Is Being Fat Really a Trap?

I can see the marketing world gearing up.  More ads for exercise equipment, "diet" plans, and other things to tempt us into spending money to kick-start our fitness goals.  I hope you're feeling motivated as the new year approaches.  I know I am.  I hope 2012 is the year I *finally*, after what will be 5 years, reach my goal.  I could go on and on about how, in many ways, I've already reached my goal and so much more, but the number goal is still out there and that's the one I'm speaking of.

So many of us have been down this weight loss path before and for many of us it can start to feel like a lost cause.  But it's not.  Though I am a firm believer that how you go about losing weight matters.  A friend posted this article, The Fat Trap, from the New York Times and I found it thought provoking.   It's written by Tara Parker-Pope, a self proclaimed overweight person who's tried time-and-again to lose weight, only to end up heavier in the end.

In summary it proposes that once we become fat our bodies strive to re-gain the lost weight.  That hormonally we are driven to seek out those lost pounds, otherwise we stay in starvation mode.  I've heard various reasons for this over the years, empty "fat" cells just waiting to be plump again is the one I've heard most often.

The thing that gets me is that in the first study Tara cites they put participants on a starvation diet

...the extreme low-calorie diet, which consisted of special shakes called Optifast and two cups of low-starch vegetables, totaling just 500 to 550 calories a day for eight weeks.

After 10 weeks on this "diet" participants lost an average of 30 pounds.  Does the following come as a surprise to anyone?

After a year, the patients already had regained an average of 11 of the pounds they struggled so hard to lose. They also reported feeling far more hungry and preoccupied with food than before they lost the weight.

I know it doesn't surprise me.  They were starving for 10 weeks.  That's not a lifestyle change one can sustain.  And it obviously wreaks havoc on the body.

A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost. For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

What I want to challenge here is the conclusion that "dieting" will leave you worse off than when you started.  I think the conclusion should be something more like extremely low-calorie diets will leave you worst off than when you started. 

“What we see here is a coordinated defense mechanism with multiple components all directed toward making us put on weight,” Proietto says. “This, I think, explains the high failure rate in obesity treatment.”

NO, NO, NO!  What explains the high failure rate (in this case) is the extreme, un-maintainable, starvation diet.  And I believe that making changes that are not sustainable, trying to lose too fast, trying to make too many changes at once, trying to change yourself but not your environment, not finding exercise you enjoy - these are the causes of failure in maintenance.  You must make changes in  your life that you can sustain, for the long term, forever - or at least for as long as you want to be thin.

For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.

This rubs me the wrong way.  I feel like I'm being told that no matter what I do, I'll probably become fat once again.  And if not me, than most of my peers on this journey.  And that just makes me mad.  Don't tell us that.

The article goes on to talk about a “biological determinism” that can make a person susceptible to weight gain or loss.  I think there must be some truth to that.  But while reporting on the genetic factor Tara noted this:

...after testing positive for fat-promoting genes, some people were more likely to eat fatty foods, presumably because they thought being fat was their genetic destiny and saw no sense in fighting it. 

Eeeexactly. And that's why I don't like this article.  Don't tell people they are likely doomed to fail based on a study that utilized a starvation diet for weight loss.  It's just not good science, in my humble, non-scientist, opinion.

Later in the article they talk about The National Weight Control Registry and go on ad-nausea about a woman who lost over 100 pounds, Janice Bridge, and how much she has to do to maintain that loss.  She's keeping a food log, weighing daily, measuring all her food, etc, etc.  The article says she "never" lets up and goes on about how she avoids sugar, white flour, etc... Tara (the writer of the article) feels overwhelmed and hopeless after hearing all this woman has to go through to maintain her weight loss. 

"Just talking to Bridge about the effort required to maintain her weight is exhausting. I find her story inspiring, but it also makes me wonder whether I have what it takes to be thin." 

But then Janice is sharing a Ben & Jerry's ice cream with her husband.  And she includes gardening as exercise.  So she does get to let up now and then.  Just not entirely.  It's called balance.  Janice is a food junkie (that's my preferred term) and is working to overcome a lifetime of bad habits coupled with using food for emotional fulfillment.

So ok, Janice Bridge has to eat 300 less calories a day to maintain her weight (than a person who was never fat).  300 calories is not a lot.   

Later the article references another study in which participants are placed on an 800 calorie diet and, lo-and-behold, they are "metabolically different than a similar-size person who is naturally the same weight."  Sure they are, after starving them.

After weight loss, when the dieter looked at food, the scans showed a bigger response in the parts of the brain associated with reward and a lower response in the areas associated with control. This suggests that the body, in order to get back to its pre-diet weight, induces cravings by making the person feel more excited about food and giving him or her less willpower to resist a high-calorie treat.  

But could it be that prior to weight loss they weren't as "excited" about food because they were indulging all the time?  But after becoming a "dieter" the food becomes more exciting?  I know that's been true for me.  Back when I posted my Top 10 Changes After Losing 67.4 Pounds my #4 change was "I actually enjoy junk food more since it's now a treat and not just an every day thing."  The kicker though, is that the areas of the brain responsible for restraint are less active.  Perhaps that's because the participants didn't really build restraint during their starvation, short-term, "quick" liquid diet.

Tara writes about another weight-loss success story.

She (Lynn) has also come to accept that she can never stop being “hypervigilant” about what she eats. “Everything has to change,” she says. “I’ve been up and down the scale so many times, always thinking I can go back to ‘normal,’ but I had to establish a new normal. People don’t like hearing that it’s not easy.”  

No, she can't go back to "normal".  But remember, Lynn's normal involved being 300 pounds.

They are addressing my concern.

One question many researchers think about is whether losing weight more slowly would make it more sustainable than the fast weight loss often used in scientific studies. Leibel says the pace of weight loss is unlikely to make a difference, because the body’s warning system is based solely on how much fat a person loses, not how quickly he or she loses it. Even so, Proietto is now conducting a study using a slower weight-loss method and following dieters for three years instead of one.

I still think they are missing a big point though.  It's not just losing weight slowly, but making sustainable changes, changes you can live with.  It's not about the pounds lost, it's about how they are lost.  That point couldn't have been made better than by Tara's statement here:

Losing a few pounds may be good for the body, but it does very little for the spirit and is unlikely to change how fat people feel about themselves or how others perceive them.

If it does little for the spirit, I suggest the person doing the losing needs to take another look at their goals and motivations.  I believe that there's hope for all of us.  I am in love with Tara's closing sentences...

"And even though all the evidence suggests that it’s going to be very, very difficult for me to reduce my weight permanently, I’m surprisingly optimistic. I may not be ready to fight this battle this month or even this year. But at least I know what I’m up against."

I would say this to Tara - yes, it's going to be hard.  Very hard. But not for the reasons you might think.  It's going to be hard to tap into that drive, to change your habits, to change your environment.  It's going to be hard to prioritize yourself, to learn new ways to cope. It might be hard to gain a higher level of fitness but the real challenge is in finding that physical movement, "exercise" that you enjoy. And yes, sometimes it's going to be hard to be hungry. 

I would say Tara - when you are ready, when you want it...go slow, make one change at a time, balance, move, do things you love that don't involve food ... to steal ww line - Stop Dieting, Start Living!