It's hard not to binge on delicious food. For more about that experience, go to the bottom of the page, and Watch an entertaining video at the end of this article.

However, that is NOT the ONLY reason why weight-loss is hard.  I've been reading about "Adaptive Thermogenesis" .  Physical systems (like machines) stay the same.  Biological systems (like humans) adapt.

Weight-loss and maintenance have less to do with motivation and will-power than most people think. In fact it has far more to do with how your body adjusts to, and is capable of, resisting a calorie deficit. Putting less fuel in the tank of one's car will always cause the car to drive a shorter distance.  However, the human body adapts to less fuel ....meaning eating fewer calories.... by becoming more ‘efficient’ and running the same distance on less fuel than before. That is the big difference between simple physics and biology

For a better understanding of the issue of energy-in/energy-out, read my Summaries of what Gary Taubes has to say about it. 
WWGF - Chapter 6 Thermodynamics for Dummies, Part 1
and Chapter 7 Thermodynamics for Dummies, Part 2.

Here is a great article by Dr. Arya Sharma M.D. on this issue:

The Role of Adaptive Thermogenesis in Resistance to Weight Loss

No intentional weight loser continues to lose weight till she disappears.

Sooner or later every diet, every medication, or every type of bariatric surgery will result in a weight loss ‘plateau’ (better referred to as a ‘floor’) - a weight, beyond which losing even more weight (and keeping it off) becomes an almost ’super-human’ feat.

However, there is considerable variation in how much weight people can lose and keep off. Although the average sustainable weight loss with ‘eat-less-move-more’ (ELMM) approaches is about 3-5% of initial weight, some folks manage to lose considerably more, while others struggle to even simply stop gaining weight.

This has less to do with motivation or will-power than most people think.
In fact, it has far more to do with how your body adjusts to and is capable of resisting a calorie deficit.

While putting less fuel in the tank of your car will consistently decrease the distance that you can drive, our bodies adapt to less fuel (i.e. eating fewer calories) by becoming more ‘efficient’ and running the same distance on less fuel than before. That is the big difference between simple physics and biology.

Biological systems adapt - physical systems (like your car) stay the same.

In the case of humans (and animals) we call the adaptation of energy needs and expenditure ‘adaptive thermogenesis’. Exactly how adaptive thermogenesis is regulated and how differences therein can largely determine both weight loss and weight regain, is the topic of a paper by Angelo Tremblay and colleagues from the Universities of Laval and Ottawa, published in the International Journal of Obesity.

As the authors point out,

“The decrease in energy expenditure that occurs during weight loss is a process that attenuates over time the impact of a restrictive diet on energy balance up to a point beyond which no further weight loss seems to be possible. For some health professionals, such a diminished energy expenditure is the normal consequence of a progressive decrease in the motivation to exercise over the course of a weight-reducing program.”

Many studies have now documented the process of ‘adaptive thermogenesis’, whereby weight loss is associated with a ‘greater-than-predicted’ decrease in energy expenditure. This occurs both through a reduction in metabolic rate as well as through an often remarkable increase in ‘fuel efficiency’ related to physical activity, whereby individuals, who have lost weight burn far fewer calories for the same amount of physical activity than before losing their weight (far more than can be explained simply by considering that they are also moving less weight around).

As the authors discuss, not only do people, who demonstrate the greatest decrease in adaptive thermogenesis in response to weight loss tend to lose less weight (for the same level of caloric restriction) but they also tend to have a greater increase in hunger and appetite.

Also, it does not appear that these ‘adaptive’ responses to weight loss diminish over time, which means that the resistance to further weight loss and the propensity to weight regain persist till the weight is eventually regained (i.e. they once again ‘fail’).

Together, these factors can easily explain why losing weight and keeping it off is far more difficult for some folks than for others - irrespective of motivation or will power.This basic biological fact is not only important to ‘dieters’ (even if it seems demotivating) - but perhaps even more important for all health professionals to be aware of.

Simply ‘blaming’ people who find it harder to lose weight or keep it off for their lack of will power or motivation, is neither fair nor helpful. You can only fight your biology so far before life is no longer fun - this is when you need to realize that you are now living below your ‘Best Weight’.

AMS
Edmonton, Alberta

Tremblay A, Royer MM, Chaput JP, & Doucet E (2012). Adaptive thermogenesis can make a difference in the ability of obese individuals to lose body weight. International journal of obesity (2005) PMID: 22846776

Dr Arya Sharma, M.D. 
Dr. Sharma’s Obesity Notes   www.drsharma.ca

Here at DietHobby, I share my own experiences and opinions as I work to maintain a very large weight-loss. I am now in the 7th year of maintaining at normal weight after spending much of my lifetime in morbid obesity.  Those who are interested can see more details in the ABOUT ME section under RESOURCES.  Recently I posted detailed records of my average food intake together with a summary of my weights during those periods. See Records: My Past 8 years. 

One of the things I've personally discovered from my own experience is that weight maintenance is very difficult, and it takes an enormous amount of ongoing, consistent effort.   When I first reached my goal weight, I had some vague idea from things I'd read, that the first 5 years of maintenance were the most difficult, and if and when I could achieve that point, it would become much easier. 

In my own case, I have discovered this not to be true.  Even though the first couple of maintenance years were difficult, the subsequent years became MORE difficult.  Maintenance did not become easier after 5 years, and I can honestly say that here in my 7th year, maintenance is more difficult than it has ever been. 

My detailed records confirm my subjective experience that .... not only do I need to eat fewer calories than the BMR or RMR charts indicate to maintain the same weight, ..... but, when I raise my daily average calorie intake ... even slightly for a brief time, or for a lengthy time period... I gain weight.  However, for the time period of the past 3 to 5 years, I've discovered that decreasing that average calorie intake to the same extent, does not cause a corresponding weight-loss. 

As an example.... if we use conventional wisdom, and assume that an excess or deficit of 3500 calories = a 1 lb fat loss....my detailed daily food-intake and weight records indicate that during the past 3 to 5 years,  if I eat an excess of 3500 calories I will definitely gain 1 lb fat, however, when I eat a deficit of 3500 calories I will NOT lose 1 fat lb.  In actuality, the 3500 calorie calculation appears to no longer be applicable to my body.  Water weight aside, and referring to fat weight only, it appears that it takes far less excess calories for me to gain 1 fat lb, and that it takes a far greater calorie deficit for me to lose 1 fat lb.  During the past 5 years, I've run many personal experiments testing this particular issue (even using different micronutrients), and each time, my results have confirmed this to be true for my own individual body.
Not only is this a frustrating condition, it is one that almost no medical professional addresses.   Probably, this is reasonable, because there is no actual scientific research on formerly obese people who have lost large amounts of weight, and have maintained it for long time periods.  I personally, am a member of the National Weight Loss Registry, and I have discovered how little data exists about this matter.

There's not much information available on this issue, so I was pleased to discover the following article by Dr. Arya Sharma, M.D.

Why Diet and Exercise is Not a Treatment for Obesity

If going on a diet or starting an exercise program resulted in persistent weight loss, we would not have an obesity epidemic.

Unfortunately, as anyone who has tried this knows, maintaining a significant degree of weight loss requires daily dedication, motivation and a limitless supply of will power - nothing short of developing a compulsive obsession.

As readers will recall, the biology of the post-weight loss state is nothing like the biology of someone who has never lost weight. There are countless ways in which the psychoneurobiology, energy physiology and metabolism in anyone who has lost weight are remarkably different from someone ‘naturally’ of that weight.

Simply stated, someone who was 150 lbs and has lost 20 lbs cannot hope to maintain that weight loss by simply eating the same amount of food or doing the same amount of exercise as someone who is ‘naturally’ a 130 lbs.

The 150 lbs person who has lost 20 lbs, to maintain their new 130 lbs, has to actually now live like someone who is ‘naturally’ a 110 lbs; just eating like someone who is 130 lbs but has never lost weight, will simply result in rapid weight regain.

This is why just cutting out a few ‘extra’ calories or walking a few ‘extra’ steps is not an effective or sustainable strategy for maintaining weight loss - for any clinically meaningful weight loss (when indicated) - we are looking at cutting hundreds of calories from the diet and adding hours of serious exercise per week - forever!

A comprehensive and fascinating overview of the fundamental changes that occur with weight loss to ultimately make sustaining this new weight an ongoing challenge, is discussed by Paul Maclean and colleagues from the University of Denver Colorado, in a paper just published in the American Journal of Physiology.

The authors provide a detailed synthesis of data from a wide range of weight loss studies that include studies in clinically overweight and obese adults, in diet-induced, polygenic animal models of obesity, and with dietary (non-surgical) interventions involving an energy restricted low fat diet.

The consistent finding from all such studies is that all individuals or animals in a post-weight-loss state face considerable ‘homeostatic pressure’ that aims to drive their weight back to initial levels.

The paper extensively discusses how changes in biological signals of fat stores (e.g. leptin) elicit profound metabolic and behavioral adaptations.

The key findings of increased hunger and appetite, reduced satiety and substantially increased ‘fuel efficiency’ have very real underlying biological drivers - drivers powerful enough to ultimately wear down even the most persistent dieter.

As the authors point out - persistent dieting is so difficult because it requires maintaining a remarkably large ‘energy gap’:

“Because both sides of the energy balance equation are affected after weight loss, the biological pressure to gain weight is a consequence of both increased appetite and suppressed energy expenditure.

During weight maintenance after weight loss, this energy gap reflects the magnitude of the daily burden that thwarts cognitive efforts to maintain the reduced weight.

Regardless of which side of the energy balance equation is most affected, the energy gap imparts a substantial pressure to eat in excess of the energy requirements.

The magnitude of the energy gap is greatest at the nadir weight after weight loss. Likewise, this energy gap does not dissipate with time in weight maintenance. Rather, studies in DIO (diet induced obesity) models indicate that the magnitude of the energy gap gradually increases the longer they maintain their reduced weight with an energy restricted diet .

The implications from these observations are that the biological pressures may strengthen with time and the amount of lost weight, gradually increasing their perceived influence.”

The paper also extensively discusses some of the lesser known metabolic adaptations to weight loss including profound changes in gut biology that enhance caloric extraction from food as well as alterations in liver function, skeletal muscle and fat tissue that promote weight regain.

While all of this may seem hopeless to readers, the authors actually end on the rather positive note that:

“… only by acknowledging that these homeostatic pressures emerge, we can proactively develop and implement regain prevention strategies to counter their influence. To ensure success, the regain prevention strategies will likely need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter.”

Obviously, it is also important to note, that no ‘weight-loss strategy” actually addresses the many complex reasons why people may gain weight in the first place.

Whoever said that treating obesity was simply a matter of ‘eating less and moving more’ (ELMM) probably also believes that they can live forever by simply breathing less.

AMS
Burlington, Ontario
Maclean PS, Bergouignan A, Cornier MA, & Jackman MR (2011). Biology’s Response to Dieting: the Impetus for Weight Regain. American journal of physiology. Regulatory, integrative and comparative physiology PMID: 21677272

Dr. Sharma’s Obesity Notes
Dr Arya Sharma, M.D.  -   www.drsharma.ca

 I, personally, have proven that it is possible to achieve a large weight-loss and to maintain the majority of that loss for at least  7 years.  However,  it is true that ... for me... this has required  "daily dedication, motivation and a limitless supply of will power - nothing short of developing a compulsive obsession".  I've also found it true that in order to achieve the maintenance of normal weight, my "regain prevention strategies" have had to be very "comprehensive, persistent, and redundant".

I have found weight-loss to be difficult, and maintenance of that weight-loss to be even more difficult.  Nevertheless, for me personally, I find this to be worthwhile, and I intend to continue on with my maintenance efforts.  And, I'm going to do my best to make my continued and consistent efforts as enjoyable as possible.

Sometimes, here on DietHobby,  
I choose to share videos that I find personally amusing.

Here's an "infomercial"  that is twisted, horrifically offensive, totally inappropriate,
............. and yet hilarious.

It made me laugh, and maybe that's good enough for today.
If you aren't easily offended, and want a chuckle,
click to expand this article and watch the video "Naptime"  just below.

  
In general, today’s society seems to think that Running, or Athleticism is a positive goal for everyone. This opinion tends to support its prejudice against obesity in general. Sometimes I am amazed at the depth of such prejudice, along with the overwhelming acceptance of the biased misinformation that accompanies it.

Many obese people are quite healthy, and they live active, functional, and fulfilling lives. An Obese person is not necessarily an Unhealthy person, and being obese is not a direct cause of either disease or ill-health.

Even though there are many studies that have found that any correlation between being Obese and being Unhealthy is merely an ASSOCIATION, many people, including those in the medical profession, wrongly believe that the mere state of being Obese is Unhealthy and that being Obese is the CAUSE of disease. Nowadays, there are even people who say it obesity causes diseases which no one has discovered either the cause or the cure… such as Cancer and Alzheimers.

I am in agreement with this recent article by Dr. David Katz which is quoted below:

I have now been interviewed several times about those Nike "find your greatness" ads we all saw during the Olympics,… in particular, about the ad that shows an obese boy running down a dirt road.

Personally, I think Nike may have meant well, but went down the wrong road.

We may reasonably commend Nike for good intentions. Of course, an athletic-ware company implying that we can all find greatness, but should do so along a course through some kind of athletic activity -- for which they, presumably, stand prepared to provide wardrobe and accessories -- may not be the purest form of altruism we've ever seen. Still, let's give Nike the benefit of that doubt, and say thank you for the concept.

For the execution, not so much.

The ad in question, suggesting that this obese boy is pursuing greatness as he runs down the road -- is presumably intended to remedy obesity bias. But it seems to me it may be propagating it. Obesity is not a barrier to greatness of many varieties. But it certainly is a barrier to great distance running.

I am concerned that the ad suggests that something for which obesity is a genuine barrier -- athletic prowess -- is what greatness is all about. This, of course, is near-sighted nonsense. I don't know for sure, but I bet Sir Isaac Newton did a truly lousy butterfly. I can't see Mother Teresa in the synchronized swim. And I bet Mozart wasn't much of a hurdler.

The boy in the ad, Nathan, made running look every bit as wretched as David Rudisha and Mo Farah made it look inspiring. If we pretend we saw greatness, or even the potential for it, in this ad, we may be buying into Nike's version of the Emperor's New Clothes.

The message that obesity is no barrier to greatness is both a good and important message. But did this poor boy running, looking like he was about to pass out or throw up (as, apparently, he actually did during filming) -- look like greatness to you? It looked like torture to me.

Even as we are trying to escape our cultural biases, they are in fact asserting themselves. Why does greatness need to be about running, or even athleticism? Why show that obesity is NOT a barrier to greatness, by picking a form of greatness to which obesity is clearly and objectively a barrier? As my friend and colleague Steve Blair points out routinely, fitness and fatness can of course go together. But severe obesity, as in this case, and distance running clearly do not.

In fact, as a physician, I would advise this young man AGAINST running until after he had lost considerable weight by lower-impact means, far less hazardous to his joints, connective tissues, and even cardiovascular system. The running this boy was doing looked not only horribly unpleasant, but also potentially dangerous, and ill-advised.

There are innumerable alternative roads to greatness. Perhaps this boy is a great writer, a great humanitarian. Perhaps he is the kindest person you could ever meet. Perhaps he is an orator, a singer, a musician, a composer, a poet, a painter, a chess master. There are countless ways this boy might be great -- and obesity would not be a barrier to any of them.

The ad could have shown a boy we were inclined to judge based on his appearance sitting down at a piano bench -- and stunning us with his virtuosity. That would have rocked our bias back on its heels and shown us, without muddling the message, that obesity and greatness can travel the same road.

If Nike wants to promote physical activity, per se, that's fine -- but that's not about greatness. Then the message is: Anyone can be active, and everyone can benefit from it (a message with which I agree wholeheartedly). Start small, do what you can do, and build from there. The message is that anyone can get to better health, and everyone deserves to do so. But health is not "greatness." And implying that doing anything at even a nominal level is "greatness" demeans what most of us want the term "greatness" to mean.

It might even suggest a double standard. To be a "great" runner if you are lean, you have to be actually great; to be a great runner if you are obese, you merely need to survive until the cameras stop rolling. I don't buy it.

Such a double standard propagates, rather than redresses, obesity bias by failing to look past Nathan's weight to all of the ways in which he might be truly great. Weight does not measure human worth. It is not an indicator of character. Bathroom scales are not designed to weigh merit. The boy in the Nike ad may well be full to the brim with greatness -- but none of it has anything to do with running.

Obesity is not a barrier to greatness. It is not a barometer of worth. But it does tend to impede running down a road, and often, achieving greatness in athletics per se. Pretending otherwise is about denying our biases, not fixing them.

Nike was right to suggest that we can all seek greatness, and that neither weight nor physical disabilities need preclude that. They were right to suggest that the boy in their ad could find greatness -- now or in the future. 

                                                        Dr. David L. Katz
                             www.davidkatzmd.com   www.turnthetidefoundation.org

                    
Everyone doesn’t need to be an athlete.
Everyone doesn’t need to be normal weight.
Those goals aren’t a necessary part of a fulfilling, or even a healthy, life.

I had an active, fulfilling, and healthy life when I was morbidly obese, and I have one now at normal weight. I like being normal weight, and I hated being fat, but this is primarily due to my own vanity. I love looking at myself in the mirror now, but (truthfully) I was fairly fond of doing that before...Now I just look at my whole body, instead of merely isolated parts of me.

My goal ... NOT to be obese .... was one that I set for myself in childhood, no doubt due to the social influences around  me. I'm very happy to have accomplished it, and I'm willing to continue expending a great deal of effort to sustain that goal.  I didn't lose weight to be "healthy".  My life experiences have caused me to internalize society's bias toward non-obesity, which means that I see myself as more attractive at normal weight. 

For whatever reason, it's important to me personally, but everyone doesn't have to share the same goals. The main reason that I’ve always worked so hard to avoid obesity, and to be a normal weight, is because … in general… society treats me better at normal weight. Because I no longer look obese, ...... strangers, acquaintances, and the people who don’t love me, tend to give me far more positive …rather than negative…attention. 

The people who love me are happy to see me be a normal weight. But, when I was fat, the people who love me treated me just as well as they do now. That is something that lets me know that they love me. I believe that people who truly love me will accept my appearance as I am, whether fat or thin, whether young or old..

I was healthy when I was fat, and I’m healthy now that I’m normal weight. It’s a matter of genetic luck. My genetic heritage gave me a body with the tendency to be fat, AND my genetic heritage also gave me a healthy body.

   I believe that one of the reasons I still have a healthy body here in my late 60s is because I did not abuse it with excessive exercise during the years when I was obese. I feel sad when I see those television “reality” shows that encourage fat people to engage in physical activities that are clearly inappropriate for their morbidly obese bodies. People who abuse their bodies with excess food don’t need to also abuse them with excess exercise. It's just two abuses. One abuse doesn't cancel out the other.

Watch the video below to be reminded of one of life's great lessons.