What are the Proven Benefits of a "Lifestyle Change"?

But what if losing weight causes those disorders? Quoting this again because I read it today in someone's post, and to me it sums up the issue of how difficult it is to maintain a loss and I don't think the words 'lifestyle change' address it at all:

"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."

http://www.nytimes.com/2007/05/08/health/08fat.html?pagewanted=all&_r=1&

The whole article is really worth a read.

The article was interesting, but locking people away and allowing no food...well here " The only food permitted was a liquid formula providing 600 calories a day" is far different than an individual making conscious decisions and changes over an extended period of time. This article makes a point to say these people were acting starved, hiding food and binging. First they were by definition starved and secondly the article has no mention of how they got fat, they may have always binged when felt deprived.

If weight loss was the cause of those disorders (not saying in some situations weight loss may not trigger new disorders to the individual) than did the obese individual magically create and store energy from nothing, or did they eat too much for whatever reason or issue and instead of taking steps to correct it, they developed more issues related to obesity as they grew in size?

The latter seems much more plausible. I would be interested if there is a correlation to the degree of obesity (or overweight), length of time spent over weight and longterm maintenance.

Over all I do not think the OPs question is answerable and any study found would be irrelevant because they are either doing insane studies, like that article or they are lumping all overweight people together regardless of mental health, prior history, hereditary and environment and counting a crash dieter the same as a longterm calorie restriction plan.

The studies mentioned were from the 1920's and 1950's

Your reply was a which came first the chicken or the egg type question, but the truth is many things cause excess weight, then excess weight causes many more issues. Dieting and failure may exuberate the issues but they still came with and during the weight gain.

The article also discusses set point, not sure of my opinion but since prior to the 19th century obesity was rare and I highly doubt the human population evolved to hold onto food in a more efficient manner at a point in history when food has never been more available and do this in a couple hundred years as opposed to 1000's for normal evolutionary patterns to appear. This theory seems far fetched. I am not saying some people are not just naturally bigger, but over a hundred pounds over weight is not just genes. To be that much larger there were contributing factors.

A bit of a jerk, aren't we? I'm out of this. You clearly engage those that are emotionally responsive to your post, but decline to comment on the actual pertinent research data.

I think that's called trolling. Godspeed, no intention of enabling you anymore. Nice forums with ignore settings

Someone, for no apparent reason, responds rudely to me. Yet I'm the troll?

And the absolute irony? Just as you were writing your "kiss off troll" retort, I was in the middle of typing a rather lengthy, considered response to your earlier post. It's posted above and was an attempt to clarify my point.

Godspeed indeed.

No, he's right, you were rude, and don't seem to be here to really talk about it, but just ask for studies over and over. Its not really cute when people do it in other topics either, especially when they don't read/understand/comment on whats brought up. Common sense is common sense, and good luck in finding your 1+1=2 study, I'm not sure its a mystery that needs exploring to find whether going back to eating at a surplus will = gain a second time. You WILL gain weight if you go back to that surplus that you previously proved you gain on. That's why a "lifestyle change" needs to be initiated for the rest of your life, or you will still have your habit of caloric surplus.

OP, I think the issue is with the words. When most here mention lifestyle change, they normally mean .... Can the person continue to do each small change for the rest of their life. I do not think they mean all of the points you made as one thing. Instead some will learn moderation, some will need to log, some will be goal motivated...it is whatever healthy change that a person can commit to for life to better themselves. All preexisting issues would of course need addressed before such a commitment could be honestly taken.

Also people that have always maintained a healthy weight do practice moderation, are in tuned to their bodies and normally have little tolerance of variance in their body composition (meaning they naturally eat less or become more active if their body composition changes any).

This content has been removed.

But what if losing weight causes those disorders? Quoting this again because I read it today in someone's post, and to me it sums up the issue of how difficult it is to maintain a loss and I don't think the words 'lifestyle change' address it at all:

"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."

http://www.nytimes.com/2007/05/08/health/08fat.html?pagewanted=all&_r=1&

The whole article is really worth a read.

The article was interesting, but locking people away and allowing no food...well here " The only food permitted was a liquid formula providing 600 calories a day" is far different than an individual making conscious decisions and changes over an extended period of time. This article makes a point to say these people were acting starved, hiding food and binging. First they were by definition starved and secondly the article has no mention of how they got fat, they may have always binged when felt deprived.

If weight loss was the cause of those disorders (not saying in some situations weight loss may not trigger new disorders to the individual) than did the obese individual magically create and store energy from nothing, or did they eat too much for whatever reason or issue and instead of taking steps to correct it, they developed more issues related to obesity as they grew in size?

The latter seems much more plausible. I would be interested if there is a correlation to the degree of obesity (or overweight), length of time spent over weight and longterm maintenance.

Over all I do not think the OPs question is answerable and any study found would be irrelevant because they are either doing insane studies, like that article or they are lumping all overweight people together regardless of mental health, prior history, hereditary and environment and counting a crash dieter the same as a longterm calorie restriction plan.

The studies mentioned were from the 1920's and 1950's

Your reply was a which came first the chicken or the egg type question, but the truth is many things cause excess weight, then excess weight causes many more issues. Dieting and failure may exuberate the issues but they still came with and during the weight gain.

The article also discusses set point, not sure of my opinion but since prior to the 19th century obesity was rare and I highly doubt the human population evolved to hold onto food in a more efficient manner at a point in history when food has never been more available and do this in a couple hundred years as opposed to 1000's for normal evolutionary patterns to appear. This theory seems far fetched. I am not saying some people are not just naturally bigger, but over a hundred pounds over weight is not just genes. To be that much larger there were contributing factors.

Not true. Many of the studies of maintenance done institute programs with extensive behavioral change components who are then followed after the program ends. These programs do teach behavioral changes along the lines of lifestyle changes that are discussed every day on here. And yet people don't maintain significant weight loss. The science is better than most of you seem to give credit for. I'm talking trials, not observational studies of the National Weight Control Registry.

QFT

By definition, if you give up the 'lifestyle change' at some point after you hit goal, then it wasn't a 'lifestyle change' and you'll gain the weight back.

So then, by definition, maintaining the lifestyle change that got you to goal, will allow you to maintain indefinitely.

It's not rocket surgery.

I bet surgeons for rockets make heaps of money.

I think OP was not challenging the idea that a "lifestyle change" won't maintain weight. Any way of eating that helps someone get to goal will work for maintenance. I think she is more asking, "Where is the evidence that eating in moderation, including treats on a semi-regular basis, and calorie counting results in more long-term success than following other diet methods?"

I don't believe she is questioning whether or not people who can stick to that plan do well. I believe she is asking if there's any proof that more people can stick to that plan. Of course calorie counting works. But many people don't comply with it. What makes it a lifestyle change any more than choosing to follow a true Paleo diet? Both groups have people who stick with it and those who don't.

The question isn't how do people gain weight back, we know how. We lose the weight, then eat like pigs again. The question is: Why do so many of us do that, given how horrible being overweight is and how hard we worked to not be anymore?

When that gets solved, then this issue can be laid to rest. For certain the simple, ill-defined phrase 'lifestyle change' isn't offering up any solutions.

It means you keep working out and eating right even after you hit your goal. You set new fitness related goals (doesn't have to just be losing weight). Mabye your goal is lose 30 lbs. Then once you get there, you maintain it and you set some other goal your interested in - maybe run a 5k, 10k, whatever. You keep working out and doing fitness related activities. You don't start eating junk because you lost your 30 lbs. You eat a maintainance amount of calories. If weight starts to creep up, you lower cals again. Rinse and repeat for life. Best thing to do is keep setting goals and enter into fitness related events so you have something to train for. Example: I'm training for a powerlifting meet and three mud obstacle races this summer. In the fall I'll be training for some other events. That's why it's a lifestyle, always have a goal to train (and eat) for.

If it was that simple everyone with even a moderate amount of nutrition information would never get fat in the first place, much less have trouble keeping weight off.

How do you see that? People who have emotional ties to food for stress and comfort, people that have binging disorders.....these issues can easily overtake the best intentions unless dealt with. Until the why is addressed, the how to fix it will never work. Not addressing the core issues is why people yo-yo and develope an even more harmful perpetuating cycle of self sabotage.

But what if losing weight causes those disorders? Quoting this again because I read it today in someone's post, and to me it sums up the issue of how difficult it is to maintain a loss and I don't think the words 'lifestyle change' address it at all:

"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."

http://www.nytimes.com/2007/05/08/health/08fat.html?pagewanted=all&_r=1&

The whole article is really worth a read.

It's called pulling excuses out of a hat.

You can probably lose weight without "semi-starvation" and extremism. Maybe. Thousands of people are doing it on this place called myfitnesspal.com.

But the loss isn't the issue. No one disputes people can lose weight. How many of us, using this place called MFP will keep off a large portion (say greater than 50%) of the weight we lose long term? That is the rub.

A common personality trait in registry members is their personal vigilance regarding weight loss maintenance. Forty-four percent of registry members weigh themselves daily, while 31% weigh themselves at least once per week. Further investigation of this population reveals that “successful weight loss maintainers continue to act like recently successful weight losers for many years after their weight loss” (Wing and Phelan, 2005).

Based on my own personal experience and common sense (questionable as that is as a source), I suspect this is the key.

The problem is that calling it a "lifestyle change" vs. a diet (although I usually do that too) or losing weight at a particular speed or in a particular way doesn't necessarily equate to these kinds of actions afterwards. For me, I acted like this for some years and then I stopped. The question is what makes people more inclined to do this or not. Given that some huge number of people eventually fail to do this, why is that? Is there anything that could make it more likely that they won't?

Re fad diets vs. calorie counting, I do think that if you understand the logic of how to lose weight and why you lost and what you need to do to maintain (which calorie counting should teach you), that makes it easier. If you use a diet plan that just tells you what to eat, I can't see how that leads to learning how to do maintenance or even understanding how one would maintain in a sustainable way. That said, that person could in theory weigh his or herself and jump back on the fad or preplanned menus for a week or two if a gain of 5 lbs was observed and maintain. And more significantly, the sensible loser must also continue monitoring and watching calories, at least if weight starts creeping up. Seems simple, but lots and lots of times people don't. So the problem is why. Of course, this is essentially the longstanding problem of why humans often struggle with doing what they know they should, even when they know it will make them happier/better off in the long run.

I'm NOT saying it's impossible, but that it's an important question to face.

By definition, if you give up the 'lifestyle change' at some point after you hit goal, then it wasn't a 'lifestyle change' and you'll gain the weight back.

So then, by definition, maintaining the lifestyle change that got you to goal, will allow you to maintain indefinitely.

I'm not trying to be a jerk, but this sounds like no true Scotsman or the "once saved always saved" corollary one gets from some sorts of evangelicals, that if someone backslides after being "born again" one was not truly "born again" in the first place. Or perhaps the assertion that one gets from some fanatical AA members, that if one can stop drinking without the AA method one was not a true alcoholic. (Not trying to start a debate about any of these--they are just parallels that come to mind.)

If someone who in all respects appears to have done a lifestyle change and believes that one has changed his or her lifestyle, what help is it to anyone to claim that those who backslide must not have done a real lifestyle change after all.

Besides, people do change their lifestyles multiple times in their life. Successfully creating a lifestyle change doesn't mean you will maintain it. One theory is that you need to look at what encourages that lifestyle vs. not. The people I know who have maintained such changes (anecdotal--I'd definitely be interested in better information, but don't have them) have external forces that help establish that lifestyle--as with any particular lifestyle. For the most part that relates to social structure. And there are studies that indicate that it's easier to avoid gaining weight if you are surrounded by in shape people with lifestyles that lead to being in shape. This is one reason why I suspect (and see on MFP as well as offline) that people who get into hobbies associated with being in shape seem to do well, comparatively. It helps create a social network, among other things.

This redundancy may in part explain the high degree of failure and weight regain observed following weight loss through lifestyle intervention [20]."

I haven't read through the whole thread because I'm pressed for time - but I do want to later on and contribute a little more. Anyway, this particular quote stood out to me. I don't agree with calorie counting for long term results (NO doubt that it works, just not for me, and I'm not a special snowflake; if anyone is particularly curious I'll delve into this later when I pop back into this thread). However, redundancy doesn't really apply to calorie counting IMO, since you can eat whatever you want within a set parameter of calories. While the calories for some may be incredibly limiting (if they want to eat, say, 1,600 calories for the rest of their life) if they don't engage in exercise they always have that option to gain more of an allowance which they could tap into just on days when they want to eat meals that need more like 2,000 calories to fully enjoy. Be back later! Thanks for this thread.

The question isn't how do people gain weight back, we know how. We lose the weight, then eat like pigs again. The question is: Why do so many of us do that, given how horrible being overweight is and how hard we worked to not be anymore?

When that gets solved, then this issue can be laid to rest. For certain the simple, ill-defined phrase 'lifestyle change' isn't offering up any solutions.

It means you keep working out and eating right even after you hit your goal. You set new fitness related goals (doesn't have to just be losing weight). Mabye your goal is lose 30 lbs. Then once you get there, you maintain it and you set some other goal your interested in - maybe run a 5k, 10k, whatever. You keep working out and doing fitness related activities. You don't start eating junk because you lost your 30 lbs. You eat a maintainance amount of calories. If weight starts to creep up, you lower cals again. Rinse and repeat for life. Best thing to do is keep setting goals and enter into fitness related events so you have something to train for. Example: I'm training for a powerlifting meet and three mud obstacle races this summer. In the fall I'll be training for some other events. That's why it's a lifestyle, always have a goal to train (and eat) for.

If it was that simple everyone with even a moderate amount of nutrition information would never get fat in the first place, much less have trouble keeping weight off.

How do you see that? People who have emotional ties to food for stress and comfort, people that have binging disorders.....these issues can easily overtake the best intentions unless dealt with. Until the why is addressed, the how to fix it will never work. Not addressing the core issues is why people yo-yo and develope an even more harmful perpetuating cycle of self sabotage.

But what if losing weight causes those disorders? Quoting this again because I read it today in someone's post, and to me it sums up the issue of how difficult it is to maintain a loss and I don't think the words 'lifestyle change' address it at all:

"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."

http://www.nytimes.com/2007/05/08/health/08fat.html?pagewanted=all&_r=1&

The whole article is really worth a read.

It's called pulling excuses out of a hat.

You can probably lose weight without "semi-starvation" and extremism. Maybe. Thousands of people are doing it on this place called myfitnesspal.com.

But the loss isn't the issue. No one disputes people can lose weight. How many of us, using this place called MFP will keep off a large portion (say greater than 50%) of the weight we lose long term? That is the rub.

I'm at over 665 days - look at my ticker that's over 50% lost and maintained. Lots of people here are at 50% or greater loss and over several years.
Other than that - talking about how it won't work, how it is semi-starvation, etc. IS excuses if you use it as a way of giving up or creating a negative mind set. You may be setting yourself up for failure by saying it can't be done.

Lifestyle changes work - be more active, eat better, exercise ...
The proof is all around you. I could point out dozens of people here that have lost 50lbs or more and kept them off for years!

BTW - a proven benefit of increased exercise is reduced heart attacks. Oooodles of studies on that.

I think we tend to think of the benefits of lifestyle changes on only weight, when there are significant benefits to lifestyle alteration on many other things. Diabetes prevention, coronary heart disease risk, just about every chronic health condition, you name it, dietary change and increased activity benefit them. Absolutely. Plenty of studies show that. I don't dispute that. I think those benefits get lost in the quest for weight loss as the sole goal.

By definition, if you give up the 'lifestyle change' at some point after you hit goal, then it wasn't a 'lifestyle change' and you'll gain the weight back.

So then, by definition, maintaining the lifestyle change that got you to goal, will allow you to maintain indefinitely.

I'm not trying to be a jerk, but this sounds like no true Scotsman or the "once saved always saved" corollary one gets from some sorts of evangelicals, that if someone backslides after being "born again" one was not truly "born again" in the first place. Or perhaps the assertion that one gets from some fanatical AA members, that if one can stop drinking without the AA method one was not a true alcoholic. (Not trying to start a debate about any of these--they are just parallels that come to mind.)

If someone who in all respects appears to have done a lifestyle change and believes that one has changed his or her lifestyle, what help is it to anyone to claim that those who backslide must not have done a real lifestyle change after all.

Besides, people do change their lifestyles multiple times in their life. Successfully creating a lifestyle change doesn't mean you will maintain it. One theory is that you need to look at what encourages that lifestyle vs. not. The people I know who have maintained such changes (anecdotal--I'd definitely be interested in better information, but don't have them) have external forces that help establish that lifestyle--as with any particular lifestyle. For the most part that relates to social structure. And there are studies that indicate that it's easier to avoid gaining weight if you are surrounded by in shape people with lifestyles that lead to being in shape. This is one reason why I suspect (and see on MFP as well as offline) that people who get into hobbies associated with being in shape seem to do well, comparatively. It helps create a social network, among other things.

Agree on the "True Scotman" analogy.

I still think that a large part of this discussion is how the OP and others interpret "lifestyle change". The large study mentions a set of common factors in successful cases: increase in physical activity, constant monitoring of weight, and dietary tracking.

I am engineer (with some studies in physiology), and for me the issues are simple (not easy): you can't manage what you don't measure. So simply measuring your energy intake and expenditure (independent variables) and weight (i.e. response, dependent variable) seem to be common in long-term weight management success. I would call that a lifestyle change: incorporating these monitoring activities as part of your plan for the rest of your life. But it seems some opinions don't think this is a lifestyle change. As with many opinion-based discussions, we're reduced to arguing over definitions and semantics.

The amount of hypocrisy in this thread astounds me. When someone makes claims about detoxes or paleo diets (which I also think are ridiculous), everyone is asking for scientific studies. But someone asks for a study about a common claim on this board and everyone is saying "oh, its common sense, you don't need a study" or "how else would you do it". OP is not saying that maintenance can be done without a lifestyle change, he's just asking for the scientific backing for the claim that is so often spouted here.

By the way, see the articles below (all from PubMed). These are from a link posted earlier in the thread by the way: http://www.nwcr.ws/Research/published research.htm


Int J Obes Relat Metab Disord. 1998 Jun;22(6):572-7.
Long-term maintenance of weight loss: do people who lose weight through various weight loss methods use different behaviors to maintain their weight?
McGuire MT1, Wing RR, Klem ML, Seagle HM, Hill JO.

Abstract
OBJECTIVE:
To evaluate whether individuals who lost weight on their own (n = 447), through organized programs (n = 313) or with liquid formula (n = 133) would differ in the strategies they used to maintain their weight losses.
DESIGN:
All subjects were members of the National Weight Control Registry, had lost > or = 13.6 kg (30 pounds), and kept it off at least one year (mean weight loss = 30.1+/-14.9 kg and mean duration of maintenance = 5.7+/-6.9 y).
RESULTS:
Liquid Formula users differed from the other two groups on many characteristics; they were more likely to be women, older, heavier, and to have had a medical disorder prior to weight loss. To maintain their weight loss, the Liquid Formula group reported greater use of dietary strategies (for example, counting calories, limiting the amount of calories from fat) and higher dietary restraint. Liquid Formula users reported that weight maintenance was more difficult than losing weight, whereas individuals who lost weight on their own reported the reverse. The On Own group reported expending a higher percentage of calories through strenuous activities such as running and weight lifting, and reported weighing themselves more frequently to maintain weight loss. Despite these behavioral differences, all three groups are maintaining their weight losses similarly by eating a low calorie diet (5792.3 kJ/d and 25% of daily calories from fat) and engaging in high levels of physical activity (11847.3 kJ/week).
CONCLUSIONS:
Despite using different methods to lose weight, individuals who lost weight on their own, through an organized program, or with a liquid formula, use similar behavioral strategies to maintain their weight loss.




Obes Res. 1999 Jul;7(4):334-41.
Behavioral strategies of individuals who have maintained long-term weight losses.
McGuire MT1, Wing RR, Klem ML, Hill JO.

Abstract
OBJECTIVE:
The purpose of the present study was to compare the behaviors of individuals who have achieved long-term weight loss maintenance with those of regainers and weight-stable controls.
RESEARCH METHODS AND PROCEDURES:
Subjects for the present study were participants in a random-digit dial telephone survey that used a representative sample of the U.S. adult population. Eating, exercise, self-weighing, and dietary restraint characteristics were compared among weight-loss maintainers: individuals who had intentionally lost > or =10% of their weight and maintained it for > or = 1 year (n = 69), weight-loss regainers: individuals who intentionally lost > or = 10% of their weight but had not maintained it (n = 56), and weight-stable controls: individuals who had never lost > or = 10% of their maximum weight and had maintained their current weight (+/-10 pounds) within the past 5 years (n = 113).
RESULTS:
Weight-loss maintainers had lost an average of 37 pounds and maintained it for over 7 years. These individuals reported that they currently used more behavioral strategies to control dietary fat intake, have higher levels of physical activity (especially strenuous activity), and greater frequency of self-weighing than either the weight-loss regainers or weight-stable controls. Maintainers and regainers did not differ in reported levels of dietary restraint, but both had higher levels of restraint than the weight-stable controls.
DISCUSSION:
These results suggest that weight-loss maintainers use more behavioral strategies to control their weight than either regainers or weight-stable controls. It would thus appear that long-term weight maintenance requires ongoing adherence to a low-fat diet and an exercise regimen in addition to continued attention to body weight.





Annu Rev Nutr. 2001;21:323-41.
Successful weight loss maintenance.
Wing RR1, Hill JO.

Abstract
Obesity is now recognized as a serious chronic disease, but there is pessimism about how successful treatment can be. A general perception is that almost no one succeeds in long-term maintenance of weight loss. To define long-term weight loss success, we need an accepted definition. We propose defining successful long-term weight loss maintenance as intentionally losing at least 10% of initial body weight and keeping it off for at least 1 year. According to this definition, the picture is much more optimistic, with perhaps greater than 20% of overweight/obese persons able to achieve success. We found that in the National Weight Control Registry, successful long-term weight loss maintainers (average weight loss of 30 kg for an average of 5.5 years) share common behavioral strategies, including eating a diet low in fat, frequent self-monitoring of body weight and food intake, and high levels of regular physical activity. Weight loss maintenance may get easier over time. Once these successful maintainers have maintained a weight loss for 2-5 years, the chances of longer-term success greatly increase.