A Little More Each Day

One working mama learning to run & to maintain my 100+ pound weight loss!

Long term metabolic consequences of obesity and weight loss

on May 4, 2016

Last week, I saw a couple of articles about Ali Vincent, the first woman to win the Biggest Loser, having regained most of the weight she’d lost on the show and the worry she felt about people discovering she’d failed. In both of the articles below, they note a quote from Ali’s conversation with Oprah in which she said “I’m supposed to be strong. I’m supposed to know how to do this.” Boy do I know she feels – I suspect all of us who have successfully lost weight feel this way when we regain.

On Monday, we got a glimpse into why people like Ali and me and many of the rest of us struggle to maintain our weight after we’ve lost it in a journal article published in Obesity that looked at changes in our metabolism after weight loss. In this study, they evaluated a group from the Biggest Loser before the started the competition, at the end of the competition and now 6 years. They found that at the end of the competition, when they’d lost weight, their resting metabolic rate (the amount of calories we burn just existing) had gone down, which you’d expect since they have less body mass to maintain. However, at the 6 year follow up, when many of regained most if not all of the weight they’d lost, their metabolism looked the same as it did back at the end of competition. It never made the adjustment to burn more calories at rest to maintain their larger size like all of those daily calorie requirement formulas tell you it should. If you wonder why it feels like it is harder to lose weight the second time around, this might be why, or at least part of the reason. This was true even for the competitor who hadn’t regained weight, so this doesn’t appear to be a factor of massive weight loss and then regain, but maybe just the weight loss. The whole paper is here and a good New York Times article discussing the results are here.

Scientifically, this is nowhere near complete. There aren’t control groups of any kind, so we don’t know if this metabolic stagnation would happen to anyone morbidly obese over time or if it is a result of the weight loss. We don’t know if it is a result of the rapid Biggest Loser style weight loss or if the same would happen with more gradual weight loss. We don’t know if what you eat or how you exercise affects it. We don’t know if this looks the same in people who’ve lost 10 pounds or 20 pounds or 100 pounds. There’s a lot we don’t know. However, this makes a fair amount of sense and the researcher is at the National Institutes of Health, which is not a fly-by-night research operation. I expect there will be a fair amount of follow up on this.

It’s depressing data, but may explain why the success rates in people who’ve lost weight are so abysmal. That in itself was an interesting point at the end of this article – despite the large amount of weight regain in these patients, they are still statistically more successful than most people who’ve lost weight. 57% had kept off at least 10 percent of what they’ve lost, compared to 20% of people reaching that bar in other studies. To put that in real numbers, I lost 100 pounds. I can regain 90 pounds and still be considered a weight loss success because I kept off 10 percent of what I’ve lost. That’s how unlikely success is and in this study, they give a glimpse as to why. We aren’t weak. We haven’t forgotten everything we learned in weight loss. We’re fighting against a system that’s rigged against us.

It can be surprisingly hard to make peace with the scale.

It can be surprisingly hard to make peace with the scale.

A friend of mine worried that this would make people depressed about even attempting to lose weight if it is this impossible. I think what this means is that we need to change the message. Weight cannot be the only measure of success because that may be the hardest level of success to achieve, through no fault of our own. Just because my metabolism is screwed up and makes it easier to regain weight does not negate all of the good I do for myself when I eat a healthy diet in healthy amounts. It does not negate the good I do when I run or strength train or get a good night of sleep. What this means is yes, it’s going to be hard, but we need to accept that and look at other measures of success other than the scale, which appears to be literally tipped against us.

I think this also emphasizes the importance of trying to avoid weight gain in the first place. In the same edition of Obesity, there’s an article that discusses the fact that childhood obesity continues to increase despite the increase in awareness and attempts at interventions in the last few years. If we really are going to be in a no-win (or rarely win) scenario once we get to adult obesity, then it is IMPERATIVE that we help our kids to avoid that. We’ve got to find ways to get our kids healthier foods and more movement. Oliver ate fast food at Sonic twice while I was gone – sorry buddy, but Mommy is home and that is OVER.

We needs more of this!

We need more of this!

Did you read about this study? What do you think? Does it change how you think about your weight loss / weight maintenance efforts?

Articles:

First Woman to Win ‘The Biggest Loser’ Opens Up About Gaining Back the Weight from Huffington Post

‘Biggest Loser’ Winner Talks Regaining the Weight from CNN

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4 responses to “Long term metabolic consequences of obesity and weight loss

  1. Meg B says:

    Thanks for using your smarts to discuss this in layman’s terms with us!

  2. I started to write a post about this yesterday and it was coming across as too mean so I stopped, so I’m glad you addressed it! I’ve rage read way too many comments from people the last few days using this study as an excuse and a weapon to not lose weight or live a healthy lifestyle, and it really irritates me. I get that the initial reaction to the study could be discouragement, but shouldn’t the reaction be “This explains some things and now I recognize I need to be more diligent” instead of “eff it, I’m just going to eat whatever because being healthy is useless”? That’s the main reaction I’ve seen. For me the study raised more questions due to its small sample size and while it’s an excellent start, I’d love to see more data. What would have been ideal for me is to have the BL guys compared to people who have lost weight slowly and more traditionally. My hope is that the metabolism issue is related to the extreme methods used (3500 calorie deficit??? Hours of workouts a day??).

  3. Jennifer @ Dashing in Style says:

    Thanks for sharing. I hadn’t read any of these articles so thanks for the links. This reminds me of a similar study that came out in 2012. It concluded that after weight loss, when people are trying to maintain their weight, the “hunger hormone” still exists, which convinces their bodies that it’s starving and tries to get the person to eat more. The article was in NYTimes and called The Fat Trap, but here’s the link: http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html?_r=0

    What made me mad about that article was that the article concluded permanent weight loss is so impossible that we shouldn’t even try to lose weight but should instead just try to not gain more. You hit the nail on the head with your point about considering the other positive effects of healthy eating and not just the scale. That message is so important, and I get frustrated that more people and media don’t push that message. Instead, people hear only about how impossible weight loss maintenance is and figure they shouldn’t even bother to eat better and exercise.

  4. […] to read an interesting perspective on it, head over to Jessica’s blog A Little More Each Day. Her post includes a summary of the research, links, and her […]

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