Be Fit For Life

with Ellen Cohen-Kaplan

You do NOT have to act like the biggest loser!

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This week, the experience of contestants on the reality show “The Biggest Loser”  made headlines, with the ultimate conclusion being that when people lose weight, they are doomed to regain most of it back. The reason given was that their body metabolism slows down to adjust to the decrease in caloric intake, ultimately causing them to gain back their weight even when they consume the recommended amount of calories that should result in maintaining their weight loss. The article is misleading on many fronts.

http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

The study tracked the lives of contestants before, during and after appearing on the show, as well as participants who were willing to be re-measured six years later. The study discovered that those contestants experienced a considerable drop in their metabolic rate, which the study’s authors speculated could have contributed to regaining a substantial percentage of their weight. On average, those participants gained back more than two-thirds of the pounds they lost on the program’s arduous diet and exercise regimen.

The coverage of this story is important because it shows us just how harmful it can be to lose massive amounts of weight unnaturally and quickly with extreme regimens. (Contestants had to perform around 7 hours of exercise a day (that even makes me cringe!) But the study does not cover, and therefore says nothing about, how metabolism responds to reasonable weight loss that is achieved by reasonable means.

Susan Roberts, PhD, who is a scientist and professor of nutrition at Tufts and author of the iDiet, runs the Energy Metabolism Lab at Tufts University Friedman School of Nutrition Science and Policy. They have published two more expansive studies that show almost no negative effect of weight loss on metabolism, beyond that we would expect to result from weight loss alone. In one of the studies, participants lost 11% of their body weight and kept it off for two years (the length of the study). They also experienced a drop in metabolic rate of just 5% and a reduction in total calorie requirements of just 7%. Once again, this looks at reasonable weight loss undertaken over a manageable amount of time.

Quite in contrast to the implications of the TV contestant study, the preponderance of credible research conducted under scientifically rigorous conditions indicates that calorie requirements do seem to decrease with weight lost, but the decrease is approximately in proportion to the weight loss. This is a much different, and more positive, message than the one circulating in the media after the publication of the study reported in Obesity; and, rather than instilling the sense of futility that characterizes the experiences of the TV contestants, other evidence strongly suggests the prospect of maintaining practical, manageable goals achieved when continuing the effective habits that made weight loss possible in the first place.

It is not appropriate to extrapolate broad conclusions from a small sample of people in an extreme situation such as The Biggest Loser. Since calorie requirements do decrease once your body is smaller, preventing weight regain requires permanent changes to calorie intake (as well as reasonable amounts of exercise — not what the contestants endured). Consuming fewer calories isn’t something that happens automatically, but it doesn’t need to be a life sentence of deprivation, because many of the good new habits learned during reasonable weight loss can be maintained to prevent weight regain.

In practical terms, one must lose weight gradually and in conjunction with an exercise program that ideally combines cardio, strength training, and core exercises to be sure that more fat than lean muscle is lost. Think of how long it took to put excess weight on- for many people, it’s over a period of several years or even decades. Why is there an expectation that 50 pounds of more can be successfully lost over a period of a few months? If you want to view some opposing scientific studies to the Biggest Loser phenomenon, check out the article and accompanying research below.

http://www.leighpeele.com/a-response-to-the-ny-times-biggest-loser-study

The change in lifestyle, volume and quality of food consumed, and overall eating habits must be changed to make lasting results. Amount of hours of sleep, managing stress levels and eating for comfort have to be altered as part of the weight loss equation. To maintain weight loss, you must address the many issues that cause overeating in the first place. While hormones such as leptin, ghrelin, and insulin play a role, a mind shift is essential when trying to keep weight off after you lose it.

The recommendations remain practical, but not headline grabbing:

  • Protein, glycemic index, fiber and volume are 4 factors that influence how you eat. You need enough protein and fiber to feel satiated, along with the proper volume and foods that don’t spike your blood sugar, causing cravings for more empty calories.
  • Eat whole foods- the fewer ingredients in the food you eat, the better your body will metabolize it. ” As Michael Pollan says, “Eat food. Not too much. Mostly plants.”and don’t eat anything your great-grandmother wouldn’t recognize as food.”
  • Limit the amount of food you eat from packages; they contain preservatives and excess ingredients that can interfere with a healthy gut microbiome
  • Monitor volume of portions – check out my blog post from September 27th, 2015 to leaern or remind yourself of typical healthy portion sizes.
  • Keeping a food log helps you monitor and control your foot intake- many apps and websites such as MyDailyPlate, LogMyFood and FoodLog make this quick and easy
  • Eat lean protein such as  eggs, fish, lean cuts of beef, poultry, pork (the other white meat) but in portions that are no more than 4-6 ounces (fist sized)
  • Fill half your plate with vegetables or fruit, one quarter with lean protein, and one quarter healthy grains such as quinoa, bulghur wheat or eliminate the grains entirely.
  • Limit gluten if you think you have a sensitivity to it- one way to test this is to see if you feel better after skipping any wheat, rye, barley, and foods that contain flour. For many people, this is a quick way to lose or maintain weight and after a while, the craving for it disappears.
  • Shoot for a weekly regimen of exercise of at 5 out of 7 days a week, with a minimum of 150 minutes of exercise, at least some of it moderately vigorous.
  • Get support. Success rates increase with the use of trainers, psychologists, and dietitians or anybody who can help with healthy choices and access to safe exercise. 

    The Biggest Loser is certainly entertaining, but it’s just that- entertainment. It’s not a recipe for how to lose weight responsibly and keep it off. When we conflate reality TV with reality, everyone loses – (not weight!). See which aspects of the list above apply to your situation to reach your desired weight and don’t believe all you read, even when backed by (dubious) scientific studies.  

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