Obesity Journal study: It's not just CICO

1356715

Replies

  • amusedmonkey
    amusedmonkey Posts: 10,330 Member
    Yes, I remember reading something similar about Biggest Loser contestants a couple of years ago. Wonder how a more reasonable deficit fairs in this regard. I know higher deficits are possibly less "efficient" than a moderate deficits, indicating a greater slowdown in metabolism. It was a small sample size relatively short study though.

    http://ajcn.nutrition.org/content/57/2/127.short

    This says nothing about CICO not working, as people would still have to be in a calorie equilibrium to maintain weight, even if the number was pushed lower.

    I'm definitely keeping this in mind for maintenance. Recognizing a potential challenge will help me be prepared for whatever is to come and think of strategies to manage it.
  • WendyLaubach
    WendyLaubach Posts: 518 Member
    I'm actually pretty encouraged to see that I can expect a maintenance calorie level to be nearly 1800 a day once I reach my goal weight. That's half again what I eat now, and I don't get hungry now, though as mealtime approaches I'm certainly feeling enthusiastic about the great food I get to eat next. Lunch is in about an hour, and I'm going to enjoy the heck out of it.
  • kimny72
    kimny72 Posts: 16,011 Member
    Gamliela wrote: »
    kimny72 wrote: »
    Gamliela wrote: »
    kimny72 wrote: »
    I also hate that they say in the article that this info is important because so many people regain the weight and blame themselves. Everyone is so quick to find excuses so here's another one, "It's not my fault, I'm doomed to be overweight." It's my metabolism's fault. It's my body's set point. The food industry made me do it. Meanwhile just this one forum is full of people who lost the weight and kept it off by finding what worked for them and taking responsibility for it. :anguished:

    Yeah, if there is any truth to it, even for obese people who lose fast, this study is still a big bummer for everyone then.

    I hope the scientific report comes available, until then I'm going to discount this thing as another fear mongering hype article doing nobody any good.

    But honestly, this is only depressing because people don't understand, not because of what it says! All I see is more proof that The Biggest Loser should be taken off the air. It is unrealistic, shaming, misleading, and does waaaaaay more harm than good to the contestants and the viewers. There is nothing in the article at least that gives any reason to apply these findings to people who lose the weight in a more moderate healthy manner. And it stinks that the article spins it that way.


    Yeah. That's what I meant too, its just another one of 'those articles'.

    and its kinda sad people went through that body punishing thing and now there is this article in the New York Times saying obesity isn't what they thought and low cal diets don't work.

    I wish they would correct that statement. Obviously people lose weight when they eat less caloriea than they burn. Maybe they just mean it isn't viable over the long term for obese people, thats kinda what I got from reading it.

    After I posted my reply, I thought, hmmmm I think we're agreeing :)
    I do feel bad for those people, especially the ones who were on towards the beginning. They assume that they are in the hands of experts so they probably feel like even if it's embarrassing they will lose the weight and be better off. But now that there is a history of the contestants to study, it looks like that's not the case.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited May 2016
    Here's a study showing the effect on sedentary TDEE of different kinds of diets. It shows that a very low calorie approach has a greater effect than a 25% deficit with no exercise (and both do improve over time). The best results in the study are a moderate deficit made up of a combination of exercise and calorie cutting (cutting calories 12.5% from sedentary TDEE, doubling that deficit by adding exercise). These people actually increased their TDEE.

    I'm linking a good blog discussing it, but there's a link to the study: http://www.myfitnesspal.com/blog/heybales?month=201401

    Also, an earlier discussion of a BL study: http://www.weightymatters.ca/2012/04/biggest-loser-destroys-participants.html

    Personally, my TDEE is higher now, since I am much more active, but my numbers also suggest that the calculators work fine for me, and my sedentary TDEE that is predicted seems about right on track with the TDEE I seem to have with the activity I do, so I don't think my BMR has been affected. (I lost 95 lbs.)
  • WendyLaubach
    WendyLaubach Posts: 518 Member
    What I see a lot on this site is an attitude that we have a kind of right to a certain level of "calories in," and that the trick is to look for the explanation why, when we eat that much, we don't lose the weight we'd like to lose. It seems turned on its head to me. No matter what the average Joe's appropriate "calories in" level is, we each have one of our own, and the way to find it is to try it and see whether we lose weight. If not, what difference does it make why not? Society, stress, saboteur loved ones, GMO, whatever. We still need to eat less, is the bottom line, assuming that the goal is to lose weight and not to explain or excuse failure to lose weight.

    Of course, if we can do something to raise our metabolism so that we can raise the "calories in" requirement, great. Only in that sense does it help to worry about "why." Similarly, I'm always interested in mind hacks that make it easier to settle into habits that will decrease CI or increase CO without living a life of settled misery.
  • blues4miles
    blues4miles Posts: 1,481 Member
    kimny72 wrote: »
    Gamliela wrote: »
    kimny72 wrote: »
    Gamliela wrote: »
    kimny72 wrote: »
    I also hate that they say in the article that this info is important because so many people regain the weight and blame themselves. Everyone is so quick to find excuses so here's another one, "It's not my fault, I'm doomed to be overweight." It's my metabolism's fault. It's my body's set point. The food industry made me do it. Meanwhile just this one forum is full of people who lost the weight and kept it off by finding what worked for them and taking responsibility for it. :anguished:

    Yeah, if there is any truth to it, even for obese people who lose fast, this study is still a big bummer for everyone then.

    I hope the scientific report comes available, until then I'm going to discount this thing as another fear mongering hype article doing nobody any good.

    But honestly, this is only depressing because people don't understand, not because of what it says! All I see is more proof that The Biggest Loser should be taken off the air. It is unrealistic, shaming, misleading, and does waaaaaay more harm than good to the contestants and the viewers. There is nothing in the article at least that gives any reason to apply these findings to people who lose the weight in a more moderate healthy manner. And it stinks that the article spins it that way.


    Yeah. That's what I meant too, its just another one of 'those articles'.

    and its kinda sad people went through that body punishing thing and now there is this article in the New York Times saying obesity isn't what they thought and low cal diets don't work.

    I wish they would correct that statement. Obviously people lose weight when they eat less caloriea than they burn. Maybe they just mean it isn't viable over the long term for obese people, thats kinda what I got from reading it.

    After I posted my reply, I thought, hmmmm I think we're agreeing :)
    I do feel bad for those people, especially the ones who were on towards the beginning. They assume that they are in the hands of experts so they probably feel like even if it's embarrassing they will lose the weight and be better off. But now that there is a history of the contestants to study, it looks like that's not the case.

    But most people did keep most of the weight off...I feel like people's expectations are skewed. If someone went from Class II obese to Class I obese that's still an improvement. If someone went from obese to overweight that's an improvement. I couldn't find the original study the article is based on though so I have no idea what they did. The article was sort of misleading as it talks about how much people's metabolisms are depressed in terms of calories, not percent. The first guy who is now 800 calories less...well he weighs ~300 lbs currently, so I'd expect his TDEE to be around 3k if not higher. So 2200 to maintain his weight at a sedentary lifestyle. If he were to eat 2000 and do a little exercise, he'd lose weight. Sure it's not the best thing to have to work from a disadvantage...also wonder if they tried thyroid drugs on any of these folks.

    My n=1 I am almost exactly what the calculators predict for my TDEE. Occasionally I lose a little slower/little faster, but over time it evens out to almost EXACTLY the predicted values. I've read studies that folks on VLCDs will sometimes see their metabolism depressed by 10%. For me that's the difference between 2,000 calories and 1,800 calories. Most saw their metabolism rebound within a few months of eating normal again, some took years. I've never done a VLCD so I don't think I have anything to worry about.
  • jemhh
    jemhh Posts: 14,261 Member
    What I see a lot on this site is an attitude that we have a kind of right to a certain level of "calories in," and that the trick is to look for the explanation why, when we eat that much, we don't lose the weight we'd like to lose. It seems turned on its head to me. No matter what the average Joe's appropriate "calories in" level is, we each have one of our own, and the way to find it is to try it and see whether we lose weight. If not, what difference does it make why not? Society, stress, saboteur loved ones, GMO, whatever. We still need to eat less, is the bottom line, assuming that the goal is to lose weight and not to explain or excuse failure to lose weight.

    Of course, if we can do something to raise our metabolism so that we can raise the "calories in" requirement, great. Only in that sense does it help to worry about "why." Similarly, I'm always interested in mind hacks that make it easier to settle into habits that will decrease CI or increase CO without living a life of settled misery.

    Yes to the bold. All of the calculators (MFP, scooby, IIFYM, etc.) give us estimates based on various mathematical formulas. The chance is low that they are spot on for anybody but it doesn't matter once you've started keeping some data (e.g., good calorie counting) for a few weeks. Start out with the estimate and then move to real life.
  • eeejer
    eeejer Posts: 339 Member
    eeejer wrote: »
    eeejer wrote: »
    if you don't lift weights while losing fat your BMR will go down more than you want. This is just 101 stuff.

    I think you're overstating it a bit there. There are plenty of exercises that can help that don't involve lifting weights. Body weight training, swimming, biking, etc. can all help maintain and build muscle mass to help with BMR. Weight training has the advantage of allowing one to change weight and rep schemes down to a rather fine degree.

    none come close to strength training.

    Weights are not the only way to strength train.

    no, but they are the only worthwhile way for the majority of people. What are you arguing exactly? Not to strength train while cutting? I mean, go for it if you want. It is very obvious this is important to most people.
  • girlviernes
    girlviernes Posts: 2,402 Member
    Well, the failure/success rates seen in this study are similar to those seen in most research for weight loss maintenance, so I am doubtful that the findings are solely due to the extremeness of the diet. My takeaway is that weight loss maintenance doesn't happen by accident. You need to maintain focus and monitor your weight, and jump on and reverse any gains you experience. Most of us will have to be MORE diligent than people who were never overweight. That's challenging. It doesn't necessarily require herculean efforts, but it does require ongoing, consistent willingness to monitor and watch our eating. As others in this thread note, you can figure out how many calories you need by close tracking, as an individual, your individual caloric needs are what matters. I'm curious, anyone here found that it was purely hunger that drove weight regain you experienced? I've been regaining but I don't think increased hunger is the issue, it started when I started going out more socially, eating out and drinking quite a bit more than when I was losing. Then I entered a very stressful period and started stress eating again. Hunger seemed to follow the worse food choices and chaotic eating rather than precede it. I held pretty steady with weight (up and down a bit) while still tracking, but once I stopped tracking is when I started to really regain.
  • WendyLaubach
    WendyLaubach Posts: 518 Member
    If I get to the golden land of Maintenance, I hope I'll have learned some habits that will help me stay on relatively painless autopilot instead of life-long diet mode. One thing I'm sure of is that I'll never be able to eat whatever and whenever I like in unlimited quantities. I doubt very many living human beings can do that, and practically none of them are living in a society where plentiful delicious food can be had for a song, while almost nothing in life requires strenuous sustained physical effort. After reading six months' worth of posts from people here who've been yo-yo-ing for years or who've successfully maintained a significant weight loss for years, the difference I see is that the successful maintainers keep an eye on their habits and their results, and take corrective action after they've gained 3-4 pounds instead of waking up after they've gained back 50.
  • peggymenard
    peggymenard Posts: 246 Member
    [quote= Pain and suffering aren't necessary, commitment and consistent adherence to reasonable changes are.
    I agree with Sunnybeaches...
  • eeejer
    eeejer Posts: 339 Member
    eeejer wrote: »
    eeejer wrote: »
    eeejer wrote: »
    if you don't lift weights while losing fat your BMR will go down more than you want. This is just 101 stuff.

    I think you're overstating it a bit there. There are plenty of exercises that can help that don't involve lifting weights. Body weight training, swimming, biking, etc. can all help maintain and build muscle mass to help with BMR. Weight training has the advantage of allowing one to change weight and rep schemes down to a rather fine degree.

    none come close to strength training.

    Weights are not the only way to strength train.

    no, but they are the only worthwhile way for the majority of people. What are you arguing exactly? Not to strength train while cutting? I mean, go for it if you want. It is very obvious this is important to most people.

    Read my initial response. It was a clarification not an argument. You're confusing strength training and weight lifting even in your last post. And, as for "most people" it still depends on their goals.

    I lift, my wife lifts, I love lifting, but it's not the only or even best way for all people.

    Well, I would argue that it is. Strength training involves weights. It involves progressive loading. It is the best way for the majority of people, even if they do other activities. Strength is applicable in all sports.
  • Azdak
    Azdak Posts: 8,281 Member
    kshama2001 wrote: »
    This only appears to cover crash dieters like those on The Biggest Loser or the 550 calories a day study. I'm curious about what happens to leptin levels when people lose weight gradually. I've been doing so for a year, and am LESS hungry than I was when I started, rather than more.

    I'm only hungry right before meals and have eliminated my afternoon snack.

    http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

    Losing a Key Hormone

    Slower metabolisms were not the only reason the contestants regained weight, though. They constantly battled hunger, cravings and binges. The investigators found at least one reason: plummeting levels of leptin. The contestants started out with normal levels of leptin. By the season’s finale, they had almost no leptin at all, which would have made them ravenous all the time. As their weight returned, their leptin levels drifted up again, but only to about half of what they had been when the season began, the researchers found, thus helping to explain their urges to eat.

    Leptin is just one of a cluster of hormones that control hunger, and although Dr. Hall and his colleagues did not measure the rest of them, another group of researchers, in a different project, did. In a one-year study funded by Australia’s National Health and Medical Research Council, Dr. Joseph Proietto of the University of Melbourne and his colleagues recruited 50 overweight people who agreed to consume just 550 calories a day for eight or nine weeks. They lost an average of nearly 30 pounds, but over the next year, the pounds started coming back.

    Dr. Proietto and his colleagues looked at leptin and four other hormones that satiate people. Levels of most of them fell in their study subjects. They also looked at a hormone that makes people want to eat. Its level rose.

    “What was surprising was what a coordinated effect it is,” Dr. Proietto said. “The body puts multiple mechanisms in place to get you back to your weight. The only way to maintain weight loss is to be hungry all the time. We desperately need agents that will suppress hunger and that are safe with long-term use.”

    There is some suggestion that there is a longer-term effect in more casual dieters as well. I haven't read through this thoroughly in about 5 yrs, but this study had some sobering information for those who need to keep off lost weight.

    Long-term persistence of adaptive thermogenesis in subjects who
    have maintained a reduced body weight
    Am J Clin Nutr 2008;88:906 –12.

    This may be one of the reasons why maintaining a vigorous workout program is essential for permanent weight loss.
  • Mentali
    Mentali Posts: 352 Member
    What I see a lot on this site is an attitude that we have a kind of right to a certain level of "calories in," and that the trick is to look for the explanation why, when we eat that much, we don't lose the weight we'd like to lose. It seems turned on its head to me. No matter what the average Joe's appropriate "calories in" level is, we each have one of our own, and the way to find it is to try it and see whether we lose weight. If not, what difference does it make why not? Society, stress, saboteur loved ones, GMO, whatever. We still need to eat less, is the bottom line, assuming that the goal is to lose weight and not to explain or excuse failure to lose weight.

    Of course, if we can do something to raise our metabolism so that we can raise the "calories in" requirement, great. Only in that sense does it help to worry about "why." Similarly, I'm always interested in mind hacks that make it easier to settle into habits that will decrease CI or increase CO without living a life of settled misery.

    I would say the "why" is important on a societal level as well as a personal level. There's no way of really knowing if the "why" is fixable until it's explored - for example, if we suddenly realized that the recommended diet from the FDA was causing slower metabolisms (not saying we found this out, just hypothetically), we would want to change the recommendations to avoid that. Or if we found out that high amounts of stress reliably lowers your metabolism, each individual person might try to minimize their stress. That's the difference it makes.

    Knowing why something is happening a certain way is always valuable.
  • scolaris
    scolaris Posts: 2,145 Member
    I need to reread.... you're extrapolating too much here I believe. Other legitimate studies show the metabolism heals with time. And VLCDs are for chumps. As are many bands. People don't deal with their real issues & are doomed to fail at maintenance.
  • LPflaum
    LPflaum Posts: 174 Member
    This is a really interesting study. But, as a lot of people have mentioned, the effects aren't necessarily shocking. When you think about the human body as a whole, we've been around for about 200,000 years, agriculture and the domestication of animals happened roughly 189,000 years AFTER we became a species, and large numbers of humans have only had consistent access to plentiful food for about the last 200 years (or 199,800 years after our species evolved). It makes sense to me that our bodies would react like this, for over 190,000 years weight loss = starvation. The biological response to starvation is to hoard as many calories as you can, ie slow the metabolism. Once the starving human has access to food again, it makes sense that the body would want to get back up to the maintenance level. I think what's really interesting is that these people's metabolisms aren't recovering. It's almost as if the body is saying "crap... we're in a situation where we starve now, we don't know when this will end... we should probably keep hoarding in case that happens again." The human body is really a fascinating thing and it's incredible how little we really know about how our metabolism actually works.
  • cavia
    cavia Posts: 457 Member
    New York Times story details that a study of Biggest Loser contestants found they regained much of the weight they lost and ruined their metabolism -- all had metabolisms that burned much less than a person their weight should have been burning.

    So, OK, it is CICO, but if you're overweight and trying to lose weight, it may mean that your calories in is a lot lower than your calculated BMR or TDEE. So the question is, how do we get our BMR really tested....

    http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

    A cautionary tale about eating starvation level calories?

    I set a 500cal/day deficit, lost 45+lbs. Did several bulks and cuts and can diet now on what used to be my maintenance calories.
  • NinaSharp
    NinaSharp Posts: 101 Member
    LPflaum wrote: »
    This is a really interesting study. But, as a lot of people have mentioned, the effects aren't necessarily shocking. When you think about the human body as a whole, we've been around for about 200,000 years, agriculture and the domestication of animals happened roughly 189,000 years AFTER we became a species, and large numbers of humans have only had consistent access to plentiful food for about the last 200 years (or 199,800 years after our species evolved). It makes sense to me that our bodies would react like this, for over 190,000 years weight loss = starvation. The biological response to starvation is to hoard as many calories as you can, ie slow the metabolism. Once the starving human has access to food again, it makes sense that the body would want to get back up to the maintenance level. I think what's really interesting is that these people's metabolisms aren't recovering. It's almost as if the body is saying "crap... we're in a situation where we starve now, we don't know when this will end... we should probably keep hoarding in case that happens again." The human body is really a fascinating thing and it's incredible how little we really know about how our metabolism actually works.

    This. All of this. You said it better than I did.
  • robininfl
    robininfl Posts: 1,137 Member
    I am sure that a healthy body responds differently than one that has been overfed then starved - the Biggest Loser people are big enough at the start that they aren't healthy, then they are starved into losing a bunch of weight as fast as possible - if I were their body I'd react badly, too.

    What I don't think, is that it's a permanent reaction. There is no way that a body wants to be morbidly obese. If one maintains a healthy weight and lifestyle for years, I am sure that the body adjusts because it's more functional like that. It's a living system, it needs time to heal from the overweight and the stress of the big loss.
  • sunnybeaches105
    sunnybeaches105 Posts: 2,831 Member
    LPflaum wrote: »
    This is a really interesting study. But, as a lot of people have mentioned, the effects aren't necessarily shocking. When you think about the human body as a whole, we've been around for about 200,000 years, agriculture and the domestication of animals happened roughly 189,000 years AFTER we became a species, and large numbers of humans have only had consistent access to plentiful food for about the last 200 years (or 199,800 years after our species evolved). It makes sense to me that our bodies would react like this, for over 190,000 years weight loss = starvation. The biological response to starvation is to hoard as many calories as you can, ie slow the metabolism. Once the starving human has access to food again, it makes sense that the body would want to get back up to the maintenance level. I think what's really interesting is that these people's metabolisms aren't recovering. It's almost as if the body is saying "crap... we're in a situation where we starve now, we don't know when this will end... we should probably keep hoarding in case that happens again." The human body is really a fascinating thing and it's incredible how little we really know about how our metabolism actually works.

    Some reading: http://community.myfitnesspal.com/en/discussion/1077746/starvation-mode-adaptive-thermogenesis-and-weight-loss/p1
  • 85Cardinals
    85Cardinals Posts: 733 Member
    BarbieAS wrote: »
    CICO based on internet calculators of TDEE is not accurate for everyone, and can be significantly off for some people. Period. Of course they work for MOST people. They're averages, and those averages have to be based on something. But there are going to be outliers.

    I don't think it's unreasonable to, after an individual has (1) given a reduced calorie intake enough time to have good data and actually see results, (2) ensured that logging is happening accurately - food is weighed, liquids are measured, etc., and (3) received a full medical workup, to suggest that they have their RMR tested.

    Everyone here on MFP is so quick to INSIST that CICO is the answer, is science, and cannot be violated or cheated. And they're 100% right. But what people fail to do is acknowledge that the "CO" side can be the wild card, rather than assuming that the only answer is that they're doing something wrong on the CI side. Some people really might be eating 1300 calories most days and not losing. It's possible.

    I'm a prime example. I successfully lost about 90lbs in college (sensibly, and relatively easily - used Weight Watchers and lost that weight over a little more than full year, about 1.5lbs/week), and then gained it all back while I was pregnant and my kids were babies. I started trying to lose again by joining MFP just shy of 4 years ago, when my second and last child was about 9 months old. I've lost about 25lbs in that entire 4 years. All the info out there - Fitbits, online calculators, HRMs, EVERYTHING - was telling me that based on my stats and activity I should be easily losing 1-2 lbs per week eating about 1,500-1,700 calories per day even before exercise calories (which I did eat some of), but the scale barely budged. Every morsel I consumed was put on a scale first. Doctor's appointments confirmed that I was in near perfect health except for my weight. Finally, last November my doctor got my RMR tested. The result was that my RMR was 25-30% lower than any calculation that existed for my statistics (depending on what it was), which makes a lot more sense when compared to my actual change in weight over time. I even have decent muscle mass for my size, and I do and have always lifted weights, but that hasn't helped. It just turns out that, for whatever unknown reason, instead of burning 2,200 calories on a super sedentary day and 3,000+ on a very good day, my range is more like 1,500-2,000. You can see why I wasn't losing, I'm sure.

    Since then, I've adjusted my intake, since it's clear that I need to stay under 1,300/day to lose even 0.75-1lbs per week, and that one bad day on a weekend could wipe out an entire week's worth of work. I've lost about 4 more lbs. However, if I ever do lose the weight (I'm still 60lbs over my goal weight) it's just going to get worse and worse - I may end up in a situation where 1,300 or less is my maintenance, even at 160lbs and with a moderately active lifestyle.

    I'm not arguing that CICO isn't solid science, or that assuming that you have a crap metabolism should be something that people jump to when things aren't working for them - there are a LOT of steps to take first. But it needs to be recognized that some people really honestly DO burn significantly less than expected.

    very well put

  • LPflaum
    LPflaum Posts: 174 Member
    robininfl wrote: »
    I am sure that a healthy body responds differently than one that has been overfed then starved - the Biggest Loser people are big enough at the start that they aren't healthy, then they are starved into losing a bunch of weight as fast as possible - if I were their body I'd react badly, too.

    What I don't think, is that it's a permanent reaction. There is no way that a body wants to be morbidly obese. If one maintains a healthy weight and lifestyle for years, I am sure that the body adjusts because it's more functional like that. It's a living system, it needs time to heal from the overweight and the stress of the big loss.

    I didn't notice in the article, but did they track the contestant's diet and exercise habits consistently over the 6 years? It would be interesting to factor in any crash dieting or massive calorie reductions and see what that did to overall metabolism. My theory above (based on literally zero science) is that once the body experiences a starvation event equivalent to what these people saw (which, 50,000 years ago, would likely have been an extinction level event), it works overtime to keep that from happening. Maybe you could re-train your body out of it with several years of not throwing it back into starvation mode, but i would think every time you try to create another massive deficit your body reads that as another starvation event and starts trying to hoard.

    Those of us on this planet did not get here by chance. We have 200,000 years worth of ancestors who were better at storing fat and energy than all of the other humans. That's how they survived long enough to reproduce, then they passed those amazing fat storage genetics on to us, and then we invented chick-fil-a.
This discussion has been closed.