Long-term weight loss considered nearly impossible


#1

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#2

i forgot where i read this, but the biggest problem with fat is supposed to be that fat cells "flatten out" when you lose weight, but the cells themselves dont' go anywhere. when your body stores the fat back up, the cells expand again, making weight gain return quickly. i think its supposed to take at least 5 years for those flattened fat cells to die out. one of the reasons lipo can be more effective.

all that being said, i heard this a long time ago, and i havent' googled it again to make sure its a real thing, so maybe i'm just talking out of my ass. i have kept about 40+ pounds off over the last 10 or so years though, so i'm calling BS on that study


#3

I'm sure this is a simplistic response, but I'm sure they could also do a study showing that it's statistically impossible to become a full-time professional writer. Surely the vast majority of people who attempt it don't succeed, because it takes a combination of consistent very hard work with other unpredictable factors. Yet, Cory, you've accomplished that as well.


#4

This is pretty much what they say, in a clear way, in the excellent book Why Calories Count - and as someone who is very good at losing weight and will stay the course for years at a time but nevertheless my weight has edged up over the years, my experience is consistent with what they are saying - that each round of weight loss leads to this inevitable rebound of weight gain.

It's not what I want to happen, but even if I have been diligent for a long time there will be some health event that comes along and undoes very quickly what has taken me years to accomplish. The first time it was my pregnancy that undid a very successful diet down to a size 6 that had been in a maintenance phase for two years.

The last round of weight loss, it took my five years to lose about 30 pounds and that was including me going through hospitalizations for asthma where they were shooting me up with steroids four times a day - so I was gaining weight like crazy and then having to re-lose that weight again. But damnit, I was finally looking trim and great, had my exercise routine worked out - my egg and oatmeal for breakfast, etc. Then, boom, I got sick and stayed sick and was put on steroids for months and my weight eventually went higher than it ever was before the five year diet.

And right now I'm scared to start again because I'm not very eager to end up even fatter after another round.


#5

There seem to be two major causes for weight gain (or lack of loss when overweight), which complicate studies. On the one hand there are clearly physiological factors, like the increased number of fat cells after a period of weight gain, or the way in which certain foods stimulate hunger or weight gain. But on the other there are the psychological reasons for weight gain, which are complicated and hard to pick out when trying to study physiological causes. For example, one can detect genetic predisposition towards obesity, but is that because the person's metabolism tends towards obesity or because their temperament tends towards eating more (or eating particularly fattening, yet satisfying, foods)? Or both?

Given that humans have been around for hundreds of thousands of years, and all evidence suggests that obesity is statistically a very very modern problem, it seems reasonable to conclude that there is something about modern society that makes it a particular problem -- not just that a proportion of people are wired that way. (And, yes, in the past fewer people had access to vast amounts of calories -- true -- but among those who did, there does not appear to have been anything like the amount of obesity we now see.) My personal hunch is that it's tied to the extraordinarily sedentary lives that we live, but what do I know?

People can lose weight by asking particular changes to their lives, for sure. The problem (and this is what the article is getting at) is that it is often unrealistic to expect individuals to live the rest of their lives making that effort. It would be good to have a better idea, however about what changes make the most difference so people could focus on those particular life changes. It would also be good to have a more sustained public heath campaign to prevent children from gaining too much weight, since all the evidence I have seen suggests that overweight children will have much more trouble maintaining a healthy weight as adults.


#6

I celebrated this news with a latke for breakfast. Cincinnati is definitely not a place where disintubination is easy.

http://izzys.com/menu.php


#7

What a bizarre report. I've maintained a 50lb weight loss since 2004 and I know many people who have maintained 100+lb weight loss for as long and longer. I'm not saying it's easy but to suggest it's all but impossible is just wrong. I and most the other the people I know have done it through Overeaters Anonymous. It's not the only way to do this, just what has worked for me.


#8

I read the same thing a long time ago, but in the context of why Kenny Rogers' breasts grew after he had lipo: the fat cells around his stomach had been completely removed, so the when he put on weight the fat had to find somewhere else to be stored. Thanks for the science, celebrity magazine!


#9

Granting their figure of only a 5% long-term success rate, that's still far from what I would call "nearly impossible." More like "really difficult." Doesn't make as good a headline, though, I suppose.


#10

I suppose it depends what you mean by long-term. I expect within 100 years I'll weigh a lot less.


#11

Right. And if they're working from 20 years of data, then they only have data for people who are getting fed too much sugar in their diet, and probably not enough fat. Dietary science has changed a hell of a lot in the last few years.

I recently dropped 8kg. When I set out, I clearly focused on making changes to diet and behavior that I could stick to permanently. I cut sugar drastically, increased fat intake back towards 100% RDA, and started making sure I hit 5,000+ steps on Fitbit at least 6x a week -- a very modest amount of exercise. But it was enough. I'm now at the "maintaining ideal weight" stage, and this week I experimented with not counting calories and found myself drifting too low in weight and had to make myself eat more than I felt like in order to compensate.

I suspect that the study results are explained by the following:

  • Most people are far too sedentary, ridiculously so.
  • Most people start unrealistic diet and exercise regimes they won't be able to sustain permanently, and then get discouraged and stop them completely.
  • Almost every food in the supermarket has too much sugar in and not enough fat. The shopping has been the single most difficult part of my health kick.
  • Many people don't do anything about the problem until it's really severe. At that point, your body has made permanent changes to composition and metabolism. That's why I went all out when I was only 10% overweight.

Maybe I'm wrong and I'll get fat next spring. Or maybe I'm one of the 5%. We'll see.


#12

It's irresponsible scare reporting to use the word "impossible." There's a dozen other ways they could have reported on the study that would have generated less bias, but it would have generated fewer clicks and well we can't have that!

The last thing the world needs is people being being given the idea that there's no point in trying.


#13

I've been fighting obesity and diabetes for 15+ years. A strenuous effort which takes a psychological toll, to count calories and to exercise for several hours every week, over the course of a year, helped me lose about 20 pounds and then plateau while still being obese. I couldn't crank up the intensity of either the dieting or the exercise; it was just not realistic.

A few months of Irregular exercise and a healthy but not obsessive diet, and I gained the weight back.

Obviously I don't want to weigh as much as I do, but I prefer sanity over depression. I try to be as healthy as I can and not focus on weight so much. It doesn't really help that almost every diabetes medication, including insulin itself, makes weight loss more difficult.


#14

Oh thanks, now I have the thought of Kenny Roger's man boobs stuck in my head. Now I have to go read The Necrinomicon just to blot it out.


#15

Thanks, Cory, for being candid about your own weight-loss experience. I think it's important to talk about how much hard work it can be for some, but with hard work it can pay off.


#16

Over a 10 year period, people get 10 years older and most people's metabolism slows significantly over 10 years


#17

Losing weight is hard. Maintaining the loss is hard too, but not unsustainable. It might be deemed unsustainable in a large meta-analysis simply because a majority of people don't discover a solution that works for them. But that conclusion is purely mathematical and academic. Individual success has nothing to do with large sample statistical data (unless, possibly, if you are highly susceptible to the sucking-vortex of the herd-mentality).

I tried the exercise and (reduced calorie) diet route for years (the herd!). I was in great shape, riding 1000 miles a month, but always carried about 20 lbs more than I wanted (which sucks when you really enjoy hill climbs on a bike). I finally discovered the (LCHF, NSNG, Paleo, Atkins, Primal, WAP diets). So many different names for essentially what amounts to a whole-foods diet. I lost 30 lbs in about 6 months. Stopped bike commuting (due to birth of daughter) and started walking. It's been 18 month now. Weight is still off. Waist has gone from 38 to 31. Pre-diabetes has reversed. Several other health markers have only improved. Cardiac scan show zero signs of heart disease (at age 47). Oh, and cholesterol...forget about it. I've always had normal total cholesterol levels, but it's also always been pattern-b ("too many" small LDL particles). And as we all "know" pattern-b will "give" you heart disease. Well, the scientific jury is still out on this one (although the press jury, and government-jury have reached their decisions). So I have pattern-b cholesterol, but no other indicators or risk factors for heart disease. Cholesterol doesn't matter, at least for me.

The diet has morphed into a lifestyle now (i.e. I don't have to "work" at it any longer, its just there). I don't count calories. I feel better than I have in years.

NSNG is the best term I've stumbled across that describes the diet. No (added) Sugar, No Grains. Everything else is game. Meats, yes! Eggs, lots! Cheese, you bet! Nuts, love 'em. Minimal, but some, non-sugary fruits. Lots of veg. I hate the term "Everything in moderation", but there are exceptions, like sushi rice (which (may) have it's own benefits. Google "resistant starch").

We'll see where this goes in 5 to 10 years. I've seen what the SAD can do to a susceptible person. My mother, who's became diabetic (strong family history) in 1985 has no kidney function (dialysis 5 days a week), and no left leg, no strength, no mobility, and a host of other medical condition. I'm not going down that road if I can help it...meta-analyses be damned. Seeing that can be very motivating.

The thing to keep in mind is that by the time a scientific study makes it out of the science community and into the press and blogosphere it has been massaged (and perverted) so much as to be almost meaningless.

A great book on the subject of interpreting health related studies and data: Death By Food Pyramid This is not a diet book, it is a history book. Well worth a read.


#20

In my view it's pretty worthless to list random foods people shouldn't eat unless you tell them why they shouldn't eat them.


#21

Relax, they'll solve this problem eventually, everyone will get skinny and then being fat will be fashionable again. I don't go in for trends.


#22

If you're talking about the 'No Sugar No Grains' above I can recommend Why we Get Fat by Gary Taubes as an excellent light-reading primer on 'why'.

Or, if you're interested enough to stomach the giant, heavily researched and footnote-heavy version of the same thing, 'Good Calories Bad Calories' is definitely worth the read. Also the best explanation I've read on how exactly bad science, good intentions and commercial interests combined into the perfect storm of worse-than-useless status quo policies regarding weight gain.


"Nutrition Heretic" Gary Taubes writes about his shaming and "relative" vindication
10,000 hours to become an expert? Sorry, that number is off