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Old 03 May 2016, 12:14 PM
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Default After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight

Kevin Hall, a scientist at a federal research center who admits to a weakness for reality TV, 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.

http://www.nytimes.com/2016/05/02/he...=fb-share&_r=0
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Old 03 May 2016, 02:18 PM
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Interesting. However I have to wonder if a significant part of the effect is from the intensity of the regimen show participants were placed on, both severe calorie restriction and very heavy exercise regimens. Or, from the description of the one guy's diet, severe restriction of food variety. Since my recent 130 pound weight loss, I have not been particularly hungry, nor have I been regaining weight. But then, all along, I was getting plenty of different fruits, seeds, vegetables, lean meats, eggs, and low-fat dairy. I averaged about a half pound a day weight loss at first, and then slowed gradually until I leveled off at my current weight. I do not feel like I have had to restrict my calories beyond what is needed generally for a 220 lb. man generally would. I have the sense that the body reacts more to sharper changes in habits, and this appears from the article to have long term effects. Perhaps the long-standing advice, recently challenged, to make smaller changes to have gradual weight loss has more to it than merely forming new habits, but also serves to prevent the kind of changes in metabolism that sabotage long-term weight goals. (but then, I have only about 9 months experience maintaining at current weight - maybe it will sneak back on).
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Old 03 May 2016, 04:43 PM
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ATNM - I had the same thought when I read that article. I had always read that a person should not lose more than 1-2 pounds per week. The article says Danny Cahill lost 239 pounds in 7 months. That is about 7.8 pounds per week - a dramatic difference. It should not be too surprising that a person's body can't adapt to such a quick change.
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Old 03 May 2016, 04:50 PM
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I am pretty sure it is not a problem to lose the first 50-60% of what you need to - assuming it is a large amount - much quicker than that, but the remaining loss should be focused on transitioning to better eating and other habits, with a lower weight loss.
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Old 03 May 2016, 05:16 PM
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Wanderwoman, thanks for posting that. It's the first time I've seen anything about a relatively long term followup on the results from that show.

For that matter, there seems to be very little about long-term follow up of results from weight loss programs in general. With all the commotion about the "obesity epidemic", it seems to me that by now we should have lots of studies, some of them having run ten or twenty or forty years. But almost every time I see a report, they're going on about results from followups done no more than two or three years after the loss. I suspect that some of the increase in the weight of the population is the result of people who were originally only slightly overweight, or who were not overweight at all but who thought they were, going on repeated weight loss diets; and winding up a little fatter as the result of each round.
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Old 04 May 2016, 01:12 AM
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Cracked had an article from a former contestant. Surprise, surprise, turns out that everything heavily scripted and edited and that screaming at people on treadmills makes for great television, but not good long-term physical or psychological health.

I liked the quote at the end:

Quote:
Looking back, I'm disgusted at the whole thing. There's no other show based on the concept of "competing for your health!" The public wouldn't stand for it if we, say, pitted cancer patients against one another to see who The Biggest Cancer Survivor was, but since we associate obesity with comedy, it's perfectly fine to turn overcoming it into prime-time television
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Old 04 May 2016, 01:10 PM
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Originally Posted by A Turtle Named Mack View Post
Interesting. I have the sense that the body reacts more to sharper changes in habits, .
I've heard the same thing--body goes into starvation, OMG-I'll-never-get-any-food-ever-again11!!!-mode and to combat that, it hangs on to excess weight.

Mouse--I read that article.

ETA: Just finished the NYT article. There's still so much we don't know about healthy weight loss/management. What I find weird is that you have the body doing its darnedest to regain the lost weight but at the same time, too much weight can lead to other problems. Seems like the human body is its own worst enemy.

Last edited by DawnStorm; 04 May 2016 at 01:24 PM.
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Old 04 May 2016, 01:55 PM
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I just posted this article about sunlight having a broad array of effects, including help with getting/staying slim, producing nitric oxide (needed for a LOT of processes) and affecting anti-inflammatory processes in the body. I wonder if sunlight exposure could be a big part of the results from this 'Biggest Loser' study. When these people are in training for the show, they are forced to do a lot of their exercise out in the sun, and even when they continued on their own away from the camp, most of them were getting a lot more time out in the sun with walking, biking, etc. But as they returned to their workaday lives, the sun exposure stops. Perhaps this is triggering the return of the fat (and this itself may be part of a genetically-based seasonal cycle, whereby as we get less sun, our body goes into survive-the-winter mode and lays on extra weight to stay warm and hold on to calories which may become in short supply - then when the sun exposure returns, the body is triggered to shed weight for the Spring and Summer).

I also have found that I have had less of saggy folds left after my weight loss than many major-weight-losers seem to have (as mentioned in the OP article). I had figured that it was because I lost weight a bit more gradually, because I was getting a lot of protein (keeping my body fed for the internal reorganization and rebuilding it needed), and a bit of genetic good fortune (I have never tended toward substantial wrinkliness or sagging). But also, before I had even started my weight loss program, I had a vitamin-D scare where the doctor found me way down and put me on a short supplementation program for the near term, and more regular sun exposure for the longer term. From that time I have been getting out in the sun with as much skin as I can reasonably expose as regularly as I can - never too long, but enough to get a good dose of D. With the myriad sun effects mentioned in the article I just linked, perhaps there is also something to stimulating the rebuilding of tissue, thus avoiding the sagginess that plagues many big-weight-losers. Totally speculation there, of course.

Last edited by A Turtle Named Mack; 04 May 2016 at 02:12 PM.
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Old 04 May 2016, 03:21 PM
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The thing about sun exposure is that latitude matters (I mentioned this in your other thread). I could spend an entire winter day nude in the sun at Seattle's latitude and not manufacture enough vitamin D to make up for the hypothermia (assuming a Seattle winter day that was sunny to begin with).

The OP mentions that one surprising thing was that the drop in metabolism appeared to be permanent. That actually makes sense to me, and I have to wonder whether there is also a drop in metabolism (a smaller one) if you lose the weight gradually. I think the best way to keep the weight off would be to assume there is.

Seaboe
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Old 05 May 2016, 02:14 AM
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One possible mechanism for the long term metabolism reduction could be a change in brown fat composition. It seems like the first thing your body would want to shed as an adaptation to prolonged starvation conditions. This could be something that doctors can reverse someday, but probably would not be tested and commercially available quickly enough to help the current generation of dieters.

Greater control over our weight should be well within our capabilities in the next couple of generations, but not soon enough to just wait for it rather than trying to control weight with the tools we currently have. Ultimately, I think technology caused the obesity crisis, and technology will solve it, at least for average citizens of developed nations. It does raise the interesting question of what new crisis that will lead to.
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Old 20 May 2016, 02:51 PM
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One possible mechanism for the long term metabolism reduction could be a change in brown fat composition. It seems like the first thing your body would want to shed as an adaptation to prolonged starvation conditions. This could be something that doctors can reverse someday, but probably would not be tested and commercially available quickly enough to help the current generation of dieters.
A very reasonable hypothesis, though it would probably require better documentation first of a reduced metabolism (beyond the reduction caused by fewer cells being maintained) as the OP results are far too small a sample to draw confident conclusions. And then a look at the types of fat and prevalence in never-fat, slowly weight losers, quick weight losers and still-fat people would need to be done. If it requires something like a biopsy to determine, this would be difficult to do.

I remember reading an article that said that brown fat was stimulated by being cold. The suggestion was that was to assist thermal control by burning fat for warmth when needed. Thus when more heat is regularly needed, the brown fat grows. I don't think it is proven, but it is a sensible hypothesis.

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Ultimately, I think technology caused the obesity crisis, and technology will solve it, at least for average citizens of developed nations. It does raise the interesting question of what new crisis that will lead to.
I am unsure what you mean by this. AFAIK, the obesity situation is caused primarily by a surfeit of food. Yes, that is primarily a result of technology, although changes in economic organization have allowed better distribution. But I fail to see how technology could 'solve' that, as that is not really a problem to be fixed. A snopester, in probably the only sensible thing s/he ever posted, noted that it is the nature of all animals, including us, to be hungry most of the time. However, we have the technological and social organization to allow us to never be hungry, and if we do not adopt habits that avoid the consequences of excess food availability - which includes embracing the naturalness and desirability of being hungry most of the time - then most of us will be obese.

As for other technological inputs to obesity, it is commonly assumed that we have a less-active lifestyle which burns fewer calories because of cars, comforts, etc. However, there is evidence that modern technologically advanced societies burn the same number of calories per person as hunter-gatherers.http://journals.plos.org/plosone/art...l.pone.0040503 http://healthland.time.com/2012/07/2...-makes-us-fat/
The difference seems to be metabolism (although the Hadza may also be doing their many physical activities much more efficiently than a westerner would, simply by learning to do them that way, probably through natural adjustments than being taught). Of course, the study population is tropical - it would be interesting to compare this to, say, subsistence hunter-gatherers of northern Siberia, where metabolisms should be geared higher to generate sufficient heat, perhaps by developing greater brown fat proportions). The metabolism difference could also be from stress. Stress burns more calories, but it also induces the body to retain calories.In fact, it just now occurs to me that stress could be the trigger for the lowered metabolism in the OP study, as well as the 'famine mode' - for a pre-technology human, what more sensible way to deal with stressful challenges than to retain resources which may be needed to get past the stressful circumstances.

Anyway, my point is that I do not know what sort of technical solution you expect to the problem of obesity. Perhaps we could stimulate additional brown fat to burn more calories. Still, that is likely to just make us hungrier. As far as I can tell, the solution has to be behavior modification, which is a moral solution, not a technological one.
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Old 20 May 2016, 08:28 PM
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Originally Posted by A Turtle Named Mack View Post
Anyway, my point is that I do not know what sort of technical solution you expect to the problem of obesity. Perhaps we could stimulate additional brown fat to burn more calories. Still, that is likely to just make us hungrier. As far as I can tell, the solution has to be behavior modification, which is a moral solution, not a technological one.
Multiple avenues of change in both our environment and our bodies. Humans didn't suddenly get morally inferior. Rich people have always had the capability to buy far more food than they could ever eat, but they haven't always been obese. In fact today they struggle with it less than the poor, despite having access to a greater abundance of food. Saying that we have more food now so we're fatter is an extreme oversimplification. It's definitely a part of the problem, but not the whole story. Lots of people have had an overabundance of food for a very long time, but the ratio of them that get fat varies quite a bit, and it's not been primarily due to having the iron will to deprive themselves.

Some foods are worse than others, and our food technology has cut a lot of corners to make cheap food that is not as nutritious as it could. Our self created environment encourages the increase in obesity, but this is a reversible trend.

Some individuals are less prone to struggle than others. It's not entirely down to differences in behavior. If one individual wants to change, then modifying their behavior is their only option. But some people have much less problem with it than others. It's not even just differences in metabolism, there are a whole host of physiological differences impacting weight gain, most of which are currently beyond our control but won't be forever. There is considerable biological variation between individuals that affects obesity, and this will all be subject to change. There is even more variation between species, and the human genetic diversity is relatively modest. They sky is the limit with biological adaptations that do not currently exist in the human population, but even just remixing genes currently in the population could drastically change weight problems.

Anyway, it's all very long term. For the indefinite present, diet and exercise, that's all we can expect in our lifetimes. Any technological progress would be welcome, but we can't wait for that to act on our current health problems.

Last edited by Errata; 20 May 2016 at 08:33 PM.
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Old 21 May 2016, 01:19 AM
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Don't forget the age-old conundrum where an overweight or obese person loses weight by doing everything they're supposed to do--eating better and exercising regularly--yet they reach some point where they can't drop anymore weight. And of course according to various matrices or whatever used to measure whether someone's overweight or obese, someone can be the picture of health, exercise regularly, eat healthily, and still be overweight and not suffer any adverse effects for it. It's almost as though humans are diverse and a one-size-fits-all system of anything really doesn't apply.

We've accepted the basic idea that people can come in a wide variety of heights and the very tall and very short often have problems that those in the middle don't. Why can't we accept a similar idea regarding weight?
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Old 21 May 2016, 03:07 AM
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We've accepted the basic idea that people can come in a wide variety of heights and the very tall and very short often have problems that those in the middle don't. Why can't we accept a similar idea regarding weight?
But . . . but . . . but . . . how would all the diet industry people make any money, if they couldn't persuade people to buy their stuff over and over and over again, in the desperate hope that this time around they'll wind up thinner instead of even fatter and with their systems even more messed up?

And who would be left that it's legitimate to sneer at for being morally inferior?

(Well, I can think of some people who actually are morally inferior. Rapists, for instance. But you can't tell who they are by looking at them. Of course, you can't tell how anybody eats by looking at them, either.)
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Old 21 May 2016, 05:37 AM
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I suppose I should stop communicating in webcomic links, but they're so danged effective and get to the point so much quicker. So here's one that Thorny Locust's post got me thinking of: The Fat Whisperer
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Old 22 May 2016, 07:12 AM
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And who would be left that it's legitimate to sneer at for being morally inferior?
If it's not entirely clear from my not very concise post, I'm not sneering at anyone and used the word "moral" only in response to the use of it that I quoted. Society has gotten heavier in a pretty short span of time, and I don't find it plausible that human nature has fundamentally changed, nor that it will change any time soon. So I dismiss that both as an adequate explanation and as a solution at the societal level.

I think there are issues with our food industry, among other things, which is something that we should be able to improve with sufficient understanding and will. If our culture can make choices that lead to worse outcomes, then it stands to reason that we should be able to do something to at least not be worse than whatever they were doing differently in previous generations. Hopefully better.
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Old 22 May 2016, 02:31 PM
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If it's not entirely clear from my not very concise post, I'm not sneering at anyone and used the word "moral" only in response to the use of it that I quoted..
That was clear to me, anyway -- sorry if it looked as if my response was aimed at you; it wasn't.
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Old 18 June 2016, 05:46 PM
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The theme on This American Life this week was "Tell Me I'm Fat". I was affected by all the stories, but this one had me enthralled.

http://www.thisamericanlife.org/radi...e-im-fat?act=2
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