Retrospective #299: Why Maintaining Weight Loss is So Hard

The excerpt I posted from the Lancet Diabetes and Endocrinology comment in Retrospective #297, “Obesity in Remission,” brought to mind a segment from “Choices,” the 2^nd of four hour-long videos reviewed in The Nutrition Debate #275, “Weight of the Nation.” You might have missed it. But if you are having trouble losing weight or, having been successful, are now putting weight back on, you should read #297, and this blog post.

Starting at minute 17 in “Choices,” Rudolph Leibel, MD, Co-Director of the New York Obesity Research Center at the Columbia University Medical Center, said, “Individuals losing weight are NOT metabolically the same as they were before they lost weight.” “The weight reduced individual will be requiring about 20% less (sic) calories per day relative to what somebody of that weight who’s never lost weight would eat…in order to keep at that body weight.”

“Consider two individuals – same gender, same age, exactly the same body weight – one of whom is at that body weight as a result of let’s say a 10 or 15% weight reduction, the other who’s been at that weight for their entire adult life. If that reduced weight individual goes out to lunch with her friend, and they both order the same meal, that will represent a 20% overeating for the weight-reduced individual, and be quite normal for the individual who’s not in that state. 20% might seem like a little, but 20% excess calorie intake a year will account for the inexorable weight regain.”

“AS FAR AS WE KNOW, THIS PHENOMENON DOES NOT GO AWAY,” Dr Leibel says. “So, being successful for a year or two doesn’t mean that you’re going to be able to go back to eating what like a person who’s never lost weight.”

“Does that seem unfair?” an off-camera voice asks an overweight woman. “Sure, it does seem unfair,” she replies. It’s unfair that I just can’t lose the weight and go back to the way a normal thin person lives their life, but that’s part of the price you pay for allowing yourself to get overweight in the first place.”  That’s the thinking of this well-meaning and very well-funded, widely-viewed and deeply-flawed HBO series. Blame yourself. You’re hungry, and you want to eat.

You can choose to blame yourself. You failed. It was your fault. You tried to follow the Government’s Dietary Guidelines since 1980, and your doctor’s advice since at least 1961 when the American Heart Association started telling us (him or her and you) to eat less saturated fat and cholesterol. That’s also when Agribusiness took the cue and started making more “low-fat” manufactured foods with added sugars and processed carbohydrates.

Or you can blame them (the government’s dietary advice, Agribusiness, Big Pharma, and your hapless doctor) and choose to eat many fewer carbs and more fat – both saturated and monounsaturated, but not polyunsaturated fats (vegetable and seed oils), which are harmful. The Omega 6 overload clogs your cells with rancid and oxidized LDL-C.

You will feel fuller when you eat fatty meats and fish and a few low-carb veggies, and therefore eat less naturally. Fat satiates. Protein digests slowly. Your blood sugar will stabilize, your cholesterol will improve, especially HDL and triglycerides. Your inflammatory marker (CRP) will too, and AS YOU LOSE LOTS OF WEIGHT, without hunger, your blood pressure will come down. And you will need to take fewer or even no medications for all of these conditions.

All these good things happened to me. And when I regained some (just a little) of the weight I lost, but continued to eat low-carb, high-fat – just too much of it – the only thing that went up was the number on the scale. All the other health makers maintained the improvements so long as I continued to eat low-carb, high-fat.

Like many of my readers, I have developed a “biological predisposition for energy storage.” I gain weight when I eat the Standard American Diet (SAD) that the government and my doctor recommend. And I live in “an environment that promotes high energy intake.”  The RESULT: an obesity–promoting interaction between the two:  I gain weight.

This condition is called Insulin Resistance. It is chronic and “does not go away,” as Dr. Leibel observed. My genes reacted to the overload of sugars and processed carbohydrates that replaced the saturated fat and cholesterol that government and my doctors advised me not to eat. This “heart healthy” diet made me fat and deprived me of the fat-soluble vitamins (A, D, E, and K) necessary for wellbeing…and caused me to develop my Carbohydrate Intolerance.