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During the this past 12 years of my weight-loss maintenance, I’ve been collecting data about my food and weight. This provides me with a great deal of personal information, and that data tells me that … over the years … my weight is continuing to creep upward, even though I keep reducing my calorie intake.

I find this fact very annoying, as well as perplexing.

Until I was faced with this personal information, I believed what our Culture teaches:  “If Fat people cut back on their food intake enough to reach a “normal” weight, their bodies will become like the bodies of “normal” people. To maintain that weight loss, they need to eat more than they did to lose the weight, but not go back to eating as they did previously: in a gluttonous manner.”

Essentially, I thought that you diet down to your goal weight number; cross the finish line; and from that time on you will maintain your weight-loss by eating like normally thin people do.

This is NOT what has been happening for ME. So, I began wondering why? What’s going on?

I spent a lot of time studying books, and articles, and research about this issue, and learned that as a “reduced obese” person, what has been happening to ME, personally, seems to fall within the theories of Set Point, and Biological Adaptation. 

My History

I’ve spent my lifetime dieting, from my youth into my old age. I’ve lost, and regained, hundreds of pounds of fat.  About 25 years ago, at age 48, I had an open RNY gastric bypass surgery, which - at the time - was still considered experimental.  This forced me to eat in a way that dropped my BMI from a 52.9 BMI = Stage 4 - Super-obese, down to a  31.4 BMI = Stage 1 - just over the border of obese.  After a few years I began actively dieting again in order to avoid a rapid regain.

About 13 years ago, around age 60, I was back up to a 38 BMI = Stage 2 -Severe obesity. I began logging my food and daily weight into a computer software diet program.  I begun losing weight, and about 16 months later, in January 2006, I reached my goal of a 22.5 BMI = in the middle of the "Normal" weight range.

During the 12 years since that time, now almost age 73, I’ve continued using a computer program to log my food and daily weight.  As a result of that effort, I’ve maintained my weight at-or-near a BMI range of “normal”. I now also have 13 years of records showing my personal daily food and weight data.

1993 Weight-Loss 

About 25 years ago, I actually experienced an open RNY Gastric Bypass surgery, after which I ate tiny amounts for many months,.... estimated amount is from 300 to 600 calories daily. “Cheating on that diet" was physically impossible for me.

The calculations in this chart demonstrate that one could reasonably assume that during that 30 week period in 1993, my body’s estimated average daily calorie burn was somewhere around 2100 calories.

2005 Weight-Loss

About 13 years ago, I dieted from 190 down to 120 lbs over a 67 week period. At that time all of my daily food was logged into a computer program, which demonstrated that my daily average calorie intake was 1224.

The calculations in this chart demonstrate that one could reasonably assume that during that 67 week period in late 2004 & 2005, my body’s estimated average daily calorie burn was somewhere around 1746 calories.

12 Years of Maintenance of Weight-Loss

Here’s a chart of my past 12 years in Maintenance.  It shows my total daily calorie amount for an entire individual year, averaged out.  It also shows my total daily weight amount for an entire individual year, averaged out.  It also includes the lowest recorded weight for each individual year.

One would expect that my average yearly weights, and my average calorie intakes would be directly proportional, in that as my average calorie intake decreases, my average weight would also decrease.  Instead it appears that those values are inversely proportional: while my calorie intake has been decreasing, my weight has been increasing.



Even with my detailed records, my exact current total calorie burn still involves a lot of guesswork, but at this point, it appears to be somewhere around 25%-or-more Below the Average BMR for a female my same age, size, and activity level.  Since I am a small, inactive, elderly female, that is a Very Small amount of food. Frankly, eating little enough for maintenance is quite hard to do, and I’ve been finding additional Weight-Loss to be nearly impossible.

To provide perspective:
 BMR (basic metabolic rate - without activity) according to Mifflin formula,
       1058 calories for an AVERAGE 60 year old female, weighing 125 lbs
       1008 calories  for an AVERAGE 70 year old female, weighing 125 lbs

Calorie Error

When looking at these ongoing calorie numbers, the first thing that comes to mind is unintentional calorie error. 

An important relevant fact is that these foods and amounts eaten were recorded at the time they were eaten, therefore the calorie counts provided are not based on inexact memories.

Calorie counting is never an exact science, and at the low calorie numbers required by my metabolic rate, an unwitting daily 10 to 20 percent error could account for a 100 to 150 calorie deviation from the actual amount.

However, another important relevant fact to recognize is that during all of these past 13 years I weighed and measured and recorded my foods in the same way.  Therefore, any inadvertent calorie error due to my methods of measuring and counting would have been consistent over time so it is unlikely to account for the calorie average deviations shown over time. 


Correlation is Not Causation

The common Scientific Belief is that that weight-loss is caused by a calorie deficit, and weight-gain is caused by a calorie surplus.  I feel certain that this is true.

Facts:

• It is a fact that I was previously morbidly obese, and that I lost down to a normal weight.
   
• It is a fact that my weight has been going up during my past 12 years of maintenance.
  
  
• It is a fact that the calories of my food intake has been going down during my past 12 years of maintenance.
  
  
• It is a fact that I am older now than I was when I originally lost the weight.
  
  
• It is a fact that I am less active now than I was when I originally lost the weight.
  
  
• It is a fact that during the past 4 years my recorded calorie intake has been less than the BMR calories for an AVERAGE 70 year old 125 lb female.
  

Correlation is not causation. Each of the above mentioned facts are variables, and there appears to be a correlation between these variables, however, this does not automatically mean that the change of one variable is the cause of the change in another variable.  Causation indicates that one event is the RESULT of the occurrence of the other event. .. That one thing CAUSES the other.

I am able to REPORT here what I’ve seen happening with my body, but I am not able to actually KNOW what is causing this to happen. I’ve thought about this issue a great deal, and I’ve done as much research on the issue as has been possible for me. This has led me toward certain general opinions and beliefs about the subject, but I have no True and Ultimate Answer to what, for ME, is a genuine personal problem.  I also have no Ultimate Answer for other people who appear to have a similar problem.

There are many articles here at DietHobby about me and my own weight and calorie History. See:


    ⁃    ABOUT ME. 

    ⁃    How Fast…How Much…Weight Lost After Gastric Bypass?

    ⁃    BLOG CATEGORIES, Status Updates.


Here at DietHobby I’ve posted a great many articles on the difficulties of long-term weight loss and the subject of Biological Adaptation. Most of them are located in the section BLOG CATEGORIES, Research - Science.   

Below are several links to some articles on the subject that I’ve found especially helpful.


    ⁃    Running down the Up Escalator

    ⁃    Set Point

    ⁃    Our Weight is Regulated by Our Biological System

    ⁃    Happily Ever After & Neuroscience

    ⁃    The Secret Life of Fat - Book Review

    ⁃    Body of Truth - Book Review

    ⁃    Biological Adaptations that Promote Weight Regain

    ⁃    Long-Term Weight-Loss Almost Impossible


The following statements by obesity specialist, Dr. Freedhoff  M.D. make a great deal of sense to me.
 
He says that:

Physiologically, Plateaus don't exist. Unless it's a temporary trick of the scale, . . . if you're not losing, either you're burning fewer calories than you think; you're eating more than you think; or some combination thereof. 


There's no Plateau, but there IS such a thing as a "FLOOR". If you've truly stopped losing weight, there are really only two questions you need to ask yourself.

    1.    Could I happily eat any less?
    2.    Could I happily exercise any more?

If the answer is "yes" then you can tighten things up, but If the answer to both is "no", there's nothing left for you to do. 

This is because if you can't happily eat any less and you can't happily exercise any more -- then it's unlikely that this will ever become part of your permanent behavior. 
 

Here is my ongoing personal solution to the problem addressed in this article.
Work to ACCEPT the reality of the situation while, at the same time, do my best to FOLLOW THROUGH WITH DOING THE INDICATED THINGS which are required for long-term maintenance of my large weight loss.

It is what it is.

The Secret Life of Fat, the Science Behind the Body’s Least Understood Organ and What it Means for You,  by Sylvia Tara, PhD (2017)

This book brings cutting-edge research together with historical perspectives to reveal fat's true identity: an endocrine organ that is critical to our health.

The Secret Life of Fat is not a diet book.  It’s a book about how fat works, about understanding body fat - specifically, its role, why it is so difficult to fight, and how it works differently for different people.

Beginning with the question “Why is it easier for some people to stay thin than others?”  Biochemist, Sylvia Tara, investigates the biology of fat and its vital purposes in the body, from reproduction to immunity. Then she examines the genetic, dietary, and other types of influences on body fat. 

She states:

“Fat enhances our brain size, strengthens our bones and immune system, helps wound healing, and can even prolong our lives.”

“Through its most powerful messenger, leptin, fat can influence our appetites. 

It can cause our muscles to reduce their energy usage. 

It can alter our sympathetic nervous system, and control the flow of hormones such as thyroid, adrenaline, and noradrenaline. 

Most profoundly, it can influence our thoughts and elicit stronger responses to food, lower our inhibition to eating, and cause us to misjudge how much we’ve eaten. 

Fat, it turns out, is capable of mind control !”

“Once we swallow food we each process it differently.  Science has shown us that food affects our hormones, and hormones affect our fat.  Insulin, leptin, ghrelin, adiponectin, estrogen, testosterone, thyroid, and other hormones influence our weight.”

Biology explains why it’s so hard to keep off the weight once you’ve lost it: People who are at a particular weight because of dieting, metabolize food differently than people who are at that same weight naturally. “Somehow, the remaining body fat of the reduced-obese,” Tara writes, manages “to survive on fewer calories than before, as though it had found another means to thrive.”

After discussing the scientific nature of fat, Tara describes her own weight struggles, and recommends persistence as the main tool for dieters, combined with any diet that is “customized for you biologically, psychologically, and socially”.

Once fat cells reach a certain size -- that is, they become filled to capacity with fat content -- then new fat cells will begin to form.  The fat cell number and size increases and shrinks based on deposits from food intake.
“We have a seemingly infinite capacity to recruit new fat cells, but we cannot get rid of them once they have been recruited" said Michael Rosenbaum, associate professor of clinical pediatrics and medicine at Columbia University. "in most cases, weight gain initially reflects ... enlargement of existing fat cells followed by an increased growth of new fat cells.”

Research has shown that obese people who have weight loss surgery have just as many fat cells two years after the surgery as before it, even though they have become much thinner.

Scientist, Dr. Rudy Leibel, says that "the body controls the number of its fat cells as carefully as it controls the amount of its fat". Fat cells die and new ones are born throughout life. Scientists have found that fat cells live for only about seven years and that every time a fat cell dies, another is formed to take its place.

Below see a 2017 New York Times article about this matter.

Are Fat Cells Forever?
              By Alice Callahan  
       February 17, 2017 - New York Times

Once fat cells are formed, can you ever get rid of them?

The number of fat cells in a person’s body seems to be able to change in only one direction: up. Fat cell number increases through childhood and adolescence and generally stabilizes in adulthood.

But this doesn’t mean that fat cells, or adipocytes, are stagnant. The size of individual fat cells is remarkably variable, expanding and contracting with weight gain or weight loss. And as with most cell types in the body, adipocytes die eventually.

“when old ones die, they are replaced by new fat cells,” said Dr. Michael Jensen, an endocrinologist and obesity researcher at the Mayo Clinic. Cell death and production appear to be tightly coupled, so although about 10 percent of adipocytes die each year, they’re replaced at the same rate.

Even among bariatric surgery patients, who can lose massive amounts of weight, the number of fat cells tends to remain the same, although the cells shrink in size, studies show.

Liposuction reduces the number of fat cells in a person’s body, but studies show the weight lost is typically regained within a year. It isn’t known whether this regain occurs through the production of new fat cells or expansion of existing ones.

People who are obese tend to have more fat cells than those who are not, and several studies have found an increase in fat cell number with weight regain following weight loss.

"The fact that fat cell number can be increased but not decreased most likely contributes to the body’s drive to regain weight after weight loss", said Dr. Kirsty L. Spalding, a cell biologist at the Karolinska Institute in Sweden and the lead author of a 2008 study showing that fat cells die and are replaced. Beyond their role in storing fat, adipocytes secrete proteins and hormones that affect energy metabolism.

“Following weight loss, adipocytes become smaller, generally smaller than those from people with a similar B.M.I.,” Dr. Spalding said. One hypothesis is that those smaller cells might send signals to increase appetite and fat storage, which could help to explain why weight loss is so difficult to maintain, though much more research is needed.