Some of the reasons that people want a quick fix:
- Media/social pressure to have that ‘perfect’ body
- look like your skinnier/leaner/more muscly friend
- instagratification: ‘fast results and get back to normal’
- minimum time and effort/maximum results
- the more extreme diet, the better it is
- lose a couple of kgs (lbs) a month is not as sexy as losing 15lbs in a month
But why do people that go on diets, most of time regain the weight they lost ?
Kevin Hall, a scientist at a federal research centre had the idea to follow the “Biggest Loser” contestants for six years after that victorious night. The project was the first to measure what happened to people over as long as six years after they had lost large amounts of weight with intensive dieting and exercise.
The results, the researchers said, were stunning. They showed just how hard the body fights back against weight loss.
“It is frightening and amazing,” said Dr. Hall, an expert on metabolism at the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health. “I am just blown away.”
It has to do with resting metabolism, which determines how many calories a person burns when at rest. When the show began, the contestants, though hugely overweight, had normal metabolisms for their size, meaning they were burning a normal number of calories for people of their weight. When it ended, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes.
Researchers knew that just about anyone who deliberately loses weight — even if they start at a normal weight or even underweight — will have a slower metabolism when the diet ends. So they were not surprised to see that “The Biggest Loser” contestants had slow metabolisms when the show ended.
What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight.
Yes, these are extreme cases, as not only were the contestants burning fat but they getting rid of muscle as well (“biggest loser” = body mass).
However, most people who have tried to lose weight know how hard it is to keep the weight off, but many blame themselves when the pounds come back. But what obesity research has consistently shown is that dieters are at the mercy of their own bodies, which muster hormones and an altered metabolic rate to pull them back to their old weights, whether that is hundreds of pounds more or that extra 10 or 15 that many people are trying to keep off.
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.”
Brain Sets the Calories
Dr. Lee Kaplan, an obesity researcher at Harvard, says the brain sets the number of calories we consume, and it can be easy for people to miss that how much they eat matters less than the fact that their bodies want to hold on to more of those calories.
Dr. Michael Rosenbaum, an obesity researcher at Columbia University who has collaborated with Dr. Hall in previous studies, said the body’s systems for regulating how many calories are consumed and how many are burned are tightly coupled when people are not strenuously trying to lose weight or to maintain a significant weight loss. Still, pounds can insidiously creep on.
“We eat about 900,000 to a million calories a year, and burn them all except those annoying 3,000 to 5,000 calories that result in an average annual weight gain of about one to two pounds,” he said. “These very small differences between intake and output average out to only about 10 to 20 calories per day — less than one Starburst candy — but the cumulative consequences over time can be devastating.”
“It is not clear whether this small imbalance and the resultant weight gain that most of us experience as we age are the consequences of changes in lifestyle, the environment or just the biology of aging,” Dr. Rosenbaum added.
The effects of small imbalances between calories eaten and calories burned are more pronounced when people deliberately lose weight, Dr. Hall said. Yes, there are signals to regain weight, but he wondered how many extra calories people were driven to eat. He found a way to figure that out.
He analyzed data from a clinical trial in which people took a diabetes drug, canagliflozin, that makes them spill 360 calories a day into their urine, or took a placebo. The drug has no known effect on the brain, and the person does not realize those calories are being spilled. Those taking the drug gradually lost weight. But for every five pounds they lost, they were, without realizing it, eating an additional 200 calories a day.
Those extra calories, Dr. Hall said, were a bigger driver of weight regained than the slowing of the metabolism. And, he added, if people fought the urge to eat those calories, they would be hungry. “Unless they continue to fight it constantly, they will regain the weight,” he said.
All this does not mean that modest weight loss is hopeless, experts say. Individuals respond differently to diet manipulations — low-carbohydrate or low-calorie diets, for example — and to exercise and weight-loss drugs, among other interventions.
But Dr. Ludwig said that simply cutting calories was not the answer.
“There are no doubt exceptional individuals who can ignore primal biological signals and maintain weight loss for the long term by restricting calories,” he said, but he added that “for most people, the combination of incessant hunger and slowing metabolism is a recipe for weight regain — explaining why so few individuals can maintain weight loss for more than a few months.”
Dr. Rosenbaum agreed. “The difficulty in keeping weight off reflects biology, not a pathological lack of willpower affecting two-thirds of the U.S.A.,” he said.
Are you more likely to maintain weight loss if you lose weight slowly?
That is the advice dieters often get, but studies have not found that to be the case. For example, a recent Australian study, funded by the Australian National Health and Medical Research Council and the Sir Edward Dunlop Medical Research Foundation, randomly assigned 204 obese people to subsist on just 450 to 800 calories a day for 12 weeks, or to cut a more modest 400 to 500 calories a day from their diets over 36 weeks. The goal for both groups was a 15 percent weight loss. Three years after the study began, almost everyone had regained the weight they lost, despite counseling on diet and exercise.
There was also no difference in the levels of two hormones, leptin and ghrelin, that drive hunger. The main difference between the groups was that more people in the rapid weight loss group lost at least 12.5 percent of their weight (80 percent, compared with 50 percent in the slow loss group) and fewer dropped out (3 percent, compared with 18 percent).
To maintain weight loss, should you avoid snacks?
Although it seems to make sense that snacks can pack on the pounds, studies that randomly assigned people to snack or not have failed to confirm this, and even observational studies have not found evidence that snacks undermine weight loss.
If you build muscle with exercise, including weight lifting, will you be able to maintain a higher metabolism?
Muscle burns more calories than fat, so it might stand to reason that the more muscle you have the faster you will burn calories. But it turns out that building muscles has almost no effect on resting metabolism, which determines how many calories a person burns when at rest.
The reason is that any muscle you add is small compared with the total amount of skeletal muscle on your body. And most of the time that muscle is at rest (you can’t go around flexing your biceps nonstop). Muscles have a very low metabolic rate at rest.
One researcher calculated that if a man weighing about 175 pounds lifts weights and puts on about 4½ pounds of muscle — a typical amount for men who lift weights for 12 weeks — he will burn an extra 24 calories a day, the amount in a couple of Life Saver candies.
Can you defeat your body’s slowed metabolism after weight loss by doing vigorous cardiovascular exercises?
You can as long as you do not eat more calories to make up for the ones you burned. It sounds simple enough, but “this is not as easy a proposition as it sounds,” says Dr. Michael Rosenbaum, a doctor and obesity researcher at Columbia University.
The brain controls your hunger and your cravings for food, and it is all too easy to accidentally consume more calories than you burned exercising. That is a major reason studies that use exercise alone to help people lose weight have generally failed to find an effect.
Exercise also has an unexpected effect, documented by Dr. Rosenbaum and Dr. Rudolph Leibel at Columbia University. They found that after you lose 10 percent or more of your weight by diet alone, your muscles start using genes that make them more efficient. They burn 20 to 30 percent fewer calories for the same exercise.
So what hope is there for weight maintenance?
Anecdotal reports by people who have succeeded in keeping weight off tend to have a common theme: constant vigilance, keeping close track of weight, controlling what food is eaten and how much (often by weighing and measuring food), exercising often, putting up with hunger and resisting cravings to the best of their ability. Those who maintain a modest weight loss often report less of a struggle than those trying to keep off large amounts of weight.
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