95% of people who lose weight put it back on. Why?
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Because people think they can go back to "normal" after they get to their goal weight. Normal is what caused us to gain in the first place. You have to change your whole life. 95% of people diet, 5% of people change their lifestyle.0
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Because those 95%-ers loss weight and hit their goal.. therefore they feel relief and freedom and ditch their lifestyle change. tisk tisk.0
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Because 95% of people don't understand the lifestyle change that goes with it.
^^^ this ^^^ most people diet as a temporary fix. it isn't untill you make it a lifestyle change and conquer the demons that got you overweight to start with that it becomes permanent.0 -
Because people are lazy and don't appreciate what they have when they have it. They don't want to work hard to EARN what they want, they want it handed to them. So even if they achieve their goal for a short time, they lose all drive and go back to being lazy slobs that whine about how hard it is to not sit on the couch and watch TV. I like to refer to them as “the 99%”… (Yes, this comment also works for multiple other topics…)0
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132 lost and keeping it off? wow! i need to get with folks that are in maintenance mode too after serious weight loss because man is this a battle!0
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There is no one reason, but here is what I know contributes...
Lower income means finding food that will be good as long as it stays in your pantry, cant spend money on healthy food, cant afford to.
totally not true but a common excuse
Eating healthier is more expensive if you don't plan ahead your meals, and if you don't look out for special offers that supermarkets are offering among other things. I think that's one of my biggest problems is having the necessary food at home to healthy living.
I agree it takes more work and more planning but it doesnt take more money. It can actually be less expensive when you cut out convenience foods
^^ This all depends on where you are. I just moved to Memphis which is notorious for having food deserts in areas around town. I live inside a food desert - that is, that the grocers who are closest to my apartment offer higher priced, lower quality foods and also offer a smaller selection of healthy foods. What does this mean for me? I plan out my meals on a bi-monthly basis. And I frequent the Farmer's Market every week because as a general rule of thumb, the produce I find is not the best. So my food budget goes up because - here's the kicker - I drive 30 minutes to the nearest quality grocer and it takes gas to drive to the Farmer's Market once a week. And I am lucky enough to have a car to then transport these groceries back to my apartment. For the people who use public transportation, you can only buy enough for what you can carry. And then it becomes a lot easier to buy a few boxes of spaghetti rather than a wide variety of fruits and veggies.
The bottom line? It takes more money to afford healthy food. It takes privilege AND money to afford fresh food. I personally make a conscious effort to shape my monthly budget in a way that I can afford healthy, fresh food; it's hard work.
Pun intended, but this is just food for thought
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I had somebody just ask me " Why are you still using MFP ? Your not still trying to lose weight are you ?" No I have reached my goal. But I need to keep myself accountable for every bite. If I don't I feel the weight would creep back on. Logging my food has become second nature. I believe a lot of people have eating problems due to the abundance and availability of food. Paleolithic man had to work hard for his food. Chasing and stalking game. Walking miles to gather food. No grocery stores no refrigerators. When he had food he gorged before it went rancid, because he never knew when he would get to eat again. It must have been very calming and reassuring to have food. Modern man feels the same way, but our availability of,food,makes it way to easy for a stress reliever.
I think that's it.
I hit my first goal and am just settling in for a new lower goal of another 17 pounds. But I went out a lot this weekend and logged, but didn't always check before I ate. I made my net goals but only barely. What did I do wrong? Ate two things that I knew were high calorie but had no idea they were as high as they were.
One piece of carrot cake: 1510 calories!!!!! Fortunately, I split it with 4 other people, but I put that down for 500 calories right there. Last year I easily would have eaten the whole thing. That's more than a day's calories.
One small meatball sub: 870 calories. Fortunately, I chose water and no chips to go with it and skipped the cheese.
Those 'smoothies' at McDonald's look relatively healthy, though fattening, but have 700+ calories.
I think portion size and not knowing exactly what is more or less fattening makes it easy to make bad choices.0 -
As incredilby challenging as losing the weight was, I have to agree with you. Maintenance is even harder because this is for life! Folks that are on the weight loss journey, please don't "diet" - diets don't work if you are wanting permanent change. Commit for life to the discipline that is going to be required of you, both in keeping your activity levels high and your eating healthy and light. So never lose sight of your goal which is a lifetime of health, keep your mind on the real goal so that when you are finished losing weight, you are mentally prepared to start maintaining. Weight loss is incredilby tough and rewarding but it's only the first step. Don't think of reaching a set weight as a finish line. Think of it more as a new starting line!As someone who has lost and gained back and also knowing other who did the same. I think a lot of people think the work is over once they have lost the weight. The truth is that maintaining your weight is actually more difficult than losing it. So many people let their guard down once they have lost and go back to old habits. Has to be something you work at for the rest of your life and even more diligently once you are trying to maintain. At least that's what I have learned.0
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They put the weight back on because they diet. It's not about the diet folks. It's about changing your lifestyle, forever. All the advertising B.S. aside, there is no drug that will work, or diet that will work. It's about what you put into your body and 'exercise', period. If you do that for the rest of your life, you will stay at a healthy weight. If not, you will not. Plain and simple. Each must make a conscious decision on which direction to choose. Once I left sports I have always had to fight the waistline issue. Every day, all the time. It wasn't until I decided to change my lifestyle permanently that I have started heading down the right path for me. That isn't to say that I will be able to do this forever, but at 53 years old I am down 77 lbs and am in better shape than in the last 25 years. It is HARD getting to the gym 4 times a week, and I could literally choke my trainer at times. But by God, I feel better each day. It has only been 8 months since I started. My life has changed for the better and I will NOT let it go this time! For all you folks who do not have to worry about what they eat (my sister), I am and have always been envious. For all the rest of us who struggle, STAY STRONG! L8R...AP0
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today's processed food is designed to keep you coming back for more!
it is no longer sustenance.
it is big company profits!
they want us to eat more and will do anything to make us do this!
our life styles have changed
we don't have the morning breakfast together @ 6am, the lunch @ 12pm followed by dinner together @ 6pm
it's broken! you can buy food anywhere (and most of it isn't food)!
MFP helps manage, it allows you to consider your input/output!
It shows you the "bad" foods
It helps you "question" the "good" foods
Once you've opened Pandora's box, there's no going back!
But how many people do look as hard? How many people are curious in what food they consume?
Diet is a poor word when used to do something for a limited time!
Exercise is something that is still misunderstood.
Changing their lifestyle, make it fit! Understand your foods, your cravings, solve them! You don't have to quit, you just don't need to partake!
Once you've got rules for your food choices, you're a stronger individual.
Once you develop an exercise plan, you need to keep it in chaos.
Most people drift back into our messed up world of consumption!
The food industry want you to buy more of what "they" want to sell you!
The drug industry wants you to pay them to keep you well!
The sports industry wants you to buy into fads!
I think out of everything I've read on the web, Mark Sisson sums most things up, we need to live Primal.
Do your best to live as we've evolved to live!
http://www.marksdailyapple.com/
Although Mark is selling you stuff, he actually gives you enough information to solve the problem without buying anything!
Paleo may be an option for some, crossfit too. find your own way, keep traveling and enjoy the journey!
Sometimes it's not about getting there, sometimes it's about meeting people and expanding your knowledge on the way 0 -
Bumping...so I can refer to this when I need it. I will be part of the 5%! :bigsmile:0
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just copying an old post.
While I'm not keen on the entire set - point theory, I do think genetic inheritance plays a very important part in the body returning to a "comfortable" weight. I really think weight is due to a combination of both genes and environment. After reading articles like the following I can't help but wonder if dieting is just too hard for some. My thinking (at the moment ) leans towards the possibility that people who relapse are just tired of the struggle to maintain the constant vigilance. Maybe it's due to a shifting of values where remaining thin is no longer a top priority in life, or counting calories and thinking about food becomes too time consuming and starts taking away from someone's life instead of adding to it. It's nice to be free from analyzing your options every time you eat something, to be able to eat something because that's what you "want", and not what you "should" have.
I'm sure there are many reasons, just throwing some possibilities out there.class="quote_top">QUOTE:
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May 8, 2007
Genes Take Charge, and Diets Fall by the Wayside
By GINA KOLATA
Correction Appended
It was 1959. Jules Hirsch, a research physician at Rockefeller University, had gotten curious about weight loss in the obese. He was about to start a simple experiment that would change forever the way scientists think about fat.
Obese people, he knew, had huge fat cells, stuffed with glistening yellow fat. What happened to those cells when people lost weight, he wondered. Did they shrink or did they go away? He decided to find out.
It seemed straightforward. Dr. Hirsch found eight people who had been fat since childhood or adolescence and who agreed to live at the Rockefeller University Hospital for eight months while scientists would control their diets, make them lose weight and then examine their fat cells.
The study was rigorous and demanding. It began with an agonizing four weeks of a maintenance diet that assessed the subjects’ metabolism and caloric needs. Then the diet began. The only food permitted was a liquid formula providing 600 calories a day, a regimen that guaranteed they would lose weight. Finally, the subjects spent another four weeks on a diet that maintained them at their new weights, 100 pounds lower than their initial weights, on average.
Dr. Hirsch answered his original question — the subjects’ fat cells had shrunk and were now normal in size. And everyone, including Dr. Hirsch, assumed that the subjects would leave the hospital permanently thinner.
That did not happen. Instead, Dr. Hirsch says, “they all regained.” He was horrified. The study subjects certainly wanted to be thin, so what went wrong? Maybe, he thought, they had some deep-seated psychological need to be fat.
So Dr. Hirsch and his colleagues, including Dr. Rudolph L. Leibel, who is now at Columbia University, repeated the experiment and repeated it again. Every time the result was the same. The weight, so painstakingly lost, came right back. But since this was a research study, the investigators were also measuring metabolic changes, psychiatric conditions, body temperature and pulse. And that led them to a surprising conclusion: fat people who lost large amounts of weight might look like someone who was never fat, but they were very different. In fact, by every metabolic measurement, they seemed like people who were starving.
Before the diet began, the fat subjects’ metabolism was normal — the number of calories burned per square meter of body surface was no different from that of people who had never been fat. But when they lost weight, they were burning as much as 24 percent fewer calories per square meter of their surface area than the calories consumed by those who were naturally thin.
The Rockefeller subjects also had a psychiatric syndrome, called semi-starvation neurosis, which had been noticed before in people of normal weight who had been starved. They dreamed of food, they fantasized about food or about breaking their diet. They were anxious and depressed; some had thoughts of suicide. They secreted food in their rooms. And they binged.
The Rockefeller researchers explained their observations in one of their papers: “It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.”
Eventually, more than 50 people lived at the hospital and lost weight, and every one had physical and psychological signs of starvation. There were a very few who did not get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and, always, counting calories and maintaining themselves in a permanent state of starvation.
“Did those who stayed thin simply have more willpower?” Dr. Hirsch asked. “In a funny way, they did.”
One way to interpret Dr. Hirsch and Dr. Leibel’s studies would be to propose that once a person got fat, the body would adjust, making it hopeless to lose weight and keep it off. The issue was important, because if getting fat was the problem, there might be a solution to the obesity epidemic: convince people that any weight gain was a step toward an irreversible condition that they most definitely did not want to have.
But another group of studies showed that that hypothesis, too, was wrong.
It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.
His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.
Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.
When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.
The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.
That, of course, was contrary to what every scientist had thought, and Dr. Sims knew it, as did Dr. Hirsch.
The message never really got out to the nation’s dieters, but a few research scientists were intrigued and asked the next question about body weight: Is body weight inherited, or is obesity more of an inadvertent, almost unconscious response to a society where food is cheap, abundant and tempting? An extra 100 calories a day will pile on 10 pounds in a year, public health messages often say. In five years, that is 50 pounds.
The assumption was that environment determined weight, but Dr. Albert Stunkard of the University of Pennsylvania wondered if that was true and, if so, to what extent. It was the early 1980s, long before obesity became what one social scientist called a moral panic, but a time when those questions of nature versus nurture were very much on Dr. Stunkard’s mind.
He found the perfect tool for investigating the nature-nurture question — a Danish registry of adoptees developed to understand whether schizophrenia was inherited. It included meticulous medical records of every Danish adoption between 1927 and 1947, including the names of the adoptees’ biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.
Dr. Stunkard ended up with 540 adults whose average age was 40. They had been adopted when they were very young — 55 percent had been adopted in the first month of life and 90 percent were adopted in the first year of life. His conclusions, published in The New England Journal of Medicine in 1986, were unequivocal. The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.
The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”
In other words, being fat was an inherited condition.
Dr. Stunkard also pointed out the implications: “Current efforts to prevent obesity are directed toward all children (and their parents) almost indiscriminately. Yet if family environment alone has no role in obesity, efforts now directed toward persons with little genetic risk of the disorder could be refocused on the smaller number who are more vulnerable. Such persons can already be identified with some assurance: 80 percent of the offspring of two obese parents become obese, as compared with no more than 14 percent of the offspring of two parents of normal weight.”
A few years later, in 1990, Dr. Stunkard published another study in The New England Journal of Medicine, using another classic method of geneticists: investigating twins. This time, he used the Swedish Twin Registry, studying its 93 pairs of identical twins who were reared apart, 154 pairs of identical twins who were reared together, 218 pairs of fraternal twins who were reared apart, and 208 pairs of fraternal twins who were reared together.
The identical twins had nearly identical body mass indexes, whether they had been reared apart or together. There was more variation in the body mass indexes of the fraternal twins, who, like any siblings, share some, but not all, genes.
The researchers concluded that 70 percent of the variation in peoples’ weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease.
The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight.
The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true — each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks.
The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.
He published it in the journal Science in 2003 and still cites it:
“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”
This is an excerpt from Gina Kolata’s new book, “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting” (Farrar, Straus & Giroux).
Correction: May 12, 2007
An article in Science Times on Tuesday about the role of genes in weight gain misstated the publication date for an article in the journal Science describing the biological controls over body weight. The article was published in 2003, not 2000.
Lots of comments after this article at the New York Times if you're interested - most not as depressing as this article and a few by readers that are maintaining a large loss of weight.0 -
of course they put it back on, isn't that why we lose it in the first place? for the fun of eating it back?0
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Becuase you can only go so long before you realize the awesomeness of nachos.
Well said:)0 -
TL:DR
It's because they diet too low and slow RMR/BMR.
Then when they go back to what TDEE used to be they put weight back on.
Its called priming the body and most folk who eat below BMR for long periods or those cutting carbs too low have it the worst.0 -
When I hit goal I plan on gaining weight. I'm going to maintain for a few months and then start my bulk. So I guess I'll be in that 95% haha, but in a good way!0
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I don't think it's always so simplistic as emotional eating. I'm not an emotional eater and I put 20 lbs back on after getting to goal about 6 years ago. It just creeps on. I gained a little over 3 lbs a year which is about 11,000 extra calories a year, which is around 211 extra calories a week. How easy is it to eat 211 extra calories a week, heck even a day. So for me to keep it off I need to track, plain and simple.0
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I had somebody just ask me " Why are you still using MFP ? Your not still trying to lose weight are you ?" No I have reached my goal. But I need to keep myself accountable for every bite. If I don't I feel the weight would creep back on.
This0 -
For me, it got too hard. I was eating very little and exercising pretty much everyday, and I wasn't educated enough when it came to weight loss and nutrition to make it happen. I was around 18 when I lost the weight, I didn't have help or a lot of support, and I was in college in a town where I didn't have any friends, and I was desperate to fit in any way I could. I didn't really know the right way to do it, and my emotions were all over the place. I had a lot going on in my life at the time and the way I was doing it just simply wasn't sustainable to begin with, and well, when things got hard or friends rejected me, food was there. Food was the one constant I had and I knew that it wouldn't ever leave me or reject me like so many people had; I personally used it as a crutch and I kept using it as comfort through tough times. I think that's one of the big factors into my own weight issues along with the lack of nutritional education and desperation.
However, I think that's what happens to a lot of dieters; they're so desperate to get the weight off and they're not educated enough to do it in a healthy way, or they know and they want to lose weight so badly that they're willing to do anything for the fast fix. People just want it over with because they think that weight loss will solve all their problems- I know definitely did, because I thought that losing weight would make people like me more and my parents love me more, and it didn't. It didn't help me make more friends or make my life easier at all, really. And honestly, I got tired of putting all the work in, and I got tired of barely eating, and I bailed. I was stupid about it and I gave up; I felt like I was getting nowhere when I had gotten pretty far, actually. It was just that I was limiting myself so much and I wasn't doing it in a way that could last a life time.0 -
Agreed.
Yes it does.It takes a lot of hard work
Having the discipline to control eating habits is hard.
Exercising is hard.
Dealing with emotional eating is hard.
Making a complete lifestyle change is hard.
5% are willing to do the hard work.
95% not so much.
I don't think it is so much 95% "are not willing" - that's a bit harsh. I find alot of people just struggle more. Not everyone has massive willpower. We all come from different backgrounds and tackle problems in different ways. Some are better at succeeding faster than others.
I've gained weight back simply because I stopped doing what I did to lose it in the first place. I kept the weight off for years but then my father died, I became very depressed, and just didn't want to log what I ate anymore.
People handle life in different ways. To just write off everyone who fails at something as being lazy is just wrong, IMO.0 -
This is it, here.For me, it got too hard. I was eating very little and exercising pretty much everyday, and I wasn't educated enough when it came to weight loss and nutrition to make it happen. I was around 18 when I lost the weight, I didn't have help or a lot of support, and I was in college in a town where I didn't have any friends, and I was desperate to fit in any way I could. I didn't really know the right way to do it, and my emotions were all over the place. I had a lot going on in my life at the time and the way I was doing it just simply wasn't sustainable to begin with, and well, when things got hard or friends rejected me, food was there. Food was the one constant I had and I knew that it wouldn't ever leave me or reject me like so many people had; I personally used it as a crutch and I kept using it as comfort through tough times. I think that's one of the big factors into my own weight issues along with the lack of nutritional education and desperation.
However, I think that's what happens to a lot of dieters; they're so desperate to get the weight off and they're not educated enough to do it in a healthy way, or they know and they want to lose weight so badly that they're willing to do anything for the fast fix. People just want it over with because they think that weight loss will solve all their problems- I know definitely did, because I thought that losing weight would make people like me more and my parents love me more, and it didn't. It didn't help me make more friends or make my life easier at all, really. And honestly, I got tired of putting all the work in, and I got tired of barely eating, and I bailed. I was stupid about it and I gave up; I felt like I was getting nowhere when I had gotten pretty far, actually. It was just that I was limiting myself so much and I wasn't doing it in a way that could last a life time.
People do not learn what changes need to be made to maintain weight after they lose it or understand fundamental concepts that connect proper dietary intake and exercise with fat loss. If one does not advance their understanding, they're going to fall back to their old habits. Lastly, although exercise is not essential for fat loss, it is one of the major determinants that aid one to maintain their body weight. When dieters do not add regular activity in their intervention either during calorie restriction or while in maintenance, they are very likely to regain their fat mass. Combine a lack of education and physical activity and that equals failure.0 -
You're right, it's unfair to categorize everyone that fails as lazy (I didn't say that). For the record, I didn't say lazy you did.People handle life in different ways. To just write off everyone who fails at something as being lazy is just wrong, IMO.
Yes, a certain percentage of the population deals with heavy emotional problems that get in the way of self improvement. I'm well familiar with the emotional impact of losing a loved one. Severe depression aside, I still think it's accurate to say that a large percentage of people are unwilling to put in the effort. As a society we've become comfortable with being comfortable. Most people are too complacent for real change.
We're talking about weight loss and fitness here, but you can substitute education or business and see the dividends of hard work.
"She's the valedictorian of her class because she put in the extra hours on her study time."
"He is a successful business man because he's never satisfied, always striving to do better".
These people are successful because they are willing to put forth the effort.0 -
zaph0d...well said 0
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I prefer a simpler answer: food is f-ing delicious.0
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So is the OP suggesting that people who are *NOT* emotional eaters will certainly enjoy long-term success? I hope that's the case! It bodes well for those of us who are not emotional eaters.0
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For me the difference was knowledge. I have only ever been 30 lbs overweight and am not an emotional eater. Once I educated myself on how simple (and yet difficult) this really was, I lost the 30 lbs and have had an easy time keeping it off for 2 years. We tend to get so bogged down in different diet fads and the minutia of which exercise is best that we fail to see the stark truth. Just move more and eat less and you'll see results. That knowledge made it impossible for me to continue to make excuses.0
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I just watched Hirsch's documentary last night on HBO. It was a tad depressing and kind of a slap in the face. WAKE UP! Basically they were saying the body will strive to get itself back to the overweight state it was in and we will have to spend the rest of our lives fighting that urge. I was talking to my sister about it afterwards, who is a nurse, and she pointed out that it is like disease management. If you are living with a chronically diseased state you have to work, for the rest of your life, at maintaining your health. Just like a diabetic will have to take medication forever, I will have to focus on my food and exercise forever.just copying an old post.
While I'm not keen on the entire set - point theory, I do think genetic inheritance plays a very important part in the body returning to a "comfortable" weight. I really think weight is due to a combination of both genes and environment. After reading articles like the following I can't help but wonder if dieting is just too hard for some. My thinking (at the moment ) leans towards the possibility that people who relapse are just tired of the struggle to maintain the constant vigilance. Maybe it's due to a shifting of values where remaining thin is no longer a top priority in life, or counting calories and thinking about food becomes too time consuming and starts taking away from someone's life instead of adding to it. It's nice to be free from analyzing your options every time you eat something, to be able to eat something because that's what you "want", and not what you "should" have.
I'm sure there are many reasons, just throwing some possibilities out there.class="quote_top">QUOTE:
class="quote">
May 8, 2007
Genes Take Charge, and Diets Fall by the Wayside
By GINA KOLATA
Correction Appended
It was 1959. Jules Hirsch, a research physician at Rockefeller University, had gotten curious about weight loss in the obese. He was about to start a simple experiment that would change forever the way scientists think about fat.
Obese people, he knew, had huge fat cells, stuffed with glistening yellow fat. What happened to those cells when people lost weight, he wondered. Did they shrink or did they go away? He decided to find out.
It seemed straightforward. Dr. Hirsch found eight people who had been fat since childhood or adolescence and who agreed to live at the Rockefeller University Hospital for eight months while scientists would control their diets, make them lose weight and then examine their fat cells.
The study was rigorous and demanding. It began with an agonizing four weeks of a maintenance diet that assessed the subjects’ metabolism and caloric needs. Then the diet began. The only food permitted was a liquid formula providing 600 calories a day, a regimen that guaranteed they would lose weight. Finally, the subjects spent another four weeks on a diet that maintained them at their new weights, 100 pounds lower than their initial weights, on average.
Dr. Hirsch answered his original question — the subjects’ fat cells had shrunk and were now normal in size. And everyone, including Dr. Hirsch, assumed that the subjects would leave the hospital permanently thinner.
That did not happen. Instead, Dr. Hirsch says, “they all regained.” He was horrified. The study subjects certainly wanted to be thin, so what went wrong? Maybe, he thought, they had some deep-seated psychological need to be fat.
So Dr. Hirsch and his colleagues, including Dr. Rudolph L. Leibel, who is now at Columbia University, repeated the experiment and repeated it again. Every time the result was the same. The weight, so painstakingly lost, came right back. But since this was a research study, the investigators were also measuring metabolic changes, psychiatric conditions, body temperature and pulse. And that led them to a surprising conclusion: fat people who lost large amounts of weight might look like someone who was never fat, but they were very different. In fact, by every metabolic measurement, they seemed like people who were starving.
Before the diet began, the fat subjects’ metabolism was normal — the number of calories burned per square meter of body surface was no different from that of people who had never been fat. But when they lost weight, they were burning as much as 24 percent fewer calories per square meter of their surface area than the calories consumed by those who were naturally thin.
The Rockefeller subjects also had a psychiatric syndrome, called semi-starvation neurosis, which had been noticed before in people of normal weight who had been starved. They dreamed of food, they fantasized about food or about breaking their diet. They were anxious and depressed; some had thoughts of suicide. They secreted food in their rooms. And they binged.
The Rockefeller researchers explained their observations in one of their papers: “It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.”
Eventually, more than 50 people lived at the hospital and lost weight, and every one had physical and psychological signs of starvation. There were a very few who did not get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and, always, counting calories and maintaining themselves in a permanent state of starvation.
“Did those who stayed thin simply have more willpower?” Dr. Hirsch asked. “In a funny way, they did.”
One way to interpret Dr. Hirsch and Dr. Leibel’s studies would be to propose that once a person got fat, the body would adjust, making it hopeless to lose weight and keep it off. The issue was important, because if getting fat was the problem, there might be a solution to the obesity epidemic: convince people that any weight gain was a step toward an irreversible condition that they most definitely did not want to have.
But another group of studies showed that that hypothesis, too, was wrong.
It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.
His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.
Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.
When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.
The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.
That, of course, was contrary to what every scientist had thought, and Dr. Sims knew it, as did Dr. Hirsch.
The message never really got out to the nation’s dieters, but a few research scientists were intrigued and asked the next question about body weight: Is body weight inherited, or is obesity more of an inadvertent, almost unconscious response to a society where food is cheap, abundant and tempting? An extra 100 calories a day will pile on 10 pounds in a year, public health messages often say. In five years, that is 50 pounds.
The assumption was that environment determined weight, but Dr. Albert Stunkard of the University of Pennsylvania wondered if that was true and, if so, to what extent. It was the early 1980s, long before obesity became what one social scientist called a moral panic, but a time when those questions of nature versus nurture were very much on Dr. Stunkard’s mind.
He found the perfect tool for investigating the nature-nurture question — a Danish registry of adoptees developed to understand whether schizophrenia was inherited. It included meticulous medical records of every Danish adoption between 1927 and 1947, including the names of the adoptees’ biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.
Dr. Stunkard ended up with 540 adults whose average age was 40. They had been adopted when they were very young — 55 percent had been adopted in the first month of life and 90 percent were adopted in the first year of life. His conclusions, published in The New England Journal of Medicine in 1986, were unequivocal. The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.
The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”
In other words, being fat was an inherited condition.
Dr. Stunkard also pointed out the implications: “Current efforts to prevent obesity are directed toward all children (and their parents) almost indiscriminately. Yet if family environment alone has no role in obesity, efforts now directed toward persons with little genetic risk of the disorder could be refocused on the smaller number who are more vulnerable. Such persons can already be identified with some assurance: 80 percent of the offspring of two obese parents become obese, as compared with no more than 14 percent of the offspring of two parents of normal weight.”
A few years later, in 1990, Dr. Stunkard published another study in The New England Journal of Medicine, using another classic method of geneticists: investigating twins. This time, he used the Swedish Twin Registry, studying its 93 pairs of identical twins who were reared apart, 154 pairs of identical twins who were reared together, 218 pairs of fraternal twins who were reared apart, and 208 pairs of fraternal twins who were reared together.
The identical twins had nearly identical body mass indexes, whether they had been reared apart or together. There was more variation in the body mass indexes of the fraternal twins, who, like any siblings, share some, but not all, genes.
The researchers concluded that 70 percent of the variation in peoples’ weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease.
The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight.
The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true — each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks.
The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.
He published it in the journal Science in 2003 and still cites it:
“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”
This is an excerpt from Gina Kolata’s new book, “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting” (Farrar, Straus & Giroux).
Correction: May 12, 2007
An article in Science Times on Tuesday about the role of genes in weight gain misstated the publication date for an article in the journal Science describing the biological controls over body weight. The article was published in 2003, not 2000.
Lots of comments after this article at the New York Times if you're interested - most not as depressing as this article and a few by readers that are maintaining a large loss of weight.0 -
The reason for weight regain is BIOLOGY.
Obesity is an extremely complex chronic disease state for which there is no current cure. "Eat less and move more " is a silly nostrum which has no basis in science. It's an extrapolation. It is NOT a solution to obesity. The body responds to everything we do and has tricks we do not even understand yet designed to keep us at a certain weight. You will regain over the long term and not even "hear its voice." Dr. Liebel has discoevred this. Body weight is involuntarily regulated by neural circuitry. But , we all can be about 8 pounds less.
This extremely small group of people who maintain most likely have a different neural circuitry wiring than most of the population.
Obesity is as heritable as height. Obesity is more heritable than ANY other condition studied by science. I am in contact with the top obesity researchers in the world such as Dr. Douglas Coleman and Dr. Rudolph Liebel. Most people on here are laughably misinformed.
Our ability to affect our body weight is very limited , especially over the long term. "The Biggest Loser" is not based on any kind of science. It's fraud.0 -
Ohhhhhhh.....missed Hirsch's documentary, no HBO. Will look for it now. Thanks!0
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I think it's a total crock to blame it on something outside your own control. Despite what he research says, it's wrong. Yes, some might have a predisposition. But, this makes it too easy to just give up. Screw that. We really don't know much about how all this works, and just giving in to "genetics" is just lame. The human mind is more powerful than that. I don't buy the research.0
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