Very low calorie diets and metabolic damage

raige123

Awesome information as always! Thanks for posting!

Elizabeth_C34

This is interesting. Thank you for posting. I'll reply later with a more comprehensive comment once I have time to digest the info.

cowboydan43

bump

KatesJourneytoLookGr8

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rosalee87

great information - thank you!

UsedToBeHusky

Thank you thank you thank you for posting this!! I have been trying to say this since I started on MFP, but I was never able to word it as materfully as you!!

dianadabutterfly

Thank you for the information. When I started using myfitnesspal I discovered that I was getting too few calories every day and had no idea. I was getting between 700-900 and optimally should get 1200 to expect any weight loss. I wasn't intentionally eating too little but had stayed very busy and neglected to eat much during the day. The first week it was difficult to get up to 1200 but that first week I lost 5 lbs and the only change I had made was to take in more calories.

George1567

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Sl1ghtly

I must admit I'm just a little surprised to read an informed post.

The issue I've noticed here (MFP) is a VLCD lacking in nutrients, combined with intense excersize. The diet, excersize, and recovery must be balanced. I think a VLCD will rarely be sufficient to sustain crossfit, a job, and a social life.. for example.

LivvyLinde

bump. thank you!

jan5555

Well said!

onedayillbamilf

:flowerforyou:

runbyme

Thank you for taking the time to bring acurate information to the dieting masses! There are very few experts on nutrition and fitness here and even if we all were, not everything that works for one is going to work for another. Humanity wasn't formed with a cookie cutter! I feel like the building blocks of nutrition apply to all but after that....it's individually game-on!
Thank you again for your post and good luck to you!

UsedToBeHusky

The VLCD has its place. If someone is choosing to used the VLCD and posts to the threads seeking validation, then you really aren't going to be able to talk them out of it. But the OP is not the only person out there reading responses. There are individuals practicing the VLCD under a doctor's care. Anti-VLCD threads can be discouraging for those individuals. Additionally, not everyone's perceptions of what VLCD actually is are accurate either.

aimstein

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stroutman81

Great post, thank you!

I'd be interested to hear your take on VLCDs and length of plateau time. Is there research out there regarding this?

In my personal experience the more low cal I go, the longer and tougher my plateaus are. A few years back I did a VLCD (at least for me, my BMR is around 2500 and I was eating 1200 per day) at the 7 week mark I hit a plateau and literally did not budge for two months no matter what tactics I tried (increasing calories, zig zagging, switching up activity etc.) There was nothing psychological about it, it was 100% physical.

By comparison I find that if I'm on a 1lb a week loss schedule, as frustratingly slow as it might seem, the plateaus seem to be fewer and further between, and also much easier to break out of. Any idea what the mechanism behind this phenomenon may be? I think it would be an important component to add to any discussion of VLCDs.

I don't think there's research specifically looking at this... at least none that I've seen. Plateaus aren't a heavily researched topic since, more often than not, it's simply a matter of inaccurate reporting of energy intake or energy expenditure. For example, there has been research performed on overweight individuals who swore they've tried everything, swore they've been eating low calories, and yet, their weight was still substantial. Thus, they're in supposed plateaus, right? But when we put them in the ward, control calorie intake/expenditure with direct or indirect calorimetry.... weight is lost.

However, research has looked at adaptive thermogenesis... or what people around here are referring to as starvation mode. Again, it's important to highlight the fact that the starvation mode happens with big or small deficits, as it relates mostly to the amount of fat lost. Per the available research though, a few things are telling...

For starters, it's different for different people. Go figure. There's definitely a genetic component to the adaptability of energy shortages. Some people can lose massive amounts of weight and never skip a beat while others can lose 30 lbs and experience substantial metabolic slowdown. Granted, how substantial the slowdown is is nowhere near as significant as people seem to assume. People think it's massive, as in metabolic rate literally shuts down and that's just not the case. But think of it like this...

You need 2000 calories to maintain. You slash that by 25% to trigger a deficit, so you're at an intake of 1500. But let's assume your energy expenditure is 15-20% slower than what it should be given your stats due to adaptive thermogenesis. That puts you're 500 calorie deficit much closer to maintenance than you realize. So what some people would consider to be small slowdowns.... 15% or whatever... can wreak havoc on someone's success.

But again, it's different for everyone.

More in line with what you're asking though... sadly we're seeing in some of the research that the adaptive thermogenesis seems to last for a year plus. Some are thinking it might last forever. Which isn't implying that people who lose weight are doomed. It does imply though that it's going to be harder to maintain weight loss than some people are factoring.

From my Nutrition 101 article:

Let’s apply some numbers to this. Granted, we’re going to be making some massive assumptions here but it should help you understand things better.

We have a 160 lb woman named Jane. She’s moderately active and has a maintenance intake of 2,200 calories. She diets down to 125 lbs. Jane has a good friend, Lisa, who’s also 125 lb. Lisa has weighed 125 lbs her entire adult life. Surprisingly they both have identical body composition measurements.

Lisa recently had her BMR tested and it came in at 1,250 calories, which is normal. Once Lisa factors in activity, she determines that her maintenance intake is 1,750 calories per day.

When Jane hears this, she decides that 1,750 calories should be her maintenance as well since they’re built so similar and they work and exercise together. Frustratingly she finds that she gains weight at this intake.

Why?

Well, for starters and as noted in the metabolic rate section, there is some variances in metabolism across populations that are matched for weight… so she might have been dealt the slow genetic card. But let’s assume that’s not the case here. Remember, Jane lost 35 lbs recently, so there’s likely some starvation response at play. Assuming it’s as bad as the worst noted in research (which is highly unlikely), her BMR is running 15% slower than Lisa’s which puts it at 1,062 and her maintenance at 1,562.

Her previously assumed maintenance of 1,750 calories was actually a ~ 190 cal/ day surplus. In Jane’s case, she’d have to adjust her calories slightly lower or bump her expenditure slightly higher than Lisa if she was going to maintain her weight.

In my personal experience the more low cal I go, the longer and tougher my plateaus are. A few years back I did a VLCD (at least for me, my BMR is around 2500 and I was eating 1200 per day) at the 7 week mark I hit a plateau and literally did not budge for two months no matter what tactics I tried (increasing calories, zig zagging, switching up activity etc.) There was nothing psychological about it, it was 100% physical.

By comparison I find that if I'm on a 1lb a week loss schedule, as frustratingly slow as it might seem, the plateaus seem to be fewer and further between, and also much easier to break out of. Any idea what the mechanism behind this phenomenon may be? I think it would be an important component to add to any discussion of VLCDs.
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It's hard to quantify how long this effect will last. As I said though, I'd bank on it being relatively permanent. And it definitely plays a role in the horrible long term success rates of weight loss attempts.

http://www.ncbi.nlm.nih.gov/pubmed/16002825

http://www.ncbi.nlm.nih.gov/pubmed/20479763

http://www.ncbi.nlm.nih.gov/pubmed/11684524

But again, going back to your set of questions, the linearity of weight loss is a very individual thing. Like I said, some people can lose weight, even on low calorie diets, without skipping a beat. Others will experience many plateaus, even while using moderate deficits. And there are so many moving parts to energy intake (accuracy of reporting, nutrient composition, varying thermic effects of different nutrients, the accuracy of the Atwater Factors, etc) and energy output (body composition, genetic variations between metabolic rates, overall stress, activity levels, accuracy of reporting, etc) that's it's very hard, if not impossible, to pinpoint one overwhelming cause.

In the research setting though, very low calorie diets tend to beat out smaller deficit diets in terms of total weight loss, which only makes sense. This isn't to say that they're superior for the long term, for health, or whatever. It just proves the point that fat is stored energy. So the bigger energy shortage you make dietarily, the greater amount of energy you're going to pull from your stores since your body still needs a given amount of energy to function. Granted, that amount required to function can drop in response to energy shortages (due to tissue loss, reduction in NEAT, adaptive thermogenesis, etc), but only to a certain extent.

Which is why we don't see fat anorexics and why we didn't see fat concentration camp prisoners.

Here's the on paper I referenced earlier:

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0004377

Does this answer any questions for you? I feel like I was rambling a bit. I'm doing like 3 things at once right now, haha. I know I used some abbreviations and may have said some things that confused people so if there are any questions, by all means, ask. I want this to be an open forum for discussion.

ysamatar

Thanks Steve!!

paigele

Having done the VLCD successfully at the same time as a family member had less success, I can bear witness to several observations:

1 My diet included more varied foods and nutrients than the less successful subject
2 My plan included regular exercise also with variety of types of exercise
3 My plan included MFP as a follo through to learn more about healthy eating
4 My length of use of the VLCD path was much shorter than the other subject, and I continued to lose when raising caloric count
5 My choices in foods to eat were healthier in their own right than those of the other subject, so they contributed more to nutrition than simply calorie count
and finally
6 My elimination of foods or reduction in their use, that proved offenders to me gave me a personal response: milk products and processed foods primarily.

I have had others ask me about my VLCD experience and I tell each of them it isn't a step to commit to lightly and I always steer them to MFP, which I believe to offer balance, support and education via community.

Thanks for being my support community.

hillm12345

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mhotch

Thanks you for this informative thread.