't tested it yet. I think it was buried well within the article that a longer-term (3-year?) study is being planned. I don't remember seeing weight training mentioned anywhere in the article.

Looks like we are sort of in the middle of both being correct - here's a quote from the article
"One question many researchers think about is whether losing weight more slowly would make it more sustainable than the fast weight loss often used in scientific studies. Leibel says the pace of weight loss is unlikely to make a difference, because the body’s warning system is based solely on how much fat a person loses, not how quickly he or she loses it."

There are no citations given in the article, but assuming this 'warning system' is related to/the same as the increased hunger and physiological changes, it might be something they already know. Inconclusive though, I agree.

"Even so, Proietto is now conducting a study using a slower weight-loss method and following dieters for three years instead of one. " Sounds like the follow-up is underway. It seems widely accepted that losing faster makes it harder to maintain, but I don't know whether this is backed up by controlled studies.

stevenleagle

To me, I KNOW (from past experience) that rapid weight loss is too easy to regain. That is why I'm using Mfp to do things differently. I know I am in this for the long haul and have been trying to lose my weight by making small incremental changes to my lifestyle each day. I try not to 'starve' myself to reach my goal weight quicker. I have tried to educate myself as to making the least amount of changes (that I can live with permanefly) for maximum effect. Eg I have tried NOT to kill myself with exercise initially but have slowly built up fitness until it has been comfortable for me to do more. I still allow myself to eat all my favorite foods (or I would not stick with it), I just do it with increasingly less frequency and in smaller portions.

The problem with all this research is that it focuses om RAPID weight loss using unrealsitic means (such as unsustainable liquid diets)where people don't have the time educate themselves and to change their long ingrained habits. It takes time to change habits, many months, many years. But it can be done. Slowly. Incrementally. By reprogramming your mind and your self.

To me it's no longer a race: it took me many years to maintain my fatness, I need to take time to build on and retain my fitness.

agthorn

Oh, I have a PhD in the sciences...

Yep, me too What area of science are you in?

Undergrad in biochemistry, PhD in pharmacology. But I work in intellectual property now :-)

RobynC79

Oh, I have a PhD in the sciences...

Yep, me too What area of science are you in?

Undergrad in biochemistry, PhD in pharmacology. But I work in intellectual property now :-)

You escaped- smart move! I'm in neuroscience -- pain physiology and neuronal injury. Fun stuff!

MaraDiaz

I was just thinking about this after I read the article. What if a person did weight training/lifting instead of just extreme dieting to lose the weight? Would that have changed the muscle fibers in the same way and also caused the body to think it was "starving" and creating a starving hormonal response and/or effecting metabolism the same way as crash dieting? hmmm...

I hope this is part of their research in future studies, it's a good question. Weight training or maybe some kind of mixed routine might not have been accounted for in this study and it might matter.

When I think about what I mainly do, which is walking, it seems like it's probably the most natural exercise. Humans used to be pretty nomadic and we didn't even have horses until relatively not that long ago, so walking was what we did. And even though I've come to really enjoy my walks, I wonder if my body isn't likely to adapt to that far faster than to any other exercise.

Still, it seems to be working for now, so I'll keep doing it.

Ge0rgiana

Wow, you ladies had some great discussion here! :flowerforyou:

Personally, I get what you're all saying. I know you're science geeks (WOW), but I'm a bit of a behavioral science geek. No, not my profession. Just a hobby. When I read the article, I was thinking that the rapid, severely calorie-restricted weight loss WAS bad, but I think it's a more honest way of replicating the behavior of the typical Joe Schmoe trying to lose weight. They just want to get it off as quickly as possible and don't always use the best judgment. As for weights, women in particular are bad about shunning them in the effort to lose. That's just the way I saw it.

Regardless, I think what they had to say about the muscle changes, appetite changes, etc. was fascinating. I've been having appetite issues, and the reward sensations I feel toward certain foods is just obnoxious. The solution I had come up with for myself was to just start lifting weights and putting on as much muscle as I can while, of course, still making efforts at eating more healthy than unhealthy foods. After reading this article, I think this may be the way for me. Currently shopping for a gym!

jsuaccounting

Wait, how is someone eating 2300 calories a day in starvation mode?

It seems a form of starvation mode kicks in even for those running a moderate deficit over time, sad to say. Is there another term for that besides starvation mode? Clearly, the dieter's body needs fewer calories than a non-dieter of the same weight, so it seemed to fit.

That is not starvation mode. That's just your body needing fewer calories to haul around your smaller mass.

A woman of her same age and mass who did not diet needed more calories to maintain than the dieter did at that weight. So something has altered the dieter's body to need fewer calories.

I just have a problem with the term "starvation" being used here. Yes there is a difference in metabolism, but starving? No.

I agree, starvation is a bad term for this effect. It is really an adaption to lower calories - better to refer to it as a lowered metabolism.

dissonancesquared

I agree. I think you have to find a new normal that is healthy which is the only way to keep it off but also I think what most diets and studies don't take into account is muscle mass. A person who is lean at 165 doesn't look like a person with high body fat % at 165. That also accounts for how you burn calories and your caloric intake.

Yeah, this was kind of my point earlier. Whenever I see these studies, it's always people on severely restricted calories (I usually see 500-800 calories per day cited) and if they do any exercise at all, it's cardio. So of course they're going to lose a lot of muscle mass along with the excess fat. They'd probably see a lot more long term success with a less severe calorie restriction plus weight lifting to maintain lean muscle.

i never thought of this, but you're right. she worked out a lot, but it was all cardio. interesting.

theres still the issue of the biochemistry though. all the people in the study showed screwy levels of some hormones related to appetite, even when they were put back on maintenance level diets. this would indicate that there are physiological differences between people maintaining a weight vs having dieted to get there that can contribute to the difficulty in maintaining long term weight loss.