Very low calorie diets and metabolic damage

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.

stroutman81

Oh, and your point about men vs. women is very valid. I train a lot of women at my gym and the vast majority of them are almost neurotic about "clean' eating, dietary compliance, etc. And I've said this elsewhere on this forum, but that sort of intense stress about things that likely don't matter all that much can cause more harm than good. Here's what I had to say in another thread:

Great post - as always! Thank you for taking the time to address it.

As for the point made about many women seeing their success/failure in absolutes. It is all about control. So many of us wear multiple hats - working all day, then managing the household and the family, feeling responsible also for our family's nutrition, and many going to school on top of that. We are so used to "managing" everything that we think we can control our diets just as rigidly - and then when we "cave" and eat something off plan, then we have failed miserably.

You and I and the whole world knows that such a small thing isn't really a failure - but to a control freak, it is, LOL! Bah, I don't even know the point I was trying to make - I guess just now admitting to myself that I am one of those women castigating herself over slight dietary indiscretions! The first step is admitting it right? (From the podium in the front of the room.) Hi, My name is Resalyn, and I am a control freak!

Regardless - GREAT POST and thank you for the further information regarding this topic.

Hahahaha, love this post. Thanks for chiming in. And that's the thing... rigidity is fine for those who can handle it. But the type A, control freak, neurotic people I encounter don't handle it well. They may not admit it... but from the outside looking in, it's a simple fact. Because everything's viewed in polarized terms... either good or bad, right or wrong, on or off... they blow up their rationality when they "slip."

They expect perfection. Perfection isn't possible... hell, it's not even real when it comes to nutrition. But because of the maze of hurdles and traps they've devised in their minds, the moment they slip, it's massive failure. They take it personally, and it demoralizes them to a point where, again, this is from my experience working with a lot of women... by no means universal... but to a point where they give up temporarily.

They go from being "perfect" to behaving in ways that ruin their progress.

More often than not, this is where I'm finding most "plateaus" stemming from. What's even more complicated is some people have this fancy way of only remembering the times they're "on" and forgetting about or minimizing the times they're "off."

It's tough.

rcwible83

thanks for the info.

jwallace84

Thank you for your post. I am very interested in learning more. I have been at a plateau for a few months now. But I'm scared to go below the 1200 mark but maybe I should try. Any thoughts? Oh and I am not new to dieting...I've been at this for 27 years (I will be 28 in April LOL)...

mrsjacksn

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MoooveOverFluffy

And you bring up an excellent point about added stress. I'm sure this will come across as overly blunt but it seems many dieters today go bat crap crazy about this stuff. They only see things in binary terms - particular foods are either healthy or horrible, their behavior is either good or bad, they're either successful or they failed, etc, etc. And all this sort of reasoning and perspective does is ramp up anxiety like crazy.

People are flipping out over 10 calories. And ya know what? I think it hurts them.

The stress response they're generating by being as anal retentive and psychotic as they are bites them in the *kitten*. Which is why I always recommend people read the book written by Robert Sapolsky called "Why Zebras Don't Get Ulcers." He's a great author and a genius when it comes to the stress response of the body. Humans unfortunately can work themselves up into such a psychological mess about the future by thinking about catastrophic thoughts and building psychological hurdles that are simply impossible to clear and thus, our biology that's really in place to keep us alive winds up going in overdrive in chronic terms.

Like I've said in numerous places on this forum now - our ability to manage stress is finite. In our body's mind, stress is stress have it be psychological, physical, real, imagined, etc. And when you've relatively small people eating like birds, doing copious amounts of exercise, stressing about work and family which is typical in this culture, and then topping it off with psychotic analysis and concern over diet and exercise - well - things tend to get messed up.

It's no wonder people are constantly stalling out, really. Granted, I believe more often than not it's a miscalculation on energy intake and expenditure, but still, this is very real.

Fat loss, sex drive, immune function, you name it and chronic stress will affect it, usually negatively.

People just need to relax, set realistic expectations, avoid perfectionism, and be patient.

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^^READ THIS.... and agree.

anulle2009

Very good Post! I feel a lot of people on here just repeat what they heard on google or whatever which we all know the internet gives us all types of information

stroutman81

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.

This is an EXCELLENT post. Hopefully people read and appreciate it.

Food is fuel.

Activity needs fuel.

If you're a desk jockey who's not very active, you can get away with eating like a bird.

If you're a freak athlete who trains like it's your job, you can't get away with eating like a bird.

Stress is cumulative and systemic. Meaning our bodies view stress... all kinds of it (physical, psychological, make believe) pretty much the same. Calorie deprivation represents a stress. Bigger deficit = more stress. So if you try pairing a low calorie diet with ridiculous volumes and intensities of exercise on top of everything else you have going on in life... guess what?

You fail.

And perpetuate the myth that all low calorie diets fail.

In fact though, it was you failing the diet. Not the diet failing you.

Read that five times.

deninevi

Thanks for the great, well informed post! Always nice to read your posts and find them very, very informative and helpful! Thanks again!

stroutman81

Thank you for your post. I am very interested in learning more. I have been at a plateau for a few months now. But I'm scared to go below the 1200 mark but maybe I should try. Any thoughts? Oh and I am not new to dieting...I've been at this for 27 years (I will be 28 in April LOL)...

This is almost impossible to answer. Let's start with this:

1. What's your weight?

2. What was your highest weight?

3. How many grams of protein, carbs, and fat do you consume on average, per day?

4. You say you consume 1200 calories per day. How accurate do you believe you are in that assessment? What makes you so sure of that accuracy?

5. How much exercise are you doing per week and what kinds?

6. When's the last time you took a break, meaning reduced or nixed exercise and brought calories up towards maintenance for a period of time?

amyy902

i get what you’re saying, and i think that it’s really good that your taking the time out of your day to try guide others, i really do, and i agree that people who don’t really understand do take it on face value..... but i can see from the other side, as a recovering anorexic myself i can see that people reading that with a pre disposed mind set could misinterpret the information to mean it’s okay to starve yourself, because its not. but i think that what you wrote was very good, and i do (not that the last bit i wrote would suggest) agree exactly with what you are saying.... not that you’ll care about what i think but that doesn’t really matter

stroutman81

i get what you’re saying, and i think that it’s really good that your taking the time out of your day to try guide others, i really do, and i agree that people who don’t really understand do take it on face value..... but i can see from the other side, as a recovering anorexic myself i can see that people reading that with a pre disposed mind set could misinterpret the information to mean it’s okay to starve yourself, because its not. but i think that what you wrote was very good, and i do (not that the last bit i wrote would suggest) agree exactly with what you are saying.... not that you’ll care about what i think but that doesn’t really matter

I think people are more likely to make informed decisions when they're armed with all of the facts. Granted, that's a stretch. I don't have a lot of faith in the human race anymore. I think, more often than not, people are going to act in ways that counter their health or whatever, regardless of how much they know.

But it's better than the alternative in my opinion. That being where someone says they're trying a very low calorie diet and this is followed by endless alarmist rants about stuff that's not even necessarily true. My grandmother used to tell me over and over again that if I play with fire, I'll wet the bed. Well she was telling me that long after the fact I figured out that it wasn't true, and I kept right on playing with it.

Moral of the story...

I'm going to objectively educate people on this topic... as it's what I know best. If I left it up to the status quot, based on what happened in the thread yesterday, I think we'd see a lot of people screaming a bunch of nonsense at someone who's going to do what they intended to do in the first place regardless.

So it's likely best to put the right information out there and that way, even screw ups don't need to be as severe as they otherwise would have been.

I'm not sure if that makes sense... but I certainly value your input. And I respect where you're coming from... EDs do not necessarily go hand in hand with VLCD, but I truly respect how someone with an ED background would sway with all their might someone from eating very low calories.

Sublog

Great, great post Steve. I grow so tired of reading some of the stuff posted as gospel around here when obviously people really don't know what they are talking about.

You are a much more patient and eloquent writer than I, so kudos.

I always tell people that their deficits should be proportionate to their fat mass. The fatter they are, the greater the deficit can be (assuming both macro and micro nutrient sufficiency is provided to the body)

I ate under my BMR for at least 9 months straight (when I was morbidly obese) without any metabolic slowdown noticed. I did eat a a high protein diet, consumed vitamins and minerals to supplement my diet and did resistance training as well. I lost on average 3 lbs per week doing this and ended up having to bump UP my calories toward the end because I didn't have the fat mass to sustain my weight loss.

How's that for a starvation response?

Labcoathipster

Thanks for posting.

Labcoathipster

Great, great post Steve. I grow so tired of reading some of the stuff posted as gospel around here when obviously people really don't know what they are talking about.

You are a much more patient and eloquent writer than I, so kudos.

Agreed.

amyy902

no i completely agree and what your doing is excellent! i think what i was trying to say and didn’t do it very well is just that its when the education isnt there people will often automatically assume and often they are getting the wrong end of this stick.

i think its fantastic that someone’s laying it out sensibly, more of it needs to be done!!!!!

caveats

And this post is the biggest reason why you can't leave MFP. Your information is too good. WE WON'T LET YOU GO. :laugh:

Thanks for taking the time to summarize your points from the deleted thread. Personally, I LOVE the fact that not only are you well versed in nutrition research and studies, you bring us an informed opinion instead of just barfing up said research for mass consumption. Thank you.

CallMeCupcakeDammit

Thank you so much for this post! I've been so confused by everything I've been reading, and what you wrote makes total sense. I just came off of a 1,000 cal diet where I ate 5 packaged meals and one of my own. I was doing the Biggest Loser Last Chance Workout, and by the 5th week I was feeling crummy all the time. I knew even with eating back most of my exercise cals that it wasn't enough to sustain that workout. I've since dumped that diet and am using MFP the way it was meant to be used. Started out with what MFP gave me, 1,200 cals, but I lost 3, then gained 4.5! I changed it to a 1.5 lb loss instead, and I've lost 2 lbs this week (WI is Sunday). I'm hoping this is what will work for me, but I know a VLCD is not going to get me through my workouts, so I won't be going there again.

Question: I had read that the less weight you had to lose, the less you should try to lose per week. I can't find the thread where I read it, but that was the reason why I thought I should change my weekly WL goal. So someone who needs to lose 100 lbs should go with 2 lbs/wk, 50 lbs to lose should lose 1.5/wk... Is this true?

Captain_Tightpants

I don't think there's research specifically looking at this... at least none that I've seen. (quote abbreviated for convenience...)

Thank you SO much for the in depth response. It's really rare to be able to tap such a comprehensive knowledge base!

So in summary then, if I'm understanding your response correctly, there's a good chance that people who have been overweight for most of their lives (like me) may have a long-term lower (by percentage) BMR and TDEE than people who have been closer to a normal weight for life, and therefore may have to either eat a little lower intake or workout a little longer than the normal weight folks to achieve comparable results?

Does this point to the possibility of non-reversible metabolic damage done by being overweight or sedentary for the long term?

(Sorry if these are dumb questions, I'm fascinated by the weight loss equation but nowhere near as well researched on it as you are.)

kathyc609

great post

stroutman81

I always tell people that their deficits should be proportionate to their fat mass. The fatter they are, the greater the deficit can be (assuming both macro and micro nutrient sufficiency is provided to the body)

I'd generally agree with this rule too.