Weight-loss Maintenance is Hard

[BrightAngel]

I frequently complain about how hard it is to maintain my large weight loss.
(and it is !)
Here's a recent article of interest involving Maintenance.
Recent research finds psysiological changes due to weight loss make weight loss difficult to maintain.

When humans (and rodents) lose 10% or more of their body weight, leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on. Skeletal muscles work more efficiently, thyroid and other hormones are reduced -- all so the body burns 15% to 20% fewer calories, enough to put back 25 pounds or more a year.

How do some people manage to overcome the leptin effect and keep weight off? Generally by watching their food intake very carefully and continuing to increase their physical activity. "Anybody who has lost weight and kept it off will tell you that they have to keep battling," says Dr. Rosenbaum. "They have essentially reinvented themselves, and they are worthy of the utmost admiration and respect."

The complete article can be found here.
http://online.wsj.com/article/SB121546349717633531.html

[OrganicGal]

Very interesting article BA. It would seem that keeping weight off may be like fighting a losing battle without extreme care and control or adding leptin to your system.

Perhaps now...we can stop being so hard on ourselves and blaming ourselves for 'lack of willpower' when it comes to keep weight off.

Not that we shouldn't lose weight if we need to. Or eat healthy and exercise no matter what, but still.

I almost feel like the article was a good news/bad news thing. Good news....you can't really blame yourself for not being able to maintain weight loss....but at the same time...bad news....unless you can replace the leptin in your system or are able to maintain the high level of care needed to keep the weight off you might be out of luck.

[blueskighs]

"Loosely put, after you've lost weight, you have more of an emotional response to food and less ability to control that response," says Michael Rosenbaum, lead author of the study in this month's Journal of Clinical Investigation.

it is hard to tell what comes first, as someone who loves to eat and has relied on food and eating as an emotional crutch for decades, and then relied on food restriction and dieting to deal with the symptoms of that ... i.e. weight gain,

I think the issues are complex.

if you are someone like me who has used food as an emotional crutch that in itself would make weight maintenance difficult, i.e. life doesn't stop and we keep having emotions.

For me the challenge is to learn to use other things than food. It is also important for me to not feel hungry or deprived, that is why I love NO S. If I was feeling hungry all the time I would feel miserable.

I guess there are some people who want to have a certain weight and live with the hunger, I am just not one of them.

Diets screw us up emotionall and physically, there is pretty much no doubt about that, three and a half months into NO S I am completely fascinated as my "psychological diet residue" surfaces.

The amazing thing about NO S is this is the FIRST TIME EVER I have had nice slow steady weight loss and KEPT IT OFF, it is not uncommon for me to lose weight in two or three months and already be starting to gain back in 4th month.

I had two wacky S weekends and am shocked I have not gained weight. However, I am certain I cannot blame those weekends on leptin as it was not physical hunger that was urging me on

I guess what I am saying is that our HABITS contribute to our weight gain and difficulty with maintenance true and, yes to keep weight off you have to change HABITS and that CAN be very difficult.

I know for me when I binge it screws up my blood sugar and it takes awhile of eating right to get that stabilized. Also, gaining weight many people don't exercise so to lose weight and keep it off you need to move, That is a complete change in lifestyle for many people.

I had terrible eating patterns in my twenties. Forunately I not only eat healthy most of the time, I ENJOY and PREFER healthy fresh food. so if that is a complete makeover then that is what that is

I have kept 26 pounds off for over 17 years, it is not 100 but it has stayed off. My freshman year in college I weight 161. For past 17 years my highest weight has been 135 pounds. Three and a half months into No S my weight is incredibly stable at 125-126. Maybe its just perspective, but NO S is just, for me the "easiest" thing I have done food wise.

Blueskighs

[rose]

The Columbia researchers put six obese subjects on liquid diets and reduced their weight by 10%

Ugh. In other words, forceful, unsustainable diet that reduces your weight quickly and then I suppose you don't stay on the diet. All reverse of the NoS diet principles. Re-read the front page at http://www.nosdiet.com

I lost 13% of my bodyweight slowwwwly during my first NoS year and I am not finding it particularly hard to maintain despite regularly going overboard on weekends. Mon-Fri is easy: Habit. Weekends are trickier, but not really hard.

(but it is true I never really dieted or lost a lot of weight quickly before noS, although my weight did fluctuate slowly up 30 pounds, down 20 pounds and up 20 pounds over 12-15 years before I started NoS. So some people who have gone through quick weight loss and/or yo-yoing before NoS may have some leftover effect from their previous experiences.)

[BrightAngel]

some people who have gone through quick weight loss and/or yo-yoing before NoS may have some leftover effect from their previous experiences.)

I don't believe there is any reputable scientific proof of your above-quoted statement.

There are quite a few studies disproving the myth that yo-yo dieting brings permanent metabolism change.
(except due to lost muscle prior to the re-establishment of normal muscle.)
And, at this point, there is no evidence at all that yo-yo dieting alters hormones (such as Leptin) any more than, or differently from, one-time dieting.

Most of us wish these scientific studies not to apply to us personally, and we tend to look for loopholes.
Based on my own experience, and research on the experiences of others,
I do not believe there is any evidence that the "Method" of weight-loss,
or the "Method" of maintenance would be a big factor in this study.

In my lifetime . . . . each time quite some years apart . . I have had large weight losses by different means.

The first large loss (over 70 lbs) was achieved by eating a balanced diet of around 1200-1300 calories per day,
losing an average of about 1/2 lb to 1 lb per week.

Another large loss (over 70 lbs) was achieved by a medically supervised liquid only diet of around 350 calories per day,
losing an average of about 2 lbs per week.

Another large loss (over 70 lbs) was achieved via a gastric bypass
making it impossible to eat more than about 300 to 500 calories a day for about a 3 - 4 month period,
then gradually increasing to around 500 - 700 calories for another 6 months or so,
causing a large weight loss initially, but averaging out to about 2 lbs per week.

My most recent large loss (over 70 lbs) was achieved about 2 1/2 years ago,
eating a balanced diet averaging about 1250 calories over a 16 - 17 month time period,
when my weight loss average was about 1 lb per week.

I have been maintaining that weight loss for the past 2 1/2 years,
which is now my record for the longest time I've ever been able to achieve sustaining one.

The findings of the study is very similiar to my own experience, in that
I experienced those same symptoms
whether I lost the weight fast through drastic means,
or whether I lost the weight slowly through slighly reduced calories.

Anyone who is able to achieve a 10% or more weight-loss through No S, or any other method,
AND be able to keep it off without experiencing (and having to counter) the physiological problem symptoms ..
(physiological, not psychological) of the study..
is a very fortunate, and I would say, unusual person.

I do not believe that maintenance of weight-loss is effortless for anyone,
no matter what the method of weight-loss,
or no matter what the method of maintence.
The No S diet method may make maintenance easier than most,
due to Habit patterns,
but I know of no evidence to show that
it doesn't bring the same physiological symptoms of weight loss indicated in this study.

There is only one way to see whether the symptoms will apply to you personally,
and that is through personal experience.
So, my advice to all No S ers is to follow the plan,
establish the Habit,
and Work to maintain those Habits.
Perhaps you will lose weight, and perhaps you will easily maintain it.

I personally, think that weight-loss and Maintenance is worth tremendous effort.
Just don't be too surprised by how difficult long-term Maintenance might actually turn out to be.

To again quote, Dr. Rosenbaum, who is the lead author of the study:

"Anybody who has lost weight and kept it off will tell you that they have to keep battling.
They have essentially reinvented themselves,
and they are worthy of the utmost admiration and respect"

While I'm on this topic, I'm going to take the opportunity to say:
Of course, my own experience is different from the "average" person
who has experienced being only mildly overweight (around a range of 5 to 35 lbs),
however, the same weight-loss basic principles apply to us all.
and, as a currently very small person who has spent a lifetime struggling with obesity,
I find it offensive when a person with a "slight" weight problem,
discounts my experience with an "but you're an elephant" mindset.
(and Rose, I'm not saying, or implying that you are doing this)

[navi]

I think that part of the issue is how much weight you have lost and when you gained the weight. After our teens we have the same number of fat cells throughout life - they just get bigger or smaller. Thus, if you were an obese teen, you would have more fat cells than a skinny person of the same height. We CAN increase the number of fat cells as adults, but only by becoming extremely obese - enough that each fat cell can no longer hold all the volume. 30 or 40 pounds is not enough for that to happen. Thus, if you have a larger number of fat cells than normal, it will be difficult to maintain a large weight loss - those cells are "starving" for lack of a better term. If you are just in the "gain & lose 40 pounds" category, it will be much easier, as you are dealing with fewer fat cells. This just illustrates that we are all individuals, and there is no one answer out there. Vanilla noS may work for some, but others may still have to keep careful track of what they eat, even on noS. That said, I have the UTMOST respect for those who have lost large amounts of weight and have managed to keep it off. It is an amazing achievement.
g

[BrightAngel]

we are all individuals, and there is no one answer out there.
Vanilla noS may work for some,
but others may still have to keep careful track of what they eat,
even on noS.

Gionta,
I agree completely with the quote above.

[navi]

Here are some links about fat cell #:

http://www.nature.com/news/2008/050508/ ... 8.800.html

http://www.weightlossforall.com/fat-cell-numbers.htm

Again, we are all different and have different challenges.

Some men can cut down from 4 beers a day to 1, do nothing else and lose 10 pounds in a month! No fair!!!!!!

Another example: when we women hit a certain age, our bodies try to pad our bellies with fat to make up for the drop in estrogen (fat is hormonal tissue) - this extra padding, though not attractive, is there for a purpose - to make the transition through menopause easier by regulating our hormones.....

From "Outsmarting the Midlife Fat Cell"
"The stubbornness of fat in menopausal women does, indeed, have to do with dwindling estrogen levels. You see, it's not just that estrogen creates fat - fat also creates estrogen. You might call it a feedback loop. This ability of fat to create estrogen (and other hormones, as well) is why women who are a little overweight are far less likely to get osteoporosis than women who are underweight. It is also a reason why serious obesity is a risk factor for hormonal disorders.

Because fat is a source of hormones, when estrogen production by the ovaries starts to drop as we approach menopause, the body hoards fat to buffer the decrease in estrogen. Waterhouse claims that women who aren't painfully thin actually have fewer menopausal symptoms than really skinny women, for this very reason.

This means that our bodies are increasingly reluctant to give up their fat cells as we advance through perimenopause, and apparently supplemental estrogen doesn't encourage them to let go - it just increases fat deposition and holds water, just like it does during our menstrual cycles (or, for that matter, in farm animals fed synthetic estrogens to fatten them.)

Once you get past menopause you'll probably find weight control much easier. You'll notice that once menopause is well and truly over, the body seems to give up its hold on the fat cells; middle-aged women tend to be plump, but old women tend to be thin. Indeed, you may find, once menopause is over, that you need to keep your weight up; really skinny old ladies are more prone to osteoporosis, among other things, than women who are a little more substantial, although, of course, being seriously obese will always be dangerous."

[BrightAngel]

You'll notice that once menopause is well and truly over, the body seems to give up its hold on the fat cells

That sounds like good news for me and my fat cells,
although I haven't personally noticed any such change
in the more than 15 years since I finished with meopause.

[blueskighs]

The No S diet method may make maintenance easier than most,
due to Habit patterns,
but I know of no evidence to show that
it doesn't bring the same physiological symptoms of weight loss indicated in this study.

Since No S is relatively new, it is true that scientific studies have not been performed with regards to its application and results. Reinhard, please correct me if I am wrong on this!
BUT it would be GREAT if they were done!

Blueskighs

[blueskighs]

Interesting quote from one of the articles gionta posted -

Fat cells may increase but that's down to you!

The number of fat cells can be increased only through severe and prolonged obesity when all present fat cells have become full. Tom Venuto explained this well in one of his interviews...

"Fat cells tend to increase in NUMBER most readily when excessive weight is gained due to overeating and or inactivity during the following periods:

1. During late childhood and early puberty
2. During pregnancy
3. Most commonly, during adulthood when extreme amounts of weight are gained

Normally during adulthood, the number of fat cells remain about the same, except in the case of obesity. When the existing fat cells are filled to capacity, new fat cells can continue to be created in order to provide additional storage even in adults. A typical overweight adult has around 75 billion fat cells. But in the case of severe obesity, this number can be as high as 250 to 300 billion!

Because of these facts, many people develop the attitude, "Well, I have more fat cells than other people, so what's the use, I'll never reach my goals". Some people argue that obesity is genetic and that once you're obese and your fat cells have multiplied, it's an uphill battle which you believe you may not ever win.

The number of fat cells you possess will certainly influence how difficult it will be for you to lose body fat. It's one of the reasons why some people have a more difficult time losing weight than others and why some people seem to gain weight more easily than others if they're not very careful and diligent with their diet and exercise programs.

If you have a difficult time about losing fat and you still harbor doubts about your ultimate potential to get lean because of genetics or fat cells, here's a question you might want to ask yourself:

Has anybody else who was obese as a child and throughout young adulthood - even 100 pounds or more overweight - lost it ALL and kept it off?

There are hundreds of people in the USA and UK who have successfully reduced fat. If someone else who has 200 billion fat cells has achieved their ideal weight and body composition, then so can you. So what if you have more fat cells - with the right action plan, you can make them 200 billion empty fat cells!"

Blueskighs

[blueskighs]

When humans (and rodents) lose 10% or more of their body weight, leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on.

While I'm on this topic, I'm going to take the opportunity to say:
Of course, my own experience is different from the "average" person
who has experienced being only mildly overweight (around a range of 5 to 35 lbs),
however, the same weight-loss basic principles apply to us all.

Apparently this particulary article refers to the percentage of body weight loss ... 10% or more versus actual number of pounds ... i.e. 5 to 35,

for example for 17 years I maintained a 16% bodyweight loss and now I am up to 21% body weight loss in total.

All very interesting stuff,
thanks for starting this great thread Bright Angel,

Blueskighs

[IChooseBalance]

I lost 70 lbs (about 30% of my body weight) through a medically supervised liquid diet - OPTIFAST. So far, I've kept that weight off with the exceptions of 2 blips, one of which is occurring now.

It IS very hard hard to maintain the weight loss. I can let my guard down just a little bit for a very short period of time and won't gain weight. Any further laxness and I'll be where I am now - 7 lbs heavier than my allowable high weight, which is on the high end of the range for my height and age.

I'm going to read the original article posted now. I just wanted to chime into say major weight loss can be maintained. It IS difficult and it IS worth the effort.

All the best.

[StrawberryRoan]

I have read several times over the years that our bodies are programmed to hold on to that stubborn ten to twenty pounds that almost everyone finds difficult to lose and keep off because it is a protective factor.

During the early lean years when man/woman depended on the occasional Mastadon or whatever kill, they might go quite a ways between meals. Therefore, their fat stores would kick in.

Luckily, we no longer need that stored layer of fat. However, some doctors think that is might serve us well to have an additional bit of weight on us in the event of an unforseen illness.

I'm covered.

[~reneew]

The Bible always talks about eating in the morning and in the evening... no mention that I know of of any lunch, or snacks. That's the way they ate way back then. That's when the "stored food" (fat) comes in. Then you think about getting sick and possibly needing some... true, but there's a fine line and I for one have crossed it by a mile

[mimi]

Hmmmm...Renee. You've reminded me...in Colossians the Bible also tells us to "Touch not; taste not; handle not; (2:21)

If I heeded that advice, I wouldn't be carrying around this extra pudge! "Food" for thought - pun intended!

Mimi

[StrawberryRoan]

And wine gladdeth the heart...

That's one of my favorite scriptures.

[BrightAngel]

Posting on May 27, 2009 to say...
I stand by my original comments.

Maintenance IS hard,
....but despite that fact....
As of the present date,
I've now been maintaining my current weight for 3 years 4 months.

[mimi]

That is positively AWESOME!

I don't know of anyone, including me, who has maintained even a small weight loss for any significant length of time, let alone a large one.

Congrats to you BrightAngel. I'm going to have to go back and read all of your posts...but first I have to lose the weight. Crossing one bridge at a time!

Mimi

[Thalia]

Bright Angel, that's fantastic! The more I read, the more I conclude that almost anyone can lose weight -- and lose it fast, even -- but very, very few can keep it off.

Have you considered joining the National Weight Control Registry? You are one of the rare, successful people they study!

I do believe that if anything can sustain weightloss, it's No S, because it's habit-based and you don't have to put an enormous amount of effort into thinking about it and keeping on it. I know I can do this the rest of my life without hardship (whether I WILL is an open question, but I know I COULD) - I've never felt that way about anything before. Even Weight Watchers' Core program, about which I was wildly gung-ho -- I knew I couldn't do that forever. And ... I didn't.

[BrightAngel]

Thanks you guys.

Bright Angel
Have you considered joining the National Weight Control Registry?
You are one of the rare, successful people they study!

Yes, Thalia, I joined the National Weight Control Registry a couple of years ago,
and I am participating in their research project on maintenance.