
After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight - yanowitz
http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html
======
kefka
Well, I'd say that the endocrine reason sounds like a valid one. I can at
least be counted in that group.

Last December, I was diagnosed with T2 diabetes. After talking with a
researcher about this (have worked with diabetes research school locally due
to job), I came across a few things:

1\. Damage is done to the pancreas at 140mg/dL 2\. Too long at 140mg/dL or
above can cause permanent damage to the pancreas. 3\. Early estimates indicate
that 110mg/dL is a lower limit of beginning damage to the pancreas

Ok. There's a lot of moving parts in food. Nutritionists will tell you all
sorts of bunkum, other than mineral assays and tests have discovered. But
there's a simple way here: keep blood sugar under 140mg/dL, no matter what.

Is that possible? To keep your blood sugar under 140mg/dL? Yes. The answer is
"Don't eat foods that raise your blood sugar above 140mg/dL". That's
interestingly easy. What it amounts to, is cutting out sugars and
carbohydrates out of your diet, and extensively testing when you come across
foods you're unsure of.

My research shows that all the standard sugars are bad for me (Sucrose,
glucose, fructose, lactose). I spike, and then fall. It also depends on what
I'm eating with them. In those cases the rise and fall are longer.

Some complex carbohydrates I can handle. Potatoes are a nope, as are bread
products. But spaghetti squash works with me well. I can handle it nicely,
with a very low rise and fall.

I also end up eating a lot of fats, protein, and veggies. But I don't crave
sugar at all. I've always liked meats, and this gives me the ability to
continue that.

~~~
atria
^ This times 1000000. There is so much chicanery and malfeasance in the
nutrition and fitness industry.

I was diagnosed with T2 diabetes a few years ago. I went to dietitian who
prescribed a diet with 60% carbs (I believe its roughly the same as the ADA
dietary guidelines). The standard treatment is medication, followed by more
medication, then insulin shots.

Frustrated, I read everything I could get my hands on, and found two books
that I'd highly recommend: 1) Dr. Bernstein's Diabetes Solution, and 2) Think
Like a Pancreas by Gary Scheiner. Dr. Bernstein is notable because he was
diagnosed with T1 when it was a fatal condition. He survived, became an
electrical engineer and ultimately went on to become an MD. He lobbied the AMA
to allow patients to have blood glucose meters, when the AMA wanted them to be
restricted to doctors offices.

I stopped listening to medical practitioners and starting experimenting with
the foods I ate, using pairs testing with a glucose monitor. There is no
question that a low carb diet is the way to go.

~~~
AnthonyMouse
> I stopped listening to medical practitioners and starting experimenting with
> the foods I ate, using pairs testing with a glucose monitor.

I sometimes wonder if the state of medical ethics is killing us. We've made it
so expensive to do a medical study that nobody is going to do it unless the
end result is something they can sell, so the only "solutions" we get are
drugs because there is no money to be made in prescribing diabetics a diet of
fish and vegetables.

It's a sad state if an individual can learn more by experimenting on
themselves than their doctor knows because the doctor isn't allowed to
participate in or publish the result of the same experiment without a multi-
million dollar budget.

~~~
burkaman
Aren't there tons of studies on whether some particular food is good for the
heart, good for the brain, etc.? It's not that nobody does them, it's just
really hard to get a conclusive result that applies to everyone. There are
lots of foods that are both good and bad for you, depending on the study.

I think the problem might be more that there aren't very many universal
results, and the fish and vegetables diet that works for one person won't work
for others.

~~~
dragonwriter
> Aren't there tons of studies on whether some particular food is good for the
> heart, good for the brain, etc.?

Not really. There's tons of studies on whether some particular food is
connected to some very narrow positive or negative outcome for the heart,
brain, etc., on which popular ideas about the food being _generally_ good for
the heart, brain, etc. are built. (And, from those, even flimsier popular
ideas about the food being _generally healthy_ or not.)

------
sageabilly
The results of this study, while interesting, seem flawed to me because losing
200+lbs in only 8 months' time is ridiculously fast. I would be more
interested in a study following people who lost weight very slowly and
steadily over time, and curious about their metabolisms and recidivism rates.

I've lost 100lbs over the last three years and have had zero issue (so far,
not saying I won't ever) with keeping at this weight. I maintained the same
weight, +/\- 3lbs, for most of 2015 without counting calories or following a
diet. In December 2015, I decided I was ready to start intentionally losing
more weight, so I tracked calories and lost an additional 15lbs over the
course of three months. My experience with losing weight and maintaining
weight loss are completely different than the results of the study in the OP,
and I am curious how much of that difference can be chalked up to how long it
took me to lose that weight.

Studies like the one in the OP are fascinating to me because no one seems to
go "Hey, your body achieved homeostasis at 450lbs (maintaining that
homeostasis for however many years the person was at that weight) and it
probably royally screwed with everything dropping half your body weight in 8
month's time." It seems obvious to me that at that point the body is in full
blown crisis mode trying to get back to the homeostasis it had developed
previously. Eight months is not a long enough time to adapt to a new
homeostasis, not to mention whether or not the body is freaking out because
it's "starving" and dropping fat stores at such a high rate.

~~~
wobbleblob
Maybe there's something different about the metabolism of people who manage to
reach a weight of 450lbs in the first place. Without exercise and watching
what you eat, almost everyone will gain weight, but most people never get
anywhere close to the 300lbs+ range.

~~~
sageabilly
Maybe! I was 305 at my heaviest, but I was also a serious powerlifter and was
at the gym 10-15 hours a week lifting, plus training for competitions. I often
wonder if having that strength base made it easier, in some ways, to drop the
weight than if I had been totally sedentary and had to start from zero with
regards to exercising.

~~~
xlm1717
Having a lot of muscle will increase your base metabolic rate. Being a serious
powerlifter, I imagine the increase due to muscle was significant (speaking
just as someone who reads into this, not as a qualified professional!). Also,
being a powerlifter, if you don't maintain the muscles, they would atrophy,
taking a lot of weight with them.

~~~
sageabilly
Interestingly enough, I stopped powerlifting about a year ago and the atrophy
hasn't happened as quickly or as much as I thought it would. Now, I say that
with the caveat that I have NO idea how big my muscles were when I was at my
strongest (which is also when I was 300 pounds), but I still have 25+ pounds
of muscle that I didn't have the last time I was the size I am now
(scientifically deduced from being able to fit into the same pair of pants
that I did when I was 180lbs, when I am now 205lbs). I currently have a knee
injury that's keeping me from doing any lower body lifts, and am only doing
upper body bodybuilding style stuff twice a week. I'm absolutely not as strong
as I used to be, but I'm still muscular... although, again, don't know how
much of that is a hold-over from my powerlifting heyday because at the time I
was like a muscular manatee... couldn't see the muscles for all the blubber on
top.

[edit] 5'11", about 1.80 meters

~~~
thirdstation
How tall are you?

------
vinceguidry
I managed to lose 40 pounds last year, using intermittent fasting. That
impressed people, but what's impressed me is how easy it was to keep it off. I
expected to have to do a lot more work than I have, I really seemed to have
found a new 'set point', where I can simply let my body self-regulate eating
and I won't gain weight. Sometimes it even goes down.

I think a person's state of mind plays a huge role. I used IF because it
seemed the easiest way to incorporate a sustained caloric deficit into my
lifestyle. The knob of "how many times a day I'm eating" was far easier to
tweak than "what I'm eating" or "how much I eat when I'm eating." I'm just
really fucking lazy and found that over time, skipping meals works with my
laziness.

With IF, I can eat what I want, as much as I want, just only once a day. I
used to be really strict about once a day, now I'll have a snack here and
there, sometimes I'll even have what amounts to a light meal outside of my
main one. Getting adjusted was a pain, but I'd alleviate it by eating small
amounts outside of the 'window' and trust that I'd cheat less over time. Which
I more or less did.

Ultimately I feel it's not really worth it to try to fight your body too hard.
If your system perceives a shock, it will defend itself. But humans seem hard-
wired for big, dramatic gestures, and so they'll do grievous damage to their
metabolic systems like crash dieting simply because they can't trust
themselves to maintain a safer, more sustainable course of action like simply
"eating less and exercising more." I think a lot of people think of the idea
of "sustained lifestyle change" and balk. Like they can never eat ice cream
again or something.

~~~
humbleMouse
I think the message here is to listen to your body. Too often one finds
themselves eating just because they were invited to lunch, or even because
they are bored. If you listen to your body and just eat when you are hungry,
magical things will happen.

~~~
CaptSpify
Although this may work for some people, it definitely won't work for me, and
many others. I constantly get "cravings" which, AFAICT, are indistinguishable
from hunger. I have to consciously add up my calories to know if I've been
eating too much. If I was to "listen to my body", I would overeat constantly.

~~~
nsxwolf
Agreed. I never eat when I'm not hungry. I can't imagine doing that. I'd
suspect a real eating disorder if I were forcing myself to eat.

~~~
tormeh
I think the idea is to not eat because it feels good or because you've got to
finish your meal, but only because you're hungry.

Says I, who just completed my meal even though it was slightly painful....

~~~
nsxwolf
I guess that's the only exception I can think of - I may continue eating at a
restaurant when I'm full because I don't like to waste, and I also don't like
to take things home.

That alone doesn't explain the 40 pounds I need to lose, though.

------
varelse
Extreme diligence seems to be the only way to fight this. If I stop
exercising, the pounds pack on within weeks. If I insure I burn at least 3000
calories a day (usually much more), I can maintain my weight indefinitely. But
I walk to work and I exercise for 1-2 hours daily. Most people cannot or will
not do this.

Add in the extreme carbohydrate and fat-laden diets most readily available to
America and it's a perfect storm for our Wall-E future, no?

When I cook at home, I can avoid this by eating a little bit of
meat/tofu/tempeh/etc with a pile of greens, but restaurant fare is a little
bit of vegetables, a small slab of meat, and a super-size portion of some
fancy grain of the week if not just white rice. Sigh...

~~~
IndianAstronaut
How do you manage the 1 to 2 hours of daily exercise with a programmer
lifestyle(assuming you are a programmer)?

~~~
varelse
I get up from my desk and go to the gym mid-day or I do so at the end of the
work day depending on my flow. Also, I've cut most meetings out of my life,
especially pointless time-eaters like daily scrum.

Also:

1\. No kids

2\. I only watch 4-6 hours of TV per week

3\. I walk to work, there's an extra hour right there at the expense of a
higher rent (totally worth it). Previously, I worked from home

4\. Most of my social life revolves around exercise rather than tech

5\. Don't work for self-destructive managers

TLDR: Find your way to a results-oriented rather than a process-oriented
position.

~~~
ameen
I so want to try this. Any tips and pointers? I'd quit the industry due to
health issues (Obesity, NAFLD, Plantar fasciitis, etc) and would love to
return if I can stay healthy in such a manner

~~~
varelse
While everyone's situation is unique, what's stopping you?

~~~
ameen
Depression I guess, I see most activities as fruitless given countless
attempts to lose weight or strengthen my muscles. I recently met with an
accident that destroyed my only healthy knee (ACL + Meniscus tears). Had an
ACL reconstruction a month ago and for some reason I'm actually hopeful.

I've charted out a diet and a fitness routine and have surprisingly kept up
with the rehabilitation process fairly well. I guess this is one of my last
opportunities to lead a healthy life.

Also, not having a social group to aid in activities could've been an issue I
guess. I'd like to learn the social aspects of sticking to a routine (Gym
buddies, mates who take part in a physical activity, learning some new tech
with a similar group of friends, etc).

------
kazinator
> _A study of Season 8’s contestants has yielded surprising new discoveries
> about the physiology of obesity_

No it didn't. Just another example of junk science.

> _Now burns 800 fewer calories a day than would be expected for a man his
> size._

"Expected for a man of his size" is a fiction. What they are insinuating here
is that the rapid weight loss did long term damage to his metabolism. But to
confirm that, you have to have data on what is burn rate was when he was
previously at his current 295 weight. (Which he must have reached at some
point in his life long before the participation of _Biggest Loser_ , on his
way to becoming 400-something). Comparing to what can be "expected" based on
plugging 295 into some model is not adequate.

Maybe he previously also burned hundreds of calories less than what can be
expected of someone of his weight. Maybe it's been like that most of his life!

~~~
kenjackson
And that may well be why he was heavy to begin with.

------
bmh_ca
There are at least three equilibriums that are apparently of relevance, based
on what I have read. These are:

1\. the hunger cycle - the hormones emitted during hunger

2\. the metabolic cycle - the neuropeptide y's and other such unmemorable
names, near the decision making part of the brain

3\. the hydrocarbon cycle – the hormones emitted as a result of fat cells that
are not flush with hydrocarbons

Diets address number 1. Number 2 and 3 are the more relevant for long-term
success, but not enough is understood about them.

Here's a TED talk with some illumination:

[https://www.ted.com/talks/sandra_aamodt_why_dieting_doesn_t_...](https://www.ted.com/talks/sandra_aamodt_why_dieting_doesn_t_usually_work?language=en)

Research about weight control and loss is further conflated by profit-oriented
companies that derive their primary income from "diet cycles".

That said, the failure of dieting is not new information:
[http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-
UCLA...](http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-
Researchers-7832)

The only known sure way to achieve substantial long-term weight loss is hyper-
diligence in portion control and metabolic stimulation. Few can do it.

One of the unknowns is whether fasting survives long-term trends, such as the
"5-2 fast" [https://thefastdiet.co.uk/](https://thefastdiet.co.uk/)

All to say, the long-term results of the biggest loser accord with the latest
research in weight control and loss.

------
rnovak
Now, here's my opinion, and I know it might be wrong. Anyone, please feel free
to correct me, but:

Everything I've read suggests that 1lb muscle requires about 50 calories a day
to maintain.

The workout programs these contestants are using are focused _solely_ on
cardio, or very heavily focused on cardio.

If _as part of_ the 239lb weight loss, Mr Cahill lost 8lbs-10lbs of muscle
(and never regained it), there's your _entire_ 400-500 calorie difference
right there.

Like I said, I could totally be wrong, but over the last year I lost 93lbs (as
of today), but my measured BMR is actually _higher_ than it should be (and
higher than it was when I started). I attribute that difference to my focus on
lifting weights more than cardio.

~~~
rayiner
Muscle burning 50 calories a day is a myth. Gaining 20 pounds of muscle adds
80-100 calories to your RMR for a typical person:
[http://articles.latimes.com/2011/may/16/health/la-he-
fitness...](http://articles.latimes.com/2011/may/16/health/la-he-fitness-
muscle-myth-20110516).

~~~
itchyouch
Yep. It's muscle recovery that is very calorically expensive. Those who have
lifted or lift can probably attest to that crazy post workout appetite.

------
dempseye
> The difficulty in keeping weight off reflects biology, not a pathological
> lack of willpower affecting two-thirds of the U.S.A.

Fifty years ago, two-thirds of the USA were not obese. Biology has not changed
in that time. What has?

~~~
simonbarker87
Fat cells never go away once you've got them. Fat cells also really don't want
to be empty. When you loose weight the fat is broken up in to H2O and CO2 (you
literally breath and pee fat away) but the fat cell generally holds onto the
water for a while and then, along with a load of other fat cells, will expel
that water in one go(which is why you tend to keep a stable weight for a few
days and then find you've lost 1 or 2 lbs "overnight"). It's called the Woosh
effect I think?

Problem is that the body doesn't want to get rid of that fat cell because
"hey, it might be handy one day to store extra energy when we can't eat for a
few days because the baboons ate everything" and so it's fairly easy to top
that cell back up with fat in the future.

With regards to the slow metabolism refereced in the article (I skimmed it)
this is tied to leptin levels which needs to be topped up with "refeed days"
every now and then just to kick start you metabolism again. A refeed day is
basically a day where you eat a lot of carbs and keep your protein and fat as
they usually are on the normal diet days.

Very broadly speaking (and short cutting lots of science and variations), it
is easier for a previously fat person to get fat again than it is for a skinny
person to get fat in the first place.

~~~
49para
Why is it that fat cells never go away but your muscles will start
catabolizing as soon as you stop drinking protein shakes ?

Are there any studies on this or is it more bro-science ?

~~~
JoeAltmaier
Because, survival. Muscle is expensive - your body wants only enough to
survive. Fat is life - your body wants all the stores it can afford.

~~~
simonbarker87
This, our DNA isn't set up to maximise muscle mass. Big cats however are a
good example of animals that are designed to keep muscle mass on - damn things
can eat once a week, sleep all the time and look like they work out everyday

~~~
49para
Right, I understand the idea.

I just haven't seen any studies on the idea that an empty fat cell will never
be destroyed.

I have seen quotes like "your whole body is reconstructed over a period of
years", i.e. cells have a lifespan, so if your body is reconstructing cells
why would it put resources into rebuilding empty fat storage containers. Or,
the other option would be fat cells are immortal, which seems to be extreme as
well.

Just looking for some actual studies on this ...

~~~
simonbarker87
ah, ok - get what you mean. To be honest I can't point you in the direction of
any studies so any explanation from me would be educated guess work.

Ok, a quick google pulls up this article in the NYTimes referencing a study -
have read the first paragraph or so and article is on the right lines of what
you are after.

[http://www.nytimes.com/2008/05/05/health/research/05fat.html](http://www.nytimes.com/2008/05/05/health/research/05fat.html)

~~~
49para
Thanks for the link, it didn't really satisfy my curiosity though :)

Obviously there are a lot of biochemical triggers for fat storage, muscle
growth etc. Leptin has a very large part to play along with insulin, etc.

If something controls the fat storage levels, it makes sense that they will
grow back after being removed via liposuction, especially if the person
doesn't fundamentally change what / how they are eating. Their insulin
resistance, leptin levels, etc will control this regardless of the actual
surgery implications.

I'd be interested in a longer term study where an obese person undergoes
something like liposuction, then also changes their diet to something more in
line with low carb to fix these insulin and leptin issues and see if those
cells actually regrow.

------
js2
In the other direction, see the documentary "Why Are Thin People Not Fat"
where a group of thin volunteers are overfed by about double their normal
calories for 4 weeks:

[http://news.bbc.co.uk/2/hi/uk_news/magazine/7838668.stm](http://news.bbc.co.uk/2/hi/uk_news/magazine/7838668.stm)

[http://youtu.be/U1hbPXooB1U](http://youtu.be/U1hbPXooB1U)

They all easily return to their starting weight, and at least one volunteer
gains muscle but not fat. The body is amazing at maintaining homeostasis.
Here's an nytimes article from 2011 that discusses much the same thing as the
article submitted:

[http://www.nytimes.com/2012/01/01/magazine/tara-parker-
pope-...](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-
trap.html)

~~~
kilroy123
There's a lot of research being done right now, that suggests your gut
microbiome has a lot to do with it. Very interesting stuff.

[http://www.scientificamerican.com/article/how-gut-
bacteria-h...](http://www.scientificamerican.com/article/how-gut-bacteria-
help-make-us-fat-and-thin/)

~~~
js2
Yup, also see this recent research that bariatric surgery causes changes to
the gut microbiome which account for some of the weight loss:

[http://www.livescience.com/51739-bariatric-surgery-gut-
bacte...](http://www.livescience.com/51739-bariatric-surgery-gut-
bacteria.html)

------
koolba
From the article (emphasis mine):

> Mr. Cahill was one of the worst off. As he regained more than 100 pounds,
> his metabolism slowed so much that, just to maintain his current weight of
> 295 pounds, he now has to eat 800 calories a day _less_ than a typical man
> his size. Anything more turns to fat.

Presenting the numbers like this seems intentionally confusing. Casually
reading this seems like he's eating 800 calories a day and still gaining
weight.

What they're really saying is that he's eat $AVG_295_LB_MAN_CALORIES - 800 per
day. That's probably around 4000 calories a day.

~~~
dempseye
Using the USDA supertracker here
([https://www.supertracker.usda.gov/bwp/](https://www.supertracker.usda.gov/bwp/))
with the following data/assumptions:

Weight: 295 lbs Age: 46 Height: 5 feet 10 inches (average height for US male)
Work activity: sedentary Leisure activity: sedentary

The _normal_ maintenance calories come out at 3117. Less 800 is 2317.

That is still enough to eat well and feel full, in my experience.

~~~
belltaco
>That is still enough to eat well and feel full, in my experience.

That's because your hormone levels aren't crazily out of whack like the
individual you reference. If your hormone levels were changed to reflect the
person that lost weight, I doubt you'd say that.

~~~
dempseye
Perhaps that is true.

I have also experienced that if I eat total shit, my hunger is boundless.
Whereas if I eat well, my hunger tops out at around where it needs to be to
maintain a healthy weight. It is not obvious why this should be the case.

~~~
Declanomous
I've had the same experience. My family has a history of heart disease, and
for a long while I tried to follow a heart healthy diet. I was always
starving, and I had difficulty concentrating. I actually managed to gain
weight as well.

A year into this experiment I gave up and started eating foods that I felt
help me concentrate the best: red meat, dairy, potatoes, butter, starchy
vegetables, deli meats, etc. I suddenly felt much better. I found it much
easier to maintain a healthy weight, and I had much more energy throughout the
day.

I spoke with my internist and a cardiologist, and they were more than ok with
the change. My BMI is exactly where it should be, my cholesterol and blood
pressure are incredibly low, and I exercise all the time. I don't want to give
the impression that everyone should start eating "unhealthy" foods, but at the
very least the foods I'm eating are much healthier than the sugar-laden foods
that are prevalent in the average diet.

For what it's worth, my cardiologist, believes "bad" cholesterol is damaging
in the absence of "good" cholesterol. His wife, who is a dietitian, disagrees
with him entirely.

------
cableshaft
I really need to lose weight, my heaviness has started to lead to other health
problems, but I find that whenever I try to eat significantly less, I have
difficulty concentrating on heavy mental tasks (i.e. programming, my job).

The constant feeling of hunger distracts me, or my mind just drifts, until I
get some food in me again.

I never see any of these articles even acknowledge this as an issue, either as
if no one else has this problem, or no one else who is dieting has a job that
requires so much brain power.

Since there's other programmers here, I was curious if other people have
noticed something similar, and how they addressed it.

My current plan is not so much to limit my eating (beyond some mild calorie
restriction) and instead force myself to exercise more often, but I'd like to
be a bit more aggressive with my diet if possible.

~~~
ajosh
I've definitely seen this. The trick for me was keeping my calorie
restrictions reasonable.

At first, I was able to compute what my body needed to live in a day and then
would cut from there. A lot of the time, I was hungry, distracted, etc. When I
got a fitbit, I connected it to MyFitnessPal. I used the same baseline and
used my exercise (walking) to add calories. This would give me a daily goal
which is basically base_calories - weight_loss_calories + walking_calories.

I found that by targeting the computed goal, I didn't suffer the same
problems. Sometimes that meant that I had to eat a bit more to get up to the
target. It also made me think about how to spend the calories that I had.

Part of what made it work for me is that I didn't go crazy trying to lose
weight. I targeted one pound per week which is a significant amount of weight
over the course of a few months. I didn't always go down by exactly one pound
but I was happy with the results.

Of course, that was my experience and yours may be different. One thing that I
think is key for anyone is to find foods that you like which are high in
nutrition and low in calories. Get some set meals that you know you can order
and stay on track. That could be some fruit and a sandwich, a particular bowl
at chipotle or whatever. Use memoization - compute the amount of calories in
something you're going to eat and keep using that information. It lowers the
cognitive load a lot and you know you'll be getting something you like.

------
proglodyte
It seems like exposing your body to colder temperatures is a sure-fire way to
increase your metabolism:
[http://www.theatlantic.com/magazine/archive/2015/01/does-
glo...](http://www.theatlantic.com/magazine/archive/2015/01/does-global-
warming-make-me-look-fat/383509/)

May be a little uncomfortable, but way better than screwing up your metabolism
via extreme dieting. I'm consistently perplexed as to why the ice-vest-under-
the-clothes weight loss method hasn't taken off yet.

~~~
HardDaysKnight
Interesting. I read in Body By Science (McGuff) that drinking two liters of
ice water a day will force your body to burn an additional 125 calories to
maintain core temperature.

I know that since I've been following the weight-lifting protocol advocated by
McGuff that my ability (and desire!) to sleep without covers, and skip wearing
a coat in cooler weather, has increased.

~~~
ck2
cold, heavy breathing, all silliness because you won't be able to maintain the
lifestyle

find changes you can live with to shave 400-500 calories per day and each week
you'll lose one pound which is a reasonable method that can be maintained

------
cheez
I can give personal, anecdotal experience as to why this happens and a chart
from Withings will illustrate perfectly. I know what I have to do now, and I'm
fighting like hell to make it happen.

[http://i.imgur.com/LR1wbH8.png](http://i.imgur.com/LR1wbH8.png)

------
blfr
Boxers and other people doing martial arts competitively have always known
this. There has been a "walking around weight" concept since I can remember.
Maintaining lower or, even more importantly in that context, higher weight
takes concentrated effort.

BTW it's a really weird post-Christian belief that there is some you apart
from your body and it can do things against your will.

~~~
tim333
>weird post-Christian belief that there is some you apart from your body

The body/mind have a lot of different parts doing different things. In the
article the folks conscious minds tried to lose weight and the body's
mechanisms tried to regain it. Not sure that's that weird?

~~~
jukkasarasti
I totally agree. Lots of parts of the body are in conflict at any given time.
For example, visual stimuli "compete" for cognitive processing. There's no
unified "you", so it makes sense to say that part of you is trying to lose
weight while another part is trying to gain it.

It's certainly not dualism in the Christian sense, but the idea that the mind
is made up of many semi-independent agents has been around since at least the
80s, probably earlier.

------
SovietDissident
_" Soon the scale hit 265. Mr. Cahill started weighing and measuring his food
again and stepped up his exercise. He got back down to 235 to 240 pounds. But
his weight edged up again, to 275, then 295.

His slow metabolism is part of the problem, and so are his food cravings. He
opens a bag of chips, thinking he will have just a few. “I’d eat five bites.
Then I’d black out and eat the whole bag of chips and say, ‘What did I do?’”"_

The article is light on the details post-TBL, but it sounds like recidivism in
terms of diet is probably a major root cause of weight gain. Also, maybe it's
hard to tell whether they're doing steady-state cardio or high-intensity
interval training (steady-state cardio has been shown to paradoxically cause
weight gain in people). In any case, it sounds like they need more guidance
and check-ins post-show.

~~~
49para
"He opens a bag of chips, thinking he will have just a few."

Thats the problem right there. Don't have things like that in your house.

Want a snack, try raw carrots or broccoli, by the time you finish binging you
would have consumed about 50 calories :)

------
yoodenvranx
There was an article on /r/science 1 or 2 weeks ago which stated that the body
needs about a year after the weight-loss to accept the new weight as normal.
Before that normalization is done it is very easy to regain the initial
weight, after the normalization it gets easier.

~~~
emodendroket
This article says this is six years later.

------
DenisM
I encourage everyone to read the "physiology" chapter at
[https://en.wikipedia.org/wiki/Adipose_tissue](https://en.wikipedia.org/wiki/Adipose_tissue)

TLDR: Blood sugar spikes above certain level are toxic, so the body responds
with an emergency action of stashing the sugar wherever possible, including
muscle, liver, and fat tissue. The former two are rather limited in their
capacity, while the latter is unlimited. Ongoing elevated levels of sugars in
the bloodstream is an ongoing cleanup job for the fat cells, and they never
get aground to release the accumulated energy back into circulation.

At the "hardware" level, that's all there is to obesity - overabundance of
quick carbs (sugars, flour, starch).

~~~
gypsy_boots
Which is similarly why a diet high in carbohydrates can lead to your body
storing more fat. It's easier for your body to turn the carbohydrates into
energy than it is to turn the fat into energy. So when it gets both, it stores
the fat for leaner times (less energy abundance) and turns the carbs into
glucose for energy. It seems like the more we learn about high fat low carb
diets, the more it seems that our body was built to use fat as its main energy
source.

~~~
great_kraken
Indeed. A basic understanding of the science is all you need. However, the
main narrative is that the body is a simply a black box that obeys solely the
laws of thermodynamics.

------
beloch
I'm curious about how the metabolic rate of these former contestants is
determined. Are they confined to a lab where their dietary intake and physical
activity can be accurately measured for an extended period of time? Probably
not. My best guess is that the subjects being studied are asked to keep food
and activity journals and then these, plus their weight, is used to calculate
their metabolic rate.

I've experimented with keeping a food journal in the past, and it's
exceptionally difficult to keep track of _everything_ you eat without this
extra work impacting your food choices. e.g. The chore of writing stuff down
might prevent me from casually snagging a handful of nuts on my way through
the kitchen, and consciousness about how it will look in the journal might
make me pass on those chips. Even ignoring these problems, it takes a lot of
effort to produce even remotely useful data. e.g. "I ate a pear." is actually
pretty vague. Breed, size, and ripeness all have a pretty big impact on the
nutrients you'll get from that pear. You need to weigh everything as a bare
minimum. Also, you need to keep the journal _all_ of the time, because if you
keep it for just a week or two that sample likely won't be very representative
of your normal habits.

Likewise, activities are hard to keep track of. With a fairly standard
ergometer (such as a Concept2 rower) you can get a reasonable measure of
activity level in a workout. Lifting weights, running, walking, etc. are all
much, much vaguer. 30 minutes of "moderate jogging" means different things to
different people. Most people are likely to overestimate or habitually pad
their activities.

So, you have a really vague, spitballed idea of what these people are eating
and doing, combined with weight gain. Are their metabolisms really slower than
expected, or is there a systematic error common to these people in that, after
a period of extreme privation (i.e. the competition) in which some of them
lost more than a pound a day, they are now underestimating their food intake
and overestimating their activity levels?

How much can basal human metabolism really vary anyways? If humans can get by
on substantially fewer calories, why don't we all _typically_ do this? Where
does all the extra energy normal people inefficiently burn off go?

~~~
npsimons
> How much can basal human metabolism really vary anyways?

The range is within 200-300 kCal for people of the same height and mass:
[http://examine.com/faq/does-metabolism-vary-between-two-
peop...](http://examine.com/faq/does-metabolism-vary-between-two-people/)

Also, you are correct to ask how data was collected: people routinely fudge
reports of intake and activity, to the point that self-reported data is
considered completely unreliable.

~~~
Jweb_Guru
You might try reading the linked study, which answers the question of how RMR
data were collected (hint: it's accurate). Actually, this entire site would
benefit from actually reading the paper.

~~~
npsimons
You mean the broken link to the study? I'll posit _you_ didn't even click
through the link I provided. Pot, meet kettle.

Just judging from the article (which leaves a lot to be desired), though, it
sounds like a small sample size, with no control group, and hasn't been
reproduced.

Edit: I'm not saying it's impossible; it's a known issue:
[http://ajcn.nutrition.org/content/69/6/1117.full](http://ajcn.nutrition.org/content/69/6/1117.full)

There are reasons that most doctors recommend lifestyle changes, slower
maintainable weight loss (eg 1lb a week) and resistance training to combat
muscle wasting. The Biggest Loser is already picking outliers, then putting
them through programs that are definitely not sustainable long term. It's very
possible that all this study shows is that losing weight TBL style is very bad
for you, _not_ that everyone gains the weight back. I still haven't after nine
years.

~~~
Jweb_Guru
The link isn't broken, and I have absolutely read it.
[http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full](http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full).
Please note their methodology. And metabolic adaptation is fairly well
established at this point, it doesn't just apply to people who lose tons of
weight at a rapid rate.

~~~
anatoly
Hi, can you address this comment on reddit that I found interesting?

[https://www.reddit.com/r/Health/comments/4hhdsj/the_science_...](https://www.reddit.com/r/Health/comments/4hhdsj/the_science_of_fat_after_the_biggest_loser_their/d2re6qs)

On the face of it it isn't obvious to me why using a least-square model
trained on just the baseline of these 16 individuals (the way they predict RMR
in the paper) is better than the standard equation, and if the standard
equation is a much closer fit to measurement, this seems suspect. But I know
next to nothing about metabolic measurements.

------
parsnipsumthing
It's worth noting that the amounts by which their metabolism was lowered are
not as shocking as they seem at first.

The 300 calories a day difference in calories burned is very limiting if your
BMR is 1800. But for some of these contestants their BMR, even at the lower
weights, might be 2000 calories per day. And if they do moderate exercise,
they can burn up to 1000 calories more than this. If you are expending 3000
calories per day then a 300 calorie difference is minimal.

------
jlos
Isolating a few of the variables would help clarify some of the questions this
study raises:

1) Amount of excess weight / median weight. E.g. Does the effect of the bodies
homeostasis change as a person gets more severely overweight?

2) Speed of weight loss. Does loosing 1lb/day/week/month affect the bodies
homeostasis differently?

3) Types of foods affect on homeostasis. Do substances like sugar have a worse
effect than others? Does a diet high in something like vegetables tend towards
a healthier homeostasis?

4) Amount of time for homeostatic change. Does being 100lbs overweight for a
year or 5 years make a difference?

>> And with his report from Dr. Hall’s group showing just how much his
metabolism had slowed, he stopped blaming himself for his weight gain.

Its critical to help people struggling with weight loss to deal not only with
the nutritional challenges, but also psychological issues behind weight loss
(guilt, depression, helplessness). However, presenting the problem as a binary
(purely biological vs purely will) may actually not be the best approach. The
individuals still played a part in their initial weight gain. The repeated
dietary decisions leading to obesity are obviously complicated by family
history, misinformation, failure to realize the full consequences, and other
factors both within and outside the control of the person. And neither does
the person's complicity, to whatever extent, in gaining weight mean they
should receive any less sympathy or help. I say this because of the
persistence of the myth that weight gain can be easily undone with just a few
weeks/months of discipline, a myth perpetuated by shows like The Big Loser.
Weight gain is an insidious danger that can have long lasting implications and
be very difficult to extricate oneself from. That point seems quite clear from
the research but never addressed in the article.

------
ck2
Well of course they did.

That show had them losing a POUND PER DAY - that's insane.

You'll never be able to maintain that kind of metabolism and calorie burn, it
would be a full time job and then some.

I spent the last year losing a pound per week and that was challenging enough.

I still can't touch more than 2000 calories per day or I will gain weight and
I run every morning.

------
dclowd9901
This jibes pretty well with my experience. Used to weigh about 220 at my peak,
and I was eating a lot those days. Cut back, drank less, exercised more
(running). Lost about 45 pounds.

However, at that point, I was running about 1000 calories a day, sometimes
less (a big reason I think The Martian is bullshit). I was not starving. My
body wasn't starving. You can (and many people should) subsist on far less
than the recommended daily allowance of calories.

If I eat a typical 2000 calorie diet, I will not just gain weight, but I will
gain weight at a rate of about a pound or two a month.

I've currently gained back about 10 pounds of what I lost, so I'm going to
have to turn on the afterburners again, but we really need to change the
dialogue of what a standard of consumption and health is.

It's very simple: if your body has a slow metabolism, you have to eat a lot
less than most people.

~~~
MustardTiger
You are either a very small person, or you are not accurately counting your
calories. The reason some people can subsist on less than the recommended
caloric intake is that the recommendation is an average. If you are below
average in size and/or activity level, then you need a below average amount of
calories.

~~~
dclowd9901
5'11" and 185. It's possible I'm miscounting calories (given how much of a
crapshoot the task is), but not by so much that it would matter greatly.

~~~
MustardTiger
Yes, it is very possible that it would matter greatly. People routinely count
their calories at 1/3 of what they are really consuming. Get a scale, weigh
your food. It is the only way to get useful accuracy.

~~~
dclowd9901
I've lost 40 pounds before. I'm not new to how to do it. I know my input is
anecdotal but I gave it because apparently it's been backed up by hard
evidence.

~~~
MustardTiger
It has not. Hard evidence constantly has shown the opposite. The only
"evidence" that supports you is "studies" that use self-reported data. Which
is worthless. Every study where people's caloric intake was measured for them
shows that your belief is mistaken.

------
sp332
Practicing weight _maintenance_ before going on a diet helps to keep the
weight off after a diet. Many people who struggle with their weight "yo-yo" as
they go on various short-term diets, losing and regaining weight and never
learning how to maintain a specific level.

------
EventHorizon
I am curious if this same effect is also seen in those who lost weight via a
calorie restricted diet without exercise. It could be plausible that the
extreme exercise regimen alone causes the body to become more efficient.

------
HardDaysKnight
Very little was said about the type of exercise they were doing. I'd guess
that most of it was "cardio." Would they have different results if they were
involved in more specifically muscle building exercises, i.e, weight lifting
(and with adequate rest)?

I've been following McGuff's Body By Science protocol for the past 6 months
and I believe that with increased muscle my overall health is improving much
more than would have resulted from typical long and slow cardio.

Has anybody else tried this?

------
solarengineer
I have followed "The Perfect Ten Diet" and began swimming. Within a year, I
went from a size 40 jeans to a size 33. I think I'm now a size 32. I haven't
weighed myself yet. I'm a lacto vegetarian (butter, cheese and curd, no milk).

I think that barring health reasons (e.g. Thyroid issues), it should be
possible for an individual to eat healthier and shed excess weight. But it
also comes down to "How badly do you want it?"

------
andthat
I wonder if it would be possible to ramp down like 10% in calories one year at
a time instead of binge dieting like this. We are always looking for quick
fixes.

~~~
citeguised
You could of course. It's just easier to cut 50% for a couple of months than
10% for years because the results come faster, and so does the motivation to
keep it up.

Also, counting calories is not really an exact science, so you want to make
sure you stay way below your daily goal, just in case the lunch had 300
calories more than you calculated. This is much easier with lower calorie-
goals.

For me a good pace was 1 kg a week, which I could do by sticking to 2000
calories. Most weeks it lost only 0.5 kg but there's still some progress.
Luckily, maintaining my weight works just fine with a daily intake of ~3000
cal.

Regarding quick-fixes: You still have to keep tracking your intake long after
you reached your goal of course, otherwise the old eating habits will come
back slowly but surely. I think this is where most "diets" fail: They hold
your hand for a few months, when you need them to do so for the rest of your
life.

------
npsimons
I think the biggest thing we should take away from this study is that losing
weight "The Biggest Loser" style is bad for your long term health, _not_ that
everyone who loses weight will gain it all back or that weight loss is
impossible. In other words, don't follow a "Biggest Loser" style program to
lose weight.

------
nicolas_t
And I'm in the second week of the Fast 5/2 diet. Not very encouraging to read
this.

Problem though is that I have to diet, my triglycerides are off the chart, my
LDL cholesterol too and my fasting blood sugar are at the limit.... Hope I can
keep my weight off somehow later.

~~~
ck2
Not sure what "Fast 5/2" is but if you are losing more than a pound a week
(maybe two) it's going to be impossible maintain it because it won't feel
natural and your calorie craving is going to rush right back.

Those poor people were manipulated into losing a pound PER DAY which is
insane. I cannot even fathom that.

Take your time, schedule a year, and see what you can do. Be patient and
persistent. Change your lifestyle/habits, try to keep busy instead of eating.
Worked for me. Not easy but doable.

~~~
nicolas_t
Thanks for the encouragement! Very much appreciated!

Fast 5/2 is basically intermittent fasting with two days/week below 600
calories (which I find surprisingly easy to do) and the rest eating normally
(but I'm also refraining from eating chocolates/biscuits/cakes and anything
overly sweet).

So far, I've lost 3 pounds in a week and an half which I think is an healthy
rate.

~~~
ceratopisan
Getting out of the chocolate habit is probably the best part (most difficult
part?) for making a difference.

------
tzs
Here's a link to the paper:
[http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full](http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full)

------
bb85
I wonder why, when we talk about obesity, there is this tendency to use
language that removes responsibility from the person, or at least move it from
their mind to their "body", as if they were different entities.

I think obese people fit the definition of addicts. Most of the time, other
addictions are fought by pushing awareness on the person, forcing them to
recognize they have a problem and that they need to change.

I don't hear much "you were born this way" or "that's just what your body
wants" for other drugs. Is it because other drugs are always viewed
negatively, whereas food is a pillar of life under normal circumstances?

Maybe it has to do with the very high prevalence of obesity, and the echo
chamber being big enough that deflection and denial are harder to combat?

~~~
emodendroket
This attitude is tiresome for precisely the reasons outlined in the article.
That one guy in the article has to consume 800 calories a day fewer than a
normal person his size to maintain his weight which likely means dealing with
constant hunger. It's not exactly surprising that few people manage to succeed
under those circumstances.

I also, frankly, think the opposite is true -- most material about obesity
spends a lot of time vilifying fat people.

~~~
bb85
I don't think that's how hunger works. Do you think hunger is triggered by an
absolute number?

Isn't hunger the sensation you feel when your body starts dipping into your
fat reserves because the content of your stomach / blood is not sufficient?

~~~
emodendroket
No... I said no such thing. However, if you lose weight you will generally
feel hungry until you start eating at levels that would restore your weight,
as detailed in the linked article and also this one:
[http://www.nytimes.com/2015/08/30/opinion/diet-advice-
that-i...](http://www.nytimes.com/2015/08/30/opinion/diet-advice-that-ignores-
hunger.html)

------
npsimons
So, on a show where they have people lose weight in the most unsustainable
(read: dramatic) way possible, they are then surprised they don't keep it off?
I am shocked. Shocked, I say!

------
KKKKkkkk1
Extreme weight loss indicates that your weight has high variance. A history of
being overweight shows that its mean is high.

------
chris_wot
Whilst all of the contestants needed to lose weight, I am concerned with the
premise of this show. It has many good qualities: exercise and a balanced diet
is very important. However, I note the following:

 _" Mr. Cahill knew he could not maintain his finale weight of 191 pounds. He
was so mentally and physically exhausted he barely moved for two weeks after
his publicity tour ended."_

This cannot be healthy. My concern is that the weight gain has occurred over
the person's lifetime, yet they can lose up to 30 pounds in a week. _The New
York Post_ , which I realise is not a terribly reliable source, reports that
the show has frequent injuries and many contestants have had serious side
effects. One contestant started losing her hair. Another showed possible signs
of kidney failure. Yet another has president issues with short-term memory
loss.

When I first saw this show advertised for the Australian version I thought it
looked amazing, even inspirational. Then I saw the weigh-ins and the show's
mechanism used to judge contestants. It was for week-to-week weight loss. If
you gained even a small amount of weight, there was a real danger of being
evicted from the show.

It's already known that yo-yo diets are incredibly dangerous. So I would like
to know what the doctors on the show were doing - they must be aware that what
they are doing is not medically recommended. They have a moral and ethical
duty to ensure their charged live a healthy lifestyle, not an extreme one that
the contestant goes through. I also wonder if the contestants are give enough
information to consent to the regime the show puts them under. I think it's
telling (and frankly, I don't think it should protect a doctor!) that the
contestants must sign the following waiver:

 _" No warranty, representation or guarantee has been made as to the
qualifications or credentials of the medical professionals who examine me or
perform any procedures on me in connection with my participation in the
series, or their ability to diagnose medical conditions that may affect my
fitness to participate in the series".

Are these really doctors? If they are, then this should in way reduce their
liability for poor medical advice, nor the show's.

My final concern is a bit more out of left field. This show is a data driven
show. They record their calorific intake, blood pressure, time and means
excercised, weight loss, psychological studies are taken... You name it, they
do it. And it's done under a very controlled environment.

The show is basically a medical study, albeit not one with a control group or
published in a scientific journal, or ine that publishes their full results.
Yet a study it is: whilst the methodology and transparency are flawed, their
are plenty of studies that exhibit the same characteristics. The difference is
that in a normal medical study at a university the study would need to be
approved by an ethics committee and follow certain parameters. _The Biggest
Loser* does not. Which means that I seriously wonder what level of liability -
both personal and corporate - the producers of this show are letting
themselves in for. They may have legal disclaimers, but if even one contestant
can prove corrosion or a lack of informed consent as to what they were
agreeing to, then those waivers would be worthless.

This show, frankly, is a huge concern.

------
gnur
This is a truly horrifying piece of information. It basically amounts to that
going on a diet will make it harder to stay at the weight you had before your
diet.

~~~
tim333
Severe dieting has long been know to do that. Mild dieting combined with
exercise seems to work better. We're a bit lacking in quantification on that
though. It was interesting to get some numbers from the article.

~~~
TillE
Yeah, this is what I'm curious about. All the weight loss diets described in
the article seem quite extreme, some even dangerously so.

Maintaining something like a 200-400 calorie deficit will lose you weight
slowly but surely, and maybe hopefully not cause extreme changes in
metabolism?

~~~
tim333
Yeah, I'm trying to lose weight like that so I hope so. People say doing some
weights to keep up muscle mass helps and it probably does though there doesn't
seem much good data on how much does what.

------
mrfusion
It's weird I was allowed to submit this if it was already submitted. Maybe a
bug?

~~~
GFischer
If you submit it and it was already submitted recently, it counts as an upvote
(probably the case here).

~~~
detaro
No, since it created a submission for them, which it doesn't if it recognizes
the dupe.

~~~
GFischer
Ah, ok, I stand corrected.

------
cowardlydragon
What raises metabolic rate? High intensity interval exercise? Long slow
distance?

I'm wondering if 2-3 hours of exercise training would be necessary to readjust
the metabolism. It's my gut as an athlete... Especially the very high
intensity interval training.

This comes from sprinters having almost magically low fat in many cases,
despite not doing nearly as much aerobic execise as, say, even a recreational
marathoner.

------
Kenji
Does that mean that formerly fat people who lost weight and eat little to keep
a low weight with their slower metabolism live longer because their body has
less energy throughput?

------
russtrotter
I get it: low-carb, hi-fat works for people and high-carb, low-fat works for
people. Let's just get that off the table, but can we, for the love of the
sustainable planet, have a hi-fat person give their testimony on how they did
it with plant foods instead of just feeding the "mmmmmm more bacon, burgers,
chicken and cheese!" mentality?

------
bluedino
While these people are on the show, they are living in house with other
contestants. You can't just order a pizza and sit on the couch with TV cameras
and your co-stars watching you.

They're forced to exercise for hours. If you're at home you're not going to
wake up at the crack of dawn and do a 5 mile run and then do weights.

They're forced to eat right. Food selection is limited. There's no cheese and
donuts and fast-food.

It's no wonder that it's impossible for them to keep this up. They just go
back to normal which is 'being lazy'.

~~~
mfoy_
Did you even read the article or are you just jumping on the /r/fatpeoplehate
bandwagon?

The takeaway is that we need to focus on prevention, don't get obese in the
first place. Once you're obese, the deck is _really_ stacked against you.

------
Hockenbrizzle
Man this is so frustrating because I have a family member who is like this. I
would really like to help them, but they just don't seem to get it.

I think the problem is that these people want instant results. That's not how
the body works. If you want to become a runner, you start running often and
because you love it. You don't force yourself to start doing intense, one-and-
done sessions in an attempt to get to your goal and then go back to your old
lifestyle once you achieve it. You have to learn to play the long game and be
patient.

I really believe that if these folks worked on a farm for several years, it
would do much more to help them with their weight problems than these TV shows
do.

~~~
URSpider94
Did you even read the article? One of the winners is literally a farmer.

~~~
Hockenbrizzle
Yes, sorry my comment was extremely useless. I did read the article but did
not see the image showing Rudy Pauls the farmer, my mistake.

My comment was very off topic, so I won't try and clarify it here.

