Tough love: Cult or ER forum?

[haha]

Hello Martha!

Ha

 

[Moemg]

Hi Martha ! We miss you a lot !

 

[HFWR]

I don't know if I buy this. Like it or not, Weight Watchers and similar programs lousy track records. Really stinking lousy. Weight loss and weight loss maintenance is difficult and the odds are seriously stacked against you. For me, tough love would never work. I'd slap my tough lover across the face and walk out of the relationship.

From Jeffrey Friedman, the scientist who was a discoverer of Leptin, a hormone important in appetite:

“Twin studies, adoption studies, and studies of familial aggregation confirm a major contribution of genes to the development of obesity. Indeed, the heritability of obesity is equivalent to that of height and exceeds that of many disorders for which a genetic basis is generally accepted. It is worth noting that height has also increased significantly in Western countries in the 20th Century.”

“Feeding is a complex motivational behavior, meaning that many factors influence the likelihood that the behavior will be initiated. These factors include the unconscious urge to eat that is regulated by leptin and other hormones, the conscious desire to eat less (or more), sensory factors such as smell or taste, emotional state, and others. The greater the weight loss, the greater the hunger and, sooner or later for most dieters, a primal hunger trumps the conscious desire to be thin.”

“Obesity is not a personal failing. In trying to lose weight, the obese are fighting a difficult battle. It is a battle against biology, a battle that only the intrepid take on and one in which only a few prevail.” A war on obesity, not the obese. [Science. 2003] – PubMed – NCBI.

Now, it is time for me to sign off and pull out my bicycle. Once a person loses weight their crappy odds improve if they are exercisers. Over the past year I lost my excess weight, I live with hungry, and I bike and bike and bike. If I keep my weight off for a couple of years my odds will improve. Maybe forever I will need to follow Uncle Mick's advice and live agile, mobile and hostile.

Another misconception, as I see it, is that aerobic exercise is helpful with weight control. Granted, there are hormonal/chemical changes that result, but "burning off" calories is somewhat self-defeating, since exercising will likely make you want to eat more...

Doesn't at all mean to stop, but I think resistance/weight training is also necessary, for more of the same hormonal/chemical reasons, and to slow the gradual loss of muscle as we age.

Changing the composition of the diet has varying success, but it's relatively easy to improve on the SAD. With individual differences, improving the diet is as important as the exact macro ratios of carb/fat/protein. Fewer industrial oils, less omega-6, fewer refined carbs...

I'm intrigued by the satiety hypothesis, but not convinced it's the major factor.

 

[grasshopper]

Not one to have a scale, I had my annual and lost 2 lbs. I would have guessed I gained 10 lbs.

 

[Martha]

[/I]

The problem I see with that is that if the obesity is just genetic, it can't have increased so much in just a few generations. It usually takes thousands of generations to see a genetic shift, yet we've seen a dramatic increase in obesity just 30 years or so.

However, I agree with you that obesity is largely out of your control if you eat the standard American diet (especially a diet low in fat and high in grains).

The way I see it is this: Yes, it's genetic, but the genes are no different than they were 30 years ago. It's a genetic problem with the metabolism of carbs, and what's changed is the advice to eat more of them.

Read Friedman. There are some indications there has been a change in our genetics, much like height. Of course, it isn't all genetics. And if there is any area of research that is filled with controversy it is research on weight. Hormones are important. There is some indication that losing weight throws levels of appetite suppression and appetite stimulating hormones way out of whack and they may stay that way indefinitely. How do you battle that? Low carb doesn't deal with that problem. There is some recent evidence that higher protein diets do help suppress appetite but it isn't conclusive and it isn't the entire picture. And all the evidence is still not clear. The only evidence that is clear is that people who lose weight by whatever means are extremely unlikely to keep that weight off. http://janetto.bol.ucla.edu/index_files/Mannetal2007AP.pdf

 

[Martha]

Another misconception, as I see it, is that aerobic exercise is helpful with weight control. Granted, there are hormonal/chemical changes that result, but "burning off" calories is somewhat self-defeating, since exercising will likely make you want to eat more...

Doesn't at all mean to stop, but I think resistance/weight training is also necessary, for more of the same hormonal/chemical reasons, and to slow the gradual loss of muscle as we age.

Changing the composition of the diet has varying success, but it's relatively easy to improve on the SAD. With individual differences, improving the diet is as important as the exact macro ratios of carb/fat/protein. Fewer industrial oils, less omega-6, fewer refined carbs...

I'm intrigued by the satiety hypothesis, but not convinced it's the major factor.

Aerobic exercise doesn't do much for losing weight (as you say, exercise makes you hungry) but people who keep the weight off almost invariably are exercisers. This includes both aerobic and resistance/weight training. I am doing both.

 

[Nords]

The only evidence that is clear is that people who lose weight by whatever means are extremely unlikely to keep that weight off.

I think "The Biggest Loser" followups have also clearly demonstrated that, although without the benefit of "peer review"...

 

[Katsmeow]

The statistics on long term maintenance of weight loss are abysmal. I think it is clear that long term success for significant weight loss requires great commitment. I emphasis "significant" weight loss. This morning I weighed in at WW. Most of the receptionists I've seen there typically have a pin that says they lost somewhere between 10 and 25 pounds. It is rare to see one who has lost a great deal and maintained it. Yes, they exist but just not common.

From everything I understand, maintaining weight loss is very, very difficult if you don't exercise regularly. And I don't mean exercise 30 minutes a day 3 times a week. Some of the best data on maintenance is that from those maintainers who have enrolled in the national weight control registry (loss of 30 pounds or more).

90% of them exercise, on average, about 1 hour a day. Everything I have read supports the idea that long term maintenance really does require for most people that kind of exercise all the time.

Also, people who lose weight have been found to have a permanently lower metabolism than someone who is the same weight and never lost weight. So the person who weighs 135 who used to weigh 185 will burn fewer calories doing the same activity as the person who always weighs 135. The research that I've read indicates that this is not a temporary change.

So, the person who loses weight and then thinks that he or she can eat like their always slim friend will often start gaining weight. To fight that the person has to continue to restrict calories and has to engage in significant exercise.

And, research is showing that the body even then fights back. The person who has lost weight may find appetite increases as the body tries to get you to go back to where you were.

So to keep weight off you have to first lose the weight, but then you have to battle increased hunger, and may find that you have to exercise an hour a day and have to continue eating the same calories that you were eating to lose weight (due to slower metabolism). If you aren't really, really committed to it, this can be very difficult.

I do think that genetics plays a huge factor in this as well. Although, it isn't necessarily everything. I wasn't really overweight as a child. As a late teenager I wanted to lose 5 or 10 pounds at time but I was within a healthy weight range. Then, as an adult, I went up, then down, then up, then down. About 20 years ago I became a lifetime member of WW losing from 167 pounds down to 119 pounds. I couldn't maintain it. I ended up gaining it all back, then gained weight while pregnant and have been trying to lose it ever since (my son is 17 now...). At some point, I was sure that I just had bad genetics. I was adopted so I didn't really know but assumed my genetic weight lottery was bad.

But, about 14 years ago after a long search, I found my birthmother. To my total shock I found that she was 5'1" and struggles to keep above 100 pounds and has never had a weight problem. I guess it is possible I have bad genetics on the paternal side (my search was not successful on that side) but she did say that when she knew my birth father he was of normal weight. So, I fortunately (?) don't have genetics to blame....

A great blog that talks a lot about weight loss maintenance is below (it is WW oriented but really has a lot that would apply to anyone losing weight and trying to maintain).

GoingSkiing | My Not So Humble Opinions on All Things Weighty

 

[Martha]

The statistics on long term maintenance of weight loss are abysmal. I think it is clear that long term success for significant weight loss requires great commitment. I emphasis "significant" weight loss. This morning I weighed in at WW. Most of the receptionists I've seen there typically have a pin that says they lost somewhere between 10 and 25 pounds. It is rare to see one who has lost a great deal and maintained it. Yes, they exist but just not common.

From everything I understand, maintaining weight loss is very, very difficult if you don't exercise regularly. And I don't mean exercise 30 minutes a day 3 times a week. Some of the best data on maintenance is that from those maintainers who have enrolled in the national weight control registry (loss of 30 pounds or more).

90% of them exercise, on average, about 1 hour a day. Everything I have read supports the idea that long term maintenance really does require for most people that kind of exercise all the time.

Also, people who lose weight have been found to have a permanently lower metabolism than someone who is the same weight and never lost weight. So the person who weighs 135 who used to weigh 185 will burn fewer calories doing the same activity as the person who always weighs 135. The research that I've read indicates that this is not a temporary change.

So, the person who loses weight and then thinks that he or she can eat like their always slim friend will often start gaining weight. To fight that the person has to continue to restrict calories and has to engage in significant exercise.

And, research is showing that the body even then fights back. The person who has lost weight may find appetite increases as the body tries to get you to go back to where you were.

So to keep weight off you have to first lose the weight, but then you have to battle increased hunger, and may find that you have to exercise an hour a day and have to continue eating the same calories that you were eating to lose weight (due to slower metabolism). If you aren't really, really committed to it, this can be very difficult.

I do think that genetics plays a huge factor in this as well. Although, it isn't necessarily everything. I wasn't really overweight as a child. As a late teenager I wanted to lose 5 or 10 pounds at time but I was within a healthy weight range. Then, as an adult, I went up, then down, then up, then down. About 20 years ago I became a lifetime member of WW losing from 167 pounds down to 119 pounds. I couldn't maintain it. I ended up gaining it all back, then gained weight while pregnant and have been trying to lose it ever since (my son is 17 now...). At some point, I was sure that I just had bad genetics. I was adopted so I didn't really know but assumed my genetic weight lottery was bad.

But, about 14 years ago after a long search, I found my birthmother. To my total shock I found that she was 5'1" and struggles to keep above 100 pounds and has never had a weight problem. I guess it is possible I have bad genetics on the paternal side (my search was not successful on that side) but she did say that when she knew my birth father he was of normal weight. So, I fortunately (?) don't have genetics to blame....

A great blog that talks a lot about weight loss maintenance is below (it is WW oriented but really has a lot that would apply to anyone losing weight and trying to maintain).

GoingSkiing | My Not So Humble Opinions on All Things Weighty

Everything you say squares with what I have read, except your statement that you personally don't have genetics to blame. You may. Just because your parents were not heavy doesn't mean that your genetics didn't participate in programming you to be overweight.

 

[73ss454]

Good to hear from you Martha!

 

[Alan]

Good to hear from you Martha!

+1

Kats,

That was a great post that I can personally relate to. Up until age 40 I ate an enormous amount and my weight was always constant at ~175lb. I had a series of injuries during my 30's, and at 40 I had stopped all my physical activities - soccer referee, soccer player, tennis. Over the next 7 years I put on 35lb before finally deciding I need to get back to a healthy weight. I lost 40lb between age 47 and 48 and have pretty well manged to maintain a weight range 172 - 180 over the last 7 years.

However, I now exercise a lot more than I ever did, but also consume far fewer calories than I ever did. It is now a constant effort to stay at my historical weight of ~175lbs.

 

[HFWR]

Heredity is a definite factor, as "heavy" parents often have heavy kids (casual, not scientific, observation), though diet likely plays a role, since if the family's diet is causing overweight parents, it's likely to not be so good for the children either. Also, if the parents aren't very active, this may be emulated by the offspring...

The activity levels of modern humans, as well as the relative abundance of "highly-rewarding foodstuffs", seems like an equation for population weight gain. Studies seem to suggest that exercise does not fully compensate for being tethered to a chair/computer/cube all day.

One more reason to FIRE!

 

[freebird5825]

This sounds like one of Freebird's softball setups.

Who...meeeeeeee ?

Hi Martha Good to hear from you.

 

[unclemick]

Who...meeeeeeee ?

Hi Martha Good to hear from you.

Ditto. Hi Martha.

Anyone catch the PBS tv program a few years back showing the Pima Indians in Mexico living perhaps 'old style' and visiting their American relatives in the US. Emphasis being on the remarkable difference in weight. Mickey D diet in the USA was not mentioned favorably.



heh heh heh -

 

[deserat]

Right - I get color graphs (Berkeley Heart Lab) showing molecule size distribution and other tests only a few of which I understand their explanation.

Back in 2009, 6' 0" 195 lbs, 38 inch waist, 400 total chloesterol my Doc understood having lived in Metaire for a while. My New Orleans diet(think fried everything) went out the window.

33 waist, 168 lbs and I would die for chili cheese fries and a Seafood platter.

Whaaa!

heh heh heh - I do sneak in some KC style pulled pork -light on the BBQ sauce once in a while.

When I worked with cardiologists, I would go the the different cardiology conferences and inevitably they were in New Orleans at one time or another - one cardiologist mentioned that their hyperlipidemia jumped 100 points when they went to the conference for that week ;-)

 

[unclemick]

New Orleans BBQ'd shrimp. The main indegredients of the sauce - butter and beer.

heh heh - oven baked. Yep butter and beer. One of my old favorites. Pascal Manales of course. .

P.S. Two yellows on my cholesterol. Outta the red zone but my LDL and HDL could stand further improvement. Still hungry.