Very low calorie diets and metabolic damage

stroutman81

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?

There are all sorts of rules out there, but generally speaking, the more fat you have to lose, the steeper a deficit you'll be able to tolerate. One rule I see tossed around a lot, and I'm not disagreeing with it, is an average rate of weight loss of 1% of total weight per week.

Obviously, the absolute amounts are going to be higher for bigger folks than they are for smaller folks.

People are sometimes shocked to hear that with my relatively lean clients who are trying to get leaner, I'll set their bar at .25 - .5 lbs per week.

stroutman81

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?

The only part you're missing is that I'm talking about post weight loss. Bigger people don't necessarily have slow metabolisms. But when people lose an appreciable amount of weight, there can be a reduction in energy expenditure that goes beyond what would be expected given the loss of tissue.

Some of this "excess slowdown" is attributed to a lower basal metabolic rate, likely tied to the milieu of hormones that regulate it. Other parts of it, which some papers suggest account for the biggest drop in energy expenditure, has to do with a reduction in NEAT (non-exercise activity thermogenesis). Which simply means that some people who lose lots of weight wind up unconsciously moving a lot less.

But yes, the net result is these folks are going to have to work a little harder and be a little more diligent if they're going to maintain the weight loss.

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

Only if the excess fat is lost. And even then, it's not necessarily the case for every overweight person who loses weight.

Amandasmfp2011

Thankyou for all of this information, it has been very interesting to read.

(Could someone please tell me what RMR is in e original post)

thepetiterunner

Thank you for this!

stroutman81

Thankyou for all of this information, it has been very interesting to read.

(Could someone please tell me what RMR is in e original post)

resting metabolic rate, which is the energy required to sustain your life at complete rest. For most people, this accounts for the greatest percentage of total daily energy expenditure. These machines we call bodies are expensive, energetically speaking!

andrejjorje

Very good read. Unfortunately this is not going to stop the eternal debate of the f.... "starvation mode".
Thanks for trying.

quote]
There was a thread that was deleted yesterday where the original poster was asking if it was okay to consume something like 800 calories per day. I'm not sure exactly why it was removed, but it likely had something to do with person after person telling the OP that she was being stupid.

I don't like personal attacks at all... but what drove me even more crazy was the fact that almost every single person felt the need to chime in about a topic they obviously haven't studied very much. We heard things like your muscles are going to fall off, you're going to kill your metabolism, you're going to wind up in the hospital with nutrition deficit, you're being anorexic, etc.

I'm not posting this thread to restart all the flaming and trolling. I want this to shine a bit of objectivity on the subject of very low calorie diets and metabolism. I spent a decent amount of time explaining things in the thread that was deleted, so it was disheartening to see the information deleted. I think we can all agree that among other important goals, this community is about education.

As this thread in question is being discussed on my profile page, someone asked me to re-explain what I discussed in the removed thread. I'm simply going to copy and paste my response here:

Yes, very low calorie diets (VLCD) can reduce RMR and disrupt various components of the endocrine system. But correlation is not causation. Meaning... is it the VLCD or is it the effect of the VLCD that leads to the slowdown? Put differently, VLCD cause high rates of fat loss due to the massive energy deficits. Fat happens to be the home of the master hormone responsible for metabolic regulation - Leptin. Leptin lets out bodies know that it's fed. So if we have less fat, we have less Leptin. If we have less Leptin, we have less of a "fed" signal to the brain. If we have less of a fed signal, the body responds accordingly with the slowdown in RMR (and some other adaptations).

But the logical question you should be asking is, "Won't smaller or normal deficits also cause a loss in fat? And won't that loss in fat lead to the same sort of negative adaptations?" And the answer is yes. It's just that the VLCD will cause these adaptations to happen faster... but you'll also lose fat faster. Follow me?

This isn't an argument for people to start following VLCD as most will fail miserably. Once you factor in the psychology aspects of them, they're just not right for most long term fat loss plans. In addition, the lower your energy intake is, the more careful you have to be about nutritional adequacy. Meaning it becomes very easy to shortchange yourself of particular facets of nutrition, which can ultimately tap into "health."

For example, back in the day when the medical community was busy trying to fix obesity, they used VLCDs and weren't mindful of protein quality or quantity. Protein happens to support muscle mass. Sure, around here we're interested in preserving skeletal muscle, as that's what helps us get "toned," "lean," "athletic looking," "ripped," or whatever the cool buzzword is nowadays. But these experiments on the obese patients led to losses in other types of muscle... namely cardiac muscle, which plays an important role in being alive, obviously.

Point is, the more food you eat, the easier it is to cover all of your nutritional bases. You can still screw things up, but it's just harder.

In the thread that was deleted last night, I spoke of the Minnesota Starvation Experiment ran by Ancel Keys, which took already relatively lean men and locked them down in the lab where they were given 50% of their calorie needs for half of a year. They also had supervised exercise ever day if memory serves me correct. We know that lean people will react faster (in terms of metabolic slowdown) to big energy deficits than fat people will. Which makes sense.... fat bodies don't "think" they're starving as quickly since they have all of this excess energy in storage, right?

But even with the test subjects in this experiment being lean to start, after the 6 month period, they only experienced a slowdown in RMR of 15% or so. I mean total energy expenditure dropped by 40% or so, but the remaining 25% (above the 15%) was due to the loss in weight (tissue costs something to maintain and a bigger body is more expensive to move around). Everyone knows that as weight is lost, calorie needs go down.

The "starvation mode" totaled 15% after half a year of low calorie dieting. And that's the primary point... life requires energy expenditure. And metabolism can be thought of as our total energy expenditure in this case. Even if there is negative adaptation to low calorie dieting, metabolism can only drop so far... there's a minimum threshold that's required to keep your heart beating, to fuel respiration, power the brain, transport nutrients, digest food, etc, etc.

I also posted a few links to more current research.... one paper compared a 25% deficit to a 890 calorie intake. The low calorie intake lost more weight than the 25% group. Yes, they had a metabolic slowdown... but so did the 25% group, which corresponds to what I said above about big and small deficits.

There's a lot more that I could say on the topic. For example, NEAT (non-exercise activity thermogenesis) is turning out to play a substantial role in the reduction in total daily energy expenditure experienced on prolonged diets... big or small deficits. Which only stands to solidify the importance of exercise while dieting. NEAT drops unconsciously... so we counteract that by doing more activity consciously via structured exercise. But we won't dive into that end of things as this is already far too long.

The bottom line is this... VLCDs are not as destructive as people around here are making them out to be. People see VLCD and immediately think of anorexia. Anorexics lose weight past the point of healthy thresholds. They also aren't mindful of nutrition quality, more often than not. Not on low calorie diets are "unhealthy."

There's a time and a place where they may even make sense for some. I've used them. I've used them with some of my clients.

It's just that those times and places don't match beginners who obviously need to learn nutrition fundamentals before they go experimenting with advanced dieting techniques. If they jump right into very strict and limiting diets, there's a good chance they're going to wind up gaining weight, not because of some crazy adaptation that winds up creating stored energy (fat) out of thin air... but because they're not going to stick with it, and when they fall off the wagon, they fall hard and typically eat their faces off.

I'm not out there advocating VLCDs. Not at all... heck, I wrote the Nutrition 101 article, which everyone should have read by now, and nowhere in it did I advocate VLCD. I'm simply trying to maintain the integrity of information while steering people in an optimal direction. It seems like too many people around here are stuck on absolutes. They believe there is 100% right ways of doing things and 100% wrong ways of doing things. There's no in between. In reality, there are very few absolutes in the game of fat loss.
[/quote]

CallMeCupcakeDammit

There are all sorts of rules out there, but generally speaking, the more fat you have to lose, the steeper a deficit you'll be able to tolerate. One rule I see tossed around a lot, and I'm not disagreeing with it, is an average rate of weight loss of 1% of total weight per week.

Obviously, the absolute amounts are going to be higher for bigger folks than they are for smaller folks.

People are sometimes shocked to hear that with my relatively lean clients who are trying to get leaner, I'll set their bar at .25 - .5 lbs per week.

Thanks!

andrejjorje

Just on the funny side if somebody that weighs 400 lbs with his normal wieght being 170 lbs comes to you and you put it on .25 lbs/week then he's going to see his dream in 19 years. For 0.5 lbs close to 10 years.:laugh:

There are all sorts of rules out there, but generally speaking, the more fat you have to lose, the steeper a deficit you'll be able to tolerate. One rule I see tossed around a lot, and I'm not disagreeing with it, is an average rate of weight loss of 1% of total weight per week.

Obviously, the absolute amounts are going to be higher for bigger folks than they are for smaller folks.

People are sometimes shocked to hear that with my relatively lean clients who are trying to get leaner, I'll set their bar at .25 - .5 lbs per week.

stroutman81

Haha, yeah, I'd never have him shooting for such a low target. He's be at 2-4 lbs per week initially. And frankly, I like to have my bigger clients weigh themselves pretty frequently.

The lower target for my leaner clients is mostly about getting them to dissociate the scale with success... start pushing them into more of a performance based mindset where form follows function and the scale no longer guides.

snaggly

Thank you for the information.

Can you explain exactly what you mean when you say VCLD? Would it mean eating the number of cals equivalent to 50% of a person's RMR not taking into account exercise cals? Or is the figure higher or lower?

stroutman81

Thank you for the information.

Can you explain exactly what you mean when you say VCLD? Would it mean eating the number of cals equivalent to 50% of a person's RMR not taking into account exercise cals? Or is the figure higher or lower?

The generally accepted definition is 800 calories or less. Some might quibble over that number, but it's really unimportant. The primary point I was trying to make in this thread is the idea that going below 1200 calories per day (or whatever the supposed universal minimum threshold is that the masses subscribe to nowadays) isn't going to make your metabolisms die.

VLCDs can be associated with a number of health risks, which is why most people shouldn't mess with them. And if you do, unless you have a very good grasp on nutrition, it should probably be under the guidance of a medical professional.

herky

excellent post!

snaggly

Thank you for the information.

Can you explain exactly what you mean when you say VCLD? Would it mean eating the number of cals equivalent to 50% of a person's RMR not taking into account exercise cals? Or is the figure higher or lower?

The generally accepted definition is 800 calories or less. Some might quibble over that number, but it's really unimportant. The primary point I was trying to make in this thread is the idea that going below 1200 calories per day (or whatever the supposed universal minimum threshold is that the masses subscribe to nowadays) isn't going to make your metabolisms die.

VLCDs can be associated with a number of health risks, which is why most people shouldn't mess with them. And if you do, unless you have a very good grasp on nutrition, it should probably be under the guidance of a medical professional.

Thank you for the explanation.

stroutman81

bump

stroutman81

bumpity bump

suziecue66

To the OP, having carb refeeds resets leptin.
I believe it is a good idea when doing VLCD to say do it for about 4 weeks and then up calories for a week or two and go at again if needed.

stroutman81

To the OP, having carb refeeds resets leptin.
I believe it is a good idea when doing VLCD to say do it for about 4 weeks and then up calories for a week or two and go at again if needed.

Not really.

I'm a huge fan of refeeds in lean folks... especially women. I'll actually insert refeeds a couple of times per week into some of my client's plans. But it doesn't "reset" leptin... at least not completely and definitely not for very long. The only thing that would reset leptin to its original levels would be to gain the weight back.

stroutman81

To the OP, having carb refeeds resets leptin.
I believe it is a good idea when doing VLCD to say do it for about 4 weeks and then up calories for a week or two and go at again if needed.

Oh, and the strategy you outlined where you're taking a break every 4 weeks or so would actually be referred to as a diet break. A refeed is more acute than this and has very specific parameters that go above and beyond merely bumping calories up.

gaelyngaelyn

AMENNNN!!! I am so tired of people who have done ZERO research telling me I am anorexic or my body is going to shut down or whatever fear tactics make THEM feel better about their own goals and diet plan. I generally net around 800 calories (eating 1200, burning 400) and I am super proud of the efforts I make to maintain a nutrient rich and well balanced diet even on a low calorie intake. I try to use those calories wisely. THANK YOU!

suziecue66

From Lyle McDonald:
http://www.bodyrecomposition.com/fat-loss/the-hormones-of-bodyweight-regulation-leptin-part-the-last.html

stroutman81

From Lyle McDonald:
http://www.bodyrecomposition.com/fat-loss/the-hormones-of-bodyweight-regulation-leptin-part-the-last.html

I'm well aware of Lyle's work. I've communicated with him extensively, I own every one of his books, and I even interviewed him for my website:

http://body-improvements.com/articles/interviews/lyle-mcdonald-interview/

The article you linked to explained why you were wrong to call your monthly break a refeed. It's more appropriately referred to as a break. Refeeds happen more acutely, as already noted. From the article that you linked to:

"interjecting high carbohydrate, high calorie refeeds of varying lengths (anywhere from 5 hours to 3 days) is (currently) the best way to raise leptin while dieting."

and

"An additional strategy, talked about in some detail in my Guide to Flexible Dieting is the idea of full diet breaks, periods of 10-14 days in-between periods of active dieting where calories are brought back to maintenance "

If you actually talk to Lyle, he'll note that most of the times refeeds are happening on a weekly basis... even multiple times per week.

This is mostly irrelevant... the primary point of contention is the idea that refeeds can bring Leptin back to its original levels, assuming that's what you meant when you used the word "reset." There's a massive difference between acutely raising leptin with nutritional strategies and resetting leptin back to its original levels pre-weight loss.

creative1981

Brilliant post - Thank you for clearing up many of my questions!

NovemberJune

thanks!

janeosu

Great post!

futbolista10

Great post!!!

yarwell

Interesting.

Very Low Carb Diets are approved medically by the UK's health authorities
http://www.nhs.uk/Livewell/loseweight/Pages/very-low-calorie-diets.aspx

with advice on limited duration and medical supervision (they say that about any diet - talk to your doctor / GP).

There are several commercial providers of nutritionally complete diets at calorie levels of 400 - 800, often used in clinical diet trials. The main thing appears to be enough protein to avoid muscle wastage, and enough mins & vits to keep you going.

bugnsamsmom

While I totally agree with you, I don't think the people (the women, really) on here are following a more science-based, "proper" VLCD. I also think (and not to speak of ALL men vs. ALL women), that the mindset of a man on a "diet" vs. a woman on a "diet" can and often is, very different. The chronic undereating and mindset of many women on here is not to follow a VLCD for a while, based on the science out there and the actual diet plans in the books. It's to starve themselves to be skinny. They post threads to gain justification for doing it (again, not based on the science behind a VLCD), and to do it for a very long time. I am also against the "OMG you are going into starvation mode and your metabolism is screwed forever!!", but I think there is a balance between the two that would be better used for most of the people on this site.

I'm having a hard time explaining it without getting your post deleted and without bringing in the people who will think I'm being sexist...

I agree with you. Both my husband and I are currently "dieting"...trying to eat healthier and to work exercise into that for a healthier lifestyle. We are both on the same page when it comes to measuring and counting food and going to the gym...BUT...our minds are in different places. We're doing the same things but our views of why are different. I'm often complaining that the weight is coming off fast enough and that I don't see the changes. Whereas he's commenting that longer walks are easier on his breathing and his knees and his pants are fitting better. Same approach...different views.

Now, as for the post being deleted. There has been a lot of talk in the media recently about the 800 calorie diets especially with brides going on feeding tubes to achieve their goal size (not weight...but size) to fit their dresses. That is not smart, I can't believe that anyone on here would agree that it is a smart approach to weightloss. And while the media is not promoting it,quite the opposite, there are many women out there with my mindset (I need to lose the weight now) who, unlike myself, WILL choose to take that approach for the quick reward but without any research or understanding behind the pros and without a care about what the cons are.

My view is not scientific...but rather...if I had the means and the right motivation...I could see myself trying this. I'm not...but I think that I could, maybe. And, if MFP, as an entity, does not agree with that approach, they have a right to not put it on their site because someone out there could, maybe, possibly come along after damaging their body and say that they learned about it from MFP, now it's a liability. Just saying....

As to the post being deleted.

stroutman81

Thanks guys... glad you enjoyed.

Gertie_Brinks

bump

dafoots0911

There was a thread that was deleted yesterday where the original poster was asking if it was okay to consume something like 800 calories per day. I'm not sure exactly why it was removed, but it likely had something to do with person after person telling the OP that she was being stupid.

I don't like personal attacks at all... but what drove me even more crazy was the fact that almost every single person felt the need to chime in about a topic they obviously haven't studied very much. We heard things like your muscles are going to fall off, you're going to kill your metabolism, you're going to wind up in the hospital with nutrition deficit, you're being anorexic, etc.

I'm not posting this thread to restart all the flaming and trolling. I want this to shine a bit of objectivity on the subject of very low calorie diets and metabolism. I spent a decent amount of time explaining things in the thread that was deleted, so it was disheartening to see the information deleted. I think we can all agree that among other important goals, this community is about education.

As this thread in question is being discussed on my profile page, someone asked me to re-explain what I discussed in the removed thread. I'm simply going to copy and paste my response here:

Yes, very low calorie diets (VLCD) can reduce RMR and disrupt various components of the endocrine system. But correlation is not causation. Meaning... is it the VLCD or is it the effect of the VLCD that leads to the slowdown? Put differently, VLCD cause high rates of fat loss due to the massive energy deficits. Fat happens to be the home of the master hormone responsible for metabolic regulation - Leptin. Leptin lets out bodies know that it's fed. So if we have less fat, we have less Leptin. If we have less Leptin, we have less of a "fed" signal to the brain. If we have less of a fed signal, the body responds accordingly with the slowdown in RMR (and some other adaptations).

But the logical question you should be asking is, "Won't smaller or normal deficits also cause a loss in fat? And won't that loss in fat lead to the same sort of negative adaptations?" And the answer is yes. It's just that the VLCD will cause these adaptations to happen faster... but you'll also lose fat faster. Follow me?

This isn't an argument for people to start following VLCD as most will fail miserably. Once you factor in the psychology aspects of them, they're just not right for most long term fat loss plans. In addition, the lower your energy intake is, the more careful you have to be about nutritional adequacy. Meaning it becomes very easy to shortchange yourself of particular facets of nutrition, which can ultimately tap into "health."

For example, back in the day when the medical community was busy trying to fix obesity, they used VLCDs and weren't mindful of protein quality or quantity. Protein happens to support muscle mass. Sure, around here we're interested in preserving skeletal muscle, as that's what helps us get "toned," "lean," "athletic looking," "ripped," or whatever the cool buzzword is nowadays. But these experiments on the obese patients led to losses in other types of muscle... namely cardiac muscle, which plays an important role in being alive, obviously.

Point is, the more food you eat, the easier it is to cover all of your nutritional bases. You can still screw things up, but it's just harder.

In the thread that was deleted last night, I spoke of the Minnesota Starvation Experiment ran by Ancel Keys, which took already relatively lean men and locked them down in the lab where they were given 50% of their calorie needs for half of a year. They also had supervised exercise ever day if memory serves me correct. We know that lean people will react faster (in terms of metabolic slowdown) to big energy deficits than fat people will. Which makes sense.... fat bodies don't "think" they're starving as quickly since they have all of this excess energy in storage, right?

But even with the test subjects in this experiment being lean to start, after the 6 month period, they only experienced a slowdown in RMR of 15% or so. I mean total energy expenditure dropped by 40% or so, but the remaining 25% (above the 15%) was due to the loss in weight (tissue costs something to maintain and a bigger body is more expensive to move around). Everyone knows that as weight is lost, calorie needs go down.

The "starvation mode" totaled 15% after half a year of low calorie dieting. And that's the primary point... life requires energy expenditure. And metabolism can be thought of as our total energy expenditure in this case. Even if there is negative adaptation to low calorie dieting, metabolism can only drop so far... there's a minimum threshold that's required to keep your heart beating, to fuel respiration, power the brain, transport nutrients, digest food, etc, etc.

I also posted a few links to more current research.... one paper compared a 25% deficit to a 890 calorie intake. The low calorie intake lost more weight than the 25% group. Yes, they had a metabolic slowdown... but so did the 25% group, which corresponds to what I said above about big and small deficits.

There's a lot more that I could say on the topic. For example, NEAT (non-exercise activity thermogenesis) is turning out to play a substantial role in the reduction in total daily energy expenditure experienced on prolonged diets... big or small deficits. Which only stands to solidify the importance of exercise while dieting. NEAT drops unconsciously... so we counteract that by doing more activity consciously via structured exercise. But we won't dive into that end of things as this is already far too long.

The bottom line is this... VLCDs are not as destructive as people around here are making them out to be. People see VLCD and immediately think of anorexia. Anorexics lose weight past the point of healthy thresholds. They also aren't mindful of nutrition quality, more often than not. Not on low calorie diets are "unhealthy."

There's a time and a place where they may even make sense for some. I've used them. I've used them with some of my clients.

It's just that those times and places don't match beginners who obviously need to learn nutrition fundamentals before they go experimenting with advanced dieting techniques. If they jump right into very strict and limiting diets, there's a good chance they're going to wind up gaining weight, not because of some crazy adaptation that winds up creating stored energy (fat) out of thin air... but because they're not going to stick with it, and when they fall off the wagon, they fall hard and typically eat their faces off.

I'm not out there advocating VLCDs. Not at all... heck, I wrote the Nutrition 101 article, which everyone should have read by now, and nowhere in it did I advocate VLCD. I'm simply trying to maintain the integrity of information while steering people in an optimal direction. It seems like too many people around here are stuck on absolutes. They believe there is 100% right ways of doing things and 100% wrong ways of doing things. There's no in between. In reality, there are very few absolutes in the game of fat loss.

WOW!!! I'm responding to this so I can have it in my topics on my page to come and read later. Thanks for posting.