trying to stay on track and finding some great questions along the way

Fourteen months ago I started a serious weight loss program that successfully transitioned into a weight maintenance program about three months ago.  Along with the weight loss and the associated benefits and problems that come with that, many questions presented themselves and finding answers and new questions has been a rich experience.

 

Some of the high points have been learning that, at least for me, losing the weight was much easier than maintaining it.  It turns out this is generally true and most diets end in failure.  Specialists in the field are not joking when they say “the best way to gain weight is to go on a diet.”  Why this is happens to be a rich area of academic study.  The general explanation most people use is the body needs less energy due to less weight to support, lower muscle mass, and a shifted metabolism.  But why does the urge to eat more than what the body needs at its new weight exist?  Is this relate to “plateauing” in weight loss?  What are the biochemical signaling links?  Why is this predominately unidirectional (why is it that underweight people are usually more successful gaining and keeping weight)? How much of this is genetic?  How much is epigenetic? ...

 

Curiously the exact energy available to us in food is only approximate.  Calorie charts must be viewed with a bit of skepticism, but they are still essential for tracking and it isn't terribly important that their listing may not match what your body is really doing - especially when what you eat doesn't dramatically shift.  You can learn to deal with the bias.  The same is true - but even more so - for exercise.  You can infer some of these relationships and adjust your calculations, like the Caloric calculations, with a weighting coefficient.  If you aren't into this sort of detail just adjust your intake downwards and/or increase your exercise if you are slowly gaining with time.

 

There are a pile of open questions and research is only beginning to probe some of them. Of course a magic bullet would be worth billions to the drug companies and many of them have tried to crack the problem with no luck.  The diet business is filled with pseudoscience and terrible nutrition advice.  Some of it may be good, some is neutral but doesn’t cause harm, and some of it is downright dangerous.  The best paths - and the best segments of the population - for dealing with the epidemic of obesity still are unclear, although prevention is probably the cheapest and most effective option at this point.

 

The fundamentals of controlling weight for someone who has never been overweight are well known, but the current level of inactivity coupled with the easy availability of low quality good make this difficult.  You would think children are important and in need of protection, but there are no signs they are well protected from this epidemic which seems to be lowering projected adult life spans in many countries.

 

In theory it is easy - eat good food, but don’t overeat, and get enough exercise.  Sadly that is impossible for the majority of the population.  

 

I’ve been overweight so I have to fight signals that my body is sending to return to a higher weight.  This means I have to monitor my activity and food intake.  Doing this isn’t too difficult with a little software assist as well as exercise coaching from a friend - basically I’m using techniques similar to those I used to lose weight, but with a different target on my daily energy balance. There are indications that the best techniques for losing weight and maintenance are somewhat different.¹  I keep a daily journal, but don’t worry about being a few hundred Calories over target here and there as long as I can cancel that excess from other days - I try to have a weekly balance where  my energy intake minus my energy expenditure are equal to my energy need.  Setting goals and giving myself rewards also seems to work for me.

 

To help with self-motivation I’m going to post the last nine months of my weight chart every few months.  It will be embarrassing to record a gain.  For background my doctor suggests the ideal weight given my height, age and bone structure is somewhere around 155 pound - conveniently close to the 70 kg assumption for a standard human used in many medical calculations.  He initially asked me to drop to something under 170.  

 

There could be some tools to make this easier and I’ll probably write one for my specific case.  I found it important to understand my regular daily energy requirement without extra exercise and had to extract that from my daily logs.  The number I come up with is about five percent lower than the standard medical calculations suggest and are probably related to a shifted metabolism.  Very interesting stuff!

 

Currently I’m experimenting on when I should be eating to feel most satiated. Earlier experimenting showed that taking my time to eat was important - one must learn to savor food, which has a real benefit of encouraging you to learn to become a better cook.  I suspect this is unlikely to generalize, but it is clearly useful for me if I’m to get to a point where I don’t have to monitor as much as I do.  In talking with some experts at Yale and the University of Toronto I’m coming to the realization that people who are successful in holding a proper weight after a significant weight loss (over 10% of their weight) need to be vigilant for at least a decade and possibly much longer before the body readjusts.

 

In the meantime I’ve learned that one needs to have quality food and real treats at times - as long as you don’t overdo it.  So there is no reason why you can’t make some delicious things. I can recommend Talenti gelato for example:-)

 

So apologies for something this personal and narrowly focused, but I suspect some of you have this issue or have family members who are trying to get to and maintain a healthy weight.  If so I strongly recommend using it as a learning experience and be able to sort out all of the snake oil.²  Informed common sense is very important in this game.  Just remember - losing weight isn’t easy, but is much easier than keeping it off.

________

¹ My physician was very impressed with the success of my weight loss program.  The core learnings I had were I needed exercise and Caloric restriction - neither was sufficient by itself, although food restriction is much easier than enough exercise. A nonjudgmental exercise coach was very important.  I would not have had the motivation without her help.  Support from family and friends was also very important.  Being a vegetarian probably helps as does cooking most of your own food.  Weight has to come off slowly - nothing faster than 3%  month or you will probably fail.  And finally you have to let yourself eat healthy and delicious food - it isn't worth the effort if you are eating cardboard.

Note there is evidence long term success in keeping weight off is different from weight loss - here is an interesting resource. (pdf)

Then they looked for patterns among what successful losers do and patterns among what successful maintainers do. And they found significant differences. For example, people who exercised consistently or ate plenty of lean protein were almost twice as likely to succeed in weight maintenance. People who engaged in a variety of exercise activities or planned their meals ahead were about two and a half times as likely to lose weight.

For losers, the most statistically significant behaviors:

• Eating a lot of fruits or vegetables
• Eating healthy snacks
• Limiting the amount of carbohydrates eaten
• Controlling portions
• Doing different exercise types

For maintainers, the most statistically significant successful:

• Eating a lot of low-fat protein
• Following a consistent exercise routine
• Reminding yourself of the need of controlling weight

There was only one behavior highly significant among both losers and maintainers:

• Thinking about how much progress you’ve made

From the study 14 behaviors were associated with either loss or maintenance but not both.

More important for loss than for maintenance:

• Participate in a weight loss program
• Look for information about weight loss, nutrition, or exercise
• Eat healthy snacks
• Limit sugar
• Plan your meals and snacks ahead of time
• Avoid skipping meals - especially breakfast
• Do variety of exercise types
• Do exercises you enjoy
• Think about how much better you feel when you are thinner

More important for maintenance than for loss:

• Eat a lot of low-fat high protein foods
• Follow a consistent exercise routine
• Reward yourself for maintaining your weight
• Remind yourself why you need to control your weight
• Journal what you eat and how much you exercise

A rich source of scientific work in this area is the open access Journal of Obesity.

 

² The pseudoscience associated with the diet and nutrition industry is awful. It turns out weight loss isn't difficult using any number of techniques, but few are effective in the long term and some are unsafe. ping me if you ever want more information..