Yesterday I posted a scientific research article about biological adaptations that promote weight regain in obese humans, with a link to a less technical article explaining the same issue. 

The article below addresses that issue from a “Health at Every Size” position.  

I agree with the article, and I admire the positions of “Health at Every Size” and “Size Acceptance”.   I spent many years of my life working to diet while living with morbid obesity.  I’ve experienced having the Fat Bias of others directed against me, and I didn’t like it.  Those cultural experiences were unpleasant enough to cause me … even now at 70 years of age … to continually struggle to keep my body in a state of starvation so that it will consume itself and be smaller than it wishes to be.

At this point, I’ve chosen NOT to personally adopt an “Intuitive Eating” non-diet lifestyle for myself.

I don’t plan to allow my body to ever tell me what to eat because, if there’s any way to avoid it,  I don’t want my body to become enormously fat again.  There’s a good chance that keeping up my constant struggle to eat a very tiny amount will - at least - reduce the speed of my weight regain.

I’m old now, so I figure that my life won’t be long enough for the what-now-appears-to-be-an-inevitable-weight-creep-upward to return me all the way back into morbid obesity.

Would I make the choice to continue the struggle if I were now in my 30’s or 40’s or even my 50’s?  If I knew, — that even though I continued to vigilantly and consistently work to successfully eat only 500 to 800 calories every day, — that eventually, my body would still wind up extremely fat again?  Probably not.

Why Do Dieters Gain Their Weight Back?
                    by Regan Chastain, of www. danceswithfat. org

…I think that one of the persistent myths that allows the diet industry to increase their profits every year with a product that doesn’t work is the idea that  “well, people gain the weight back because they just go back to their old habits!” (Of course in this case “their old habits” means not putting their body into a state of starvation so that it will consume itself and become smaller, but we’ll get to that in a minute.)

The thing about intentional weight loss is that research shows that almost everyone can lose weight short term, but then almost everyone gains it back – with the majority of people gaining back more than they lost. Weight loss companies make money by taking credit for the first part and blaming the client for the second part. When I was in school they taught us that if most of the kids failed the test, then the problem was probably the teacher and not the students.  So if only a tiny fraction of people are able to maintain weight loss, is it really believable that the product works but almost everybody is just too weak-willed to do it? Or is it more likely that the product doesn’t work and the very few people who are able to be “successful” are held up (wrongly) as proof of efficacy rather than (correctly) as exceptions? Consider this:

Your body doesn’t understand that there is a certain size and shape that brings with it an increased social capital.  Your body can’t imagine a situation in which it is hungry and there is food, but you won’t feed it. And so when your body is hungry but you ignore it, it assumes that there is no food available. Your body is like “No problem, I’ve evolved to survive famine let me just get those systems online. I’ll just get started lowering our metabolism.”

In the meantime, you go run on a treadmill. Your body now thinks that there is a famine and you have to run from bears. But your body is like “No problem, I’ve got this.” So it lowers your metabolism even more, drops calorically expensive “extra” muscle, floods the body with hunger hormones (since, what with the famine and the running from bears, it wants to make sure that you don’t forget to eat) and it holds back hormones that tell you that you are full. Basically, your body is hard at work doing everything it can to lower the amount of food that you need to live and store as much food as it can.

At the end of this process your body is biologically different than it was when you started. Your body has now turned into a weight gaining, fat storing, weight maintaining machine, biologically different than a body that has never dieted, and likely with a new set point weight – higher than your original weight – that your body is trying to maintain because it now is worried that there will be another famine and bear situation. Bodies are still biologically different even a year or more after someone stops dieting.

Of course people are allowed to try to intentionally manipulate their body size if they want, but I think people deserve to know that the most likely outcome of intentional weight loss is weight gain, and not necessarily for the reasons we’ve been told. “Just don’t go back to your old habits!” seems like something we can control.  “Just change your body biologically back to how it was before you dieted!” not so much.

If we are looking to increase our odds for health (knowing that health is not an obligation, a barometer of worthiness, entirely within our control, or guaranteed under any circumstances) there is no evidence to suggest that intentional weight loss will help with that, and there are evidence-based ways to support our health that don’t involve self-created famine or bear attack scenarios.  We each get to make choices but it would be nice if we weren’t bombarded with so much bad “information” along the way.

The following is author Michael Neill's perspective on Natural Eating:

Working from the perspective of the Inside out, rather than from the Outside In, here is the way we would all naturally eat if we hadn’t been taught to eat differently.

When your body is hungry eat.
Eat what you want, not what you think you should.
Eat consciously and enjoy every mouthful.
When you think your body’s hunger is satisfied, stop eating.

Think about it - but for our societal training in mealtimes and childhood training using food as both reward and punishment, why would you ever eat if you weren't hungry?

If it weren't for all the information and misinformation around us about what we're supposed to eat, why would you ever even put something in your mouth you didn't want to eat?

But for our multi-tasking on-the-go culture and the fact that most of us try to eat what we should instead of what we want, why wouldn't you take the time to enjoy every mouthful of the food you are eating?

And but for everything we've learned about the importance of cleaning our plates and fears about being hungry later because we're not supposed to eat between mealtimes, why would you ever keep eating past the point of full?

Speaking as someone who has played around with numerous outside-in eating programs over the years, ranging from Atkins on one side to Potatoes not Prozac at another, I know first hand the allure of the outside-in. Everyone has cool sounding success stories and shiny scientific data, along with pictures of people who we just know we'll look like when we've followed the program for as long as they have.

Worse still, most outside-in eating programs actually work - for as long as you follow them. So we ignore the overwhelming data suggesting that diets are the most successful weight-gain programs in history and assume it must be our fault - if only we were more disciplined, or hadn't been born with the fat gene, or whatever our best guess as to why we're the only ones who can't make something work that statistically doesn't work for over 95% of dieters, we'd lose weight and keep it off for life.

But as always, life lived from the inside-out is simpler than that. When we're looking in the direction of what's natural as opposed to what's normal, we see that all the reasons we would eat when we weren't hungry have one thing in common - they're made of Thought.

We think it would be rude not to eat what we're given and immoral to leave food on our plates. We think we know better than our bodies about what they need to function optimally, and because we are so out of touch with our bodies, we collect evidence to make these thoughts seem even more real and substantive.

What about so-called "emotional eating"? Well, since every emotion is a thought, the feelings of insecurity, discomfort, stress and fear we eat to mask are really just misguided attempts to hide from our own thinking. And as I've said elsewhere, "there aren't enough cookies in the world to make you feel loved and whole."

Your well-being is innate. Your value and worth in the world is a given. And when you begin to see the nature of Thought, you view your own thoughts with a degree of perspective and neutrality that allows you to see right through them.

You are OK right now, regardless of what you weigh. That doesn't mean that if you consistently eat when you're not hungry that you won't face health risks - over time, you most assuredly will. It just means being thin won't make you a better person.

So the critical question isn't "what do you want to weigh?", "how do you want to look?" or even "how do you want to eat?"

It's just this:

"Do you want to live more or less in tune with your nature?"

Michael Niel is a "success coach" and author of several best selling books based on the 3 Principles. He has several informative YouTube videos, one of which is here in the DietHobby ARCHIVES in the article entitled:  Our Thoughts Create Our World.

My observation is that the fat people who become "normal" size and maintain that size for more than just a few years, manage to do this through doing the hard work it takes to continually and consistently oppose the natural physiological desires of their "reduced obese" bodies.

Rather than allow their bodies to tell them how to eat, they use their minds to overrule those bodies and consciously choose to eat food containing far less calories than their individual body desires.  Forever … one-day-at-a-time. 
It is possible, but it isn't easy.  
See Running Down the Up Escalator.

First, let me clarify that my definition of a "fat" or "obese" or "reduced obese" person is not someone who merely hangs somewhere around their BMI Obesity border. Meeting that criteria requires a person to put in more than two or three years at a weight of … at least …. 20 to 50 pounds above their BMI Obesity border. To me, those who fail to meet that requirement are merely "overweight", a condition that is often temporary for them. Although many of these people term themselves as "fat" or previously obese, in general, they appear to have a very limited understanding of true obesity or the fat condition.

An overweight person tends to think that because they went on their first diet and easily lost and kept off 10 or 20 lbs, then an obese person, on their 50th diet can do the same thing for a longer time and lose and keep off 100+ lbs. This attitude is easily seen within the numerous online diet forums that are full of overweight or formerly overweight people who are eager to offer copious advice and personal judgments along these lines to people who are obese or reduced obese.
This unequal comparison … apples to oranges … often confuses people who are truly obese or "reduced" obese and frequently results in negative self-judgments which are just wrong.

So, applying this clarification, There are psychological desires (of the mind), and physiological desires (of the body). What does it take to continually and consistently use one's mind to oppose the natural physiological desires of one's body? Is the ongoing difficulty of opposing those desires worth the effort that it takes to be "normal" weight?

This is a Judgment call that depends   
on the severity of the individual's mental pain which is caused by the culture's fat-bias, and the severity of the individual's physical pain which is caused by denying to one's own obese, or reduced obese body, the food substances which that body believes it needs for survival. 

We must each decide this for ourselves. Thus far, for me personally, the balance tilts toward accepting the physical pain to avoid the mental pain. However, my personal dieting history, including the past 8+ years of experiencing the difficulty of maintenance …. even though I've consistently continued my positive dieting behaviors …. have changed my perspectives on the feasibility of dieting and maintenance, especially for the "morbidly" obese.

Here's an excellent article by a healthy, "morbidly" obese person who discusses her own relationship with her physical body.

Me, My Body, and Relationship Counseling
           by Ragen Chastain www. danceswithfat

My body and I used to have a seriously bad relationship, and looking back it’s not that surprising. I grew up the daughter of a Marine and a multi-sport athlete. If I fell and ran to my father, I could expect to hear “Are you hurt or are you injured?” Hurt meant that it was time to suck it up; injured meant you were going to the doctor. He, along with coaches and dance teachers told me to “walk it off”, “play through the pain” and that “pain is fear leaving the body.”

I was told over and over again that my body was just a limitation to be overcome through mental toughness  – blocking out or working through the pain. It didn’t come naturally at first – I seemed to have an innate sense that my body deserved better than that, but at some point I turned a corner and got really good at thinking of my body as something separate, and something to be ignored.

I worked through stress fractures, and an IT band so tight it felt like it was going to rip in half, pulled muscles, sprains, strains, jammed fingers, knee injuries and a host of other issues. I ignored my body when it asked for food and hydration, and I scoffed at it when it asked for rest.

I became a compulsive exerciser and I started to look down on my body even more. I refused to give it what it needed and pushed it beyond reasonable, and then unreasonable, limits.  When my body would finally bend or break under the strain, I treated it with utter contempt. I believed that my body was just a “meat sack,”  a collection of muscles and bones that were trying to limit what I could do. I believed that my mind had to be stronger than my body and I felt triumphant when I ignored my body’s signals and “pushed through.”

If I ever had an acquaintance who treated me the way that I treated my body for all those years, I would never speak to them again. In fact, I would never have let it go on that long. But through all of this my body stuck with me (even though I wasn’t giving it the food, hydration, or rest it needed), my body continued to support me. It never gave up on me. If my body could talk, all it would have said for years would have probably be something like “&$*#(*@ *$*&*#(*$  and for the love of pete can we please take a nap?!” but I wouldn’t have listened.

We live in a culture that preaches that our bodies are limitations. I still think of my body as something separate (and I know and honor those for whom that doesn’t work.)  But it’s different now -  I consider my body as a cherished friend.  Think of everything your body does for you without you even asking: breathing, blinking, heart beating… every cell in your body is getting blood right now and you’re not even thinking about it.

I don’t know about you, but there are days when I am too distracted to focus on a game of solitaire. I’m pretty sure that  if I was consciously in charge of breathing and blinking and heart beat I would have been dead in middle school when I got my first Walkman and regularly walked into stuff because I was so into the soundtrack of A Chorus Line.

I’m not saying that pushing your body is always wrong, you have to decide what works for you. I know I’ve danced through plenty of injuries. What I’m suggesting is that you consider treating your body like you would treat a friend.  I can’t even count the things that my best friend has done for me, even though he might rather have been doing something else (hello marathon!) because he’s my best friend and he loves me and I asked. It’s the same with my body.

I’m privileged to be temporarily able-bodied and I learned more about that when I had a neck injury last year and lost the use of my right arm for almost three months.  I learned that even if my body has limitations, that doesn’t make my body a limitation and that I worked best when it was me and my body against a problem, and not me against my body. I don’t know what is in the future for me and my body and like any relationship, my body and I have to keep up the communication and we have breakdowns, but we’ve come a long way since our days of giving each other the silent treatment, and I’m feel like our relationship is healthier than it’s ever been.

My online Scrapbook, which I call DietHobby, contains articles about the diet subjects on my mind, which are organized in its ARCHIVES to provide me with future reference. Recently I've been reading, and referring to, books and articles about Fat Acceptance. The article above is one of those which I find valuable enough to scrapbook here.  

The word "Diet" simply means "food and drink regularly provided or consumed, i.e. habitual nourishment".

However, our present pop culture has basically changed the term "Diet", to primarily mean "a regimen of eating and drinking sparingly so as to reduce one's weight".

All research indicates that none of those "regimens" or methods are effective to reduce people from fat to a "normal" size long-term, except for a very tiny fraction of the fat population.

That information appears to have gotten around because just about everyone is trying to give their Diet - i.e. eating regimen, "way of eating", or "lifestyle", a different label… anything other than the word "Diet".

"Intuitive Eating" type "nondiets" have been doing this since they first introduced their concepts - "eat when hungry, stop when full".

Lean Cuisine now has ads that say "ditch the diet and go on a try it!" and then suggest that people eat their frozen meals to lose weight.

Special K now says to stop worrying about the number on a scale…but they still want people to buy their products in an attempt to lose weight… they just want this to be called "Size Sassy".

Weight Watchers now says they aren't a "Diet", they're a "lifestyle choice".
Yeah ... It's a lifestyle where you choose to be on a Diet.

The Bottom line is that all eating plans are diets, no matter what they are called. They can say it's "not a diet", it's a "lifestyle", a "way-of-eating", a "nondiet", "size sassy", but at the end of the day it's still the same Diet concepts that have been proven to fail the vast majority of people, and… in fact… have the exact opposite of the intended physical result on the majority of people who try it.

Call it what you will. My observation is that the fat people who become "normal" size and maintain that size for more than just a few years, manage to do this through doing the hard work it takes to continually and consistently oppose the natural physiological desires of their "reduced obese" bodies. Rather than allow their bodies to tell them how to eat, they use their minds to overrule those bodies and consciously choose to eat food containing far less calories than their individual body desires.

Forever … one-day-at-a-time.
It is possible, but it isn't easy.  
See Running Down the Up Escalator.

 Here at DietHobby there are many articles about my weight-loss and maintenance of that weight-loss.

For more details see ABOUT ME in the Resources section, and various Status Updates etc. in the ARCHIVES.

I've consistently recorded all my food into a computer food journal every day for more than NINE years.

I've also recorded my weight daily or weekly during that time. Those detailed records show a large weight loss, followed by a couple of years holding pattern, followed by about five years of gradual weight-gain while eating a calorie average of around 1050 calories daily.

Despite my careful adherence to calorie budgets, and detailed documentation, people tend to disbelieve this truth. I'm tired of being considered a liar. In fact, involving myself further in discussions on the issue is becoming too exhausting to even contemplate. My records are helpful to me personally, but are generally discounted by others as inaccurate, mistaken, or faulty in some way because … what these records show "simply cannot be true".

This is a common phenomenon.
 
Medical personnel and weight loss gurus get to openly doubt the claims of any and all failed dieters because their fat bodies are the visible proof that they are lying.

Former dieters who claim diets don’t work were probably just doing it wrong all along, or else they didn’t try Guru X, Y or Z, who would have set them straight right away.

However, the bottom line is, diets don’t fail because failed dieters are liars, but because the only diets that yield substantial, noticeable weight loss in a statistically significant portion of the population are the same diets that are largely unsustainable for many, many reasons.

The problem isn’t lying dieters, it’s that the expectations surrounding diets and weight loss are built on lies, half-truths, insinuations, flawed research and cults of personality.

It is important to realize and understand that people regain lost weight due to biological reasons which are totally out of their control.

When a person engages in the kind of severe caloric restriction necessary to lose significant amounts of weight, it triggers hormonal changes in their body that pushes back against that caloric deficit, both physically and emotionally.

The body's response to caloric restriction involves issues involving leptin, ghrelin and adaptive thermogenesis. In a nutshell, one's body does everything it can to preserve what few calories it is taking in. This is the semi-starvation neurosis that is most noticeable in the infamous Minnesota Starvation Experiment. Those continual, ongoing, unpleasant symptoms are the body’s way of trying to urge a person to find more calories. Most people find that kind of lifestyle unsustainable.

The 3500 kcal per pound Theory was derived by estimating the energy content of weight lost, but it ignores dynamic physiological adaptions to altered body weight that lead to changes of both the resting metabolic rate as well as the energy cost of physical activity.

Calorie-restricted diets are unsustainable for the vast majority of people and the ubiquitous expectations of 3,500 calories per pound lead to inevitable disenchantment with lifestyle changes. Weight regain is incredibly complicated and simply assigning blame to the dieter is inadequate when you look at the totality of evidence.

People have been given unrealistic expectations for what caloric restriction achieves. When someone jumps on a restricted-calorie "lifestyle change" and only loses a net 5% or 10% after two years, and that restricted-calorie diet is so miserable due to hormonal responses and/or whatever life changes may occur, that they tend to give up those changes and regain the weight.
 An analogy would be if you’re a runner and you push yourself further and further, harder and harder because you believe that if you just work hard enough you’ll be the fastest runner alive. But there are internal cues like soreness, fatigue, and injury which are your body’s ways of telling you to knock it off. You can ignore those cues and continue your training regimen, but many people will find the increased regimen unsustainable, then fall back either to their less rigorous habits or quit training all together.

So whose fault is it if a person doesn't keep training at that higher level? In a simplistic sense, we can say the runner. If they just stuck with it, their body may eventually yield the results desired, but something interfered. That “something” is the unsustainability of the goal for that runner's body.

When people gain weight, their energy needs increase to keep the extra tissue alive and move it around. Likewise when weight is lost, their baseline needs decrease. So when people cut calories below the baseline requirement - thereby triggering weight loss - the gap between their intake and their baseline energy needs begins to shrink. At some point, it may disappear altogether, at which point weight loss stops. This can happen even BEFORE a formerly fat person becomes underweight or even of "normal" weight.

A 3500 calorie deficit might roughly equal one pound of fat. But what starts as a 3500 deficit in week 1 of a "lifestyle change" will be closer to a zero calorie deficit in week 100.  The 3500 =1 lb Calorie Theory has a tendency to breakdown further at very high weights, and at very low weights, in that it appears to be far less accurate when applied to extremely obese people who maintain a very high weight long-term, as well as for extremely "reduced" obese people who are working to maintain a low weight long-term.

Fat bodies require more calories than slimmer ones. However, the human body is not a budget, and individual mileage varies.  All formulas which calculate the calories required by any person of any size, age, or weight are based on "averages" of the people who were included in specific, limited, research studies, and the numbers given by the use of any such forumla are ESTIMATES only.  Ten to twenty percent deviations are common, below and above, and even within those limited research studies some of the people's calorie needs fell even lower.

People who successfully lose weight can explain how they did it, but when people who fail at losing weight explain how they did it, they're assumed to be liars.

The common assumption is that the reason a majority of people fail to lose weight on a diet, is because they don't follow the diet, and those people who claim that they do follow the diet but haven't lost the expected amount of weight are liars.

There is no specific scientific evidence that proves weight regainers are actually following the diet when they regain the weight. However, there is a great deal of anecdotal evidence. There are many, many, many people who say that they have tried anything and everything from caloric restriction to low-carb eating and have not gotten results. They’ve exercised, followed the rules and done everything right, but not had the same experience that the successful people have. This is when the successful people begin their diagnostic check. “Have you tried X? Have you tried Y? Have you tried Z?”

Anecdotal evidence that diets don’t work is immediately dismissed. However, there is no other evidence available… no long-term, peer-reviewed research which reliably monitors the dietary habits of subjects. Scientific evidence on this issue is hard to come by because it would be incredibly expensive and difficult for any research team to do a long-term controlled study that actually proves subjects do or do not follow diets when they do not lose much weight.

The only such study in existence is the Minnesota Starvation Experiment, which only happened due to a remarkable set of circumstances around WWII, involving a rigidly controlled environment and a limited number of selected subjects who started as healthy, young, normal-weight men.

What CAN be asked and answered is “What happens when we have subjects follow a particular diet and/or exercise routine after X number of years?” This kind of evidence simply shows us how that diet fares in “normal” life, and the fact that the long-term failure rates of all known weight loss approaches simply means that they either they don’t work for the vast majority of people or that they are unsustainable. Either way, all available evidence shows that this path does not generally provide the desired results…i.e. long-term maintenance of weight-loss.

Every year, there are hundreds of thousands of people who lose 50 or 100 or 150 pounds, but we don't consistently learn of their ultimate success or failure after one, two, or five years. Successful people are self-selecting, and we never know the true followup rate of these amazing success stories.

Those hundreds of thousands of people who achieve their goal of losing 50 pounds or more are only a sliver of the millions of people who try and don't get anywhere the expected weight-loss results.

The vast majority of people who try to lose weight regain it, regardless of whether they maintain their diet or exercise program. This occurs in all studies, no matter how many calories or what proportions of fat, protein or carbohydrates are used in the diet, or what types of exercise programs are pursued.

What current scientific studies do prove is how woefully inadequate our claims of diet efficacy are. Even in those controlled settings, when intake and expenditure is strictly controlled and it comes closest to recreating your budget analogy, the results still show that the human body is not a bank account.

Energy out - the human body is a dynamic system with metabolic inconsistencies that we cannot easily account for on an individual basis.

Energy in - even if we measure our food, calorie estimates are merely best guesses, and to say: "just eat less" simply tells people that over time they need to eat less and less and less food to continue losing weight at a steady rate. (Or in my own case… to continue maintaining weight-loss long-term.)

It ultimately comes down to this:

One argument is: "We have proof that weight loss works” which is supported by a cohort of people who provide anecdotal evidence that caloric deficits provide the desired result of significant, long-term weight loss. However, there is no scientific evidence in existence proving this proposition to be true.

The other argument is: “We have proof that the vast majority of people who try to lose weight regain it, regardless of whether they maintain their diet or exercise program”. There are reams of scientific research which support that argument AND a cohort of people who provide supporting anecdotal evidence.

Whatever argument one chooses to accept, all studies have proven that our bodies are not machines. They have organic differences, and they continually adapt. Although a calorie budget can be useful, weight loss is far more difficult and complicated than setting a budget and adhering to it.