When the weight loss comes back: unsustainable versus permanent fat loss

The American game show, America’s Biggest Loser, is famous for extreme dieting, hard core exercise and generally braking the balls of its contestants in a very short space of time. They show us before pictures, 12 week later pictures but what they don’t show us is 12 months or 5 years later pictures. As this 2017 study¹ says, “It is estimated that only about 20% of individuals who experience significant weight loss are able to maintain their lost weight². Data from participants in the Biggest Loser Television program demonstrate the difficulty in maintaining lost weight over time. The average weight loss of the 14 participants during the 30-week intervention was 58 kg, but six years later, nearly all of the contestants had regained the weight they had lost³.”

“…nearly all of the contestants had regained the weight they had lost.”

Many of those people put on even more weight than they lost in the first place as their willpower plummeted and their appetite came back with a vengeance. Ryan Benson, for example, who won the competition in 2005, was 300 lbs (136kgs), dropped to 175 and then before you know it was back above he old level up to 325 lbs!

Furthermore in a 2015 UK study that looked at 76,704 obese men and 99,791 obese women they found that over a 9 year period only 0.5% of the men and 0.8% actually lost weight. The study concluded, depressingly, "The probability of attaining normal weight or maintaining weight loss is low. Obesity treatment frameworks grounded in community-based weight management programs may be ineffective."

"...over a 9 year period only 0.5% of the men

and 0.8% of the women actually lost weight."

So let’s now take a look at some of the common mistakes of unsustainable weight loss and then later on what we can do about it instead.

One of the most common ways to lose weight is to embark on a diet that removes an entire macronutrient food group be it either fat, carbohydrates or protein. Most of the modern English speaking world has been on a low fat, high processed carbohydrate diet since Ancel Key’s famously manipulated “7 countries study” which he started in the 1950s. This has been a disastrous 60 year experiment with record numbers of people with sugar related illnesses such as diabetes, cancers, cardiovascular and neurodegenerative diseases.

And more recently many people have started to swing the other way to a low carb, high fat, diet. This certainly works for some people as they are now more likely to be eating closer to their metabolic type but it doesn’t work for everyone. And in the long term low carb diets can start to damage the mucosal lining of the gastrointestinal tract, create bacteria gut dysbiosis, cause hypothyroidism and fry your adrenals.

And then we have a whole group of people eschewing animal protein completely which can lead to osteoporosis, mental challenges such as depression, irrational anger and obsessive compulsive disorders (see this post on how our diet affects our mental and emotional health), higher risk of bone fractures and anemia.

Short term it works, eat less, burn fat, lose weight. So it's very popular. But in the long term it doesn’t work for the following reasons:

1. Willpower

Eating less than your body needs requires willpower. And you have a finite amount of willpower that gets recharged every time you go to sleep. Over time your willpower bucket gets drained and the desire to overeat to compensate for the period that you under-ate gets stronger and stronger until finally you cross the Rubicon and calorie consumption increases to match your reset hunger levels again and the weight comes back.

2. Grehlin

The less you eat the more the pituitary gland in the brain will instruct the body to secrete Grehlin to ramp up your appetite. Your body is literally fighting you on the inside. An internal pitched battle eschews between your conscious desires (lose weight) and your subconscious needs (maintain fat reserves).

3. Metabolism

Your metabolism, controlled by your thyroid, literally decides how much energy you burn. By increasing your metabolism, by just a little you will burn excess calories. But if your body, for whatever reasons, thinks that you’re not getting enough quality fuel on board it will down regulate your metabolism which means you’ll burn fewer calories. What researchers found after studying the contestants of the Biggest Loser gameshow was that even as the years went by the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight. Stephan Guyenet, the PHD obesity specialist researcher calls this the "fat set point".

4. Leptin

Leptin is a hormone secreted by your fat cells and your body wants to preserve those valuable stores of fuel for the winter. Your body will defend this “fat set point” so as it notices the amount of leptin in your blood stream decreasing it sends a signal to your brain to increase hunger and increase the fat back to where your body thinks it needs to be – which is usually not where you want it to be!

5. Less connected

If you follow people over the long term, dieters are more likely than non-dieters to end up gaining weight over the next two to 15 years after the calorie restricting diet they’ve been on. As they increasingly intellectualise their eating habits as opposed to eating instinctively they are more prone to eating junk food, overeating, eating emotionally and generally not listening to their body’s needs.

The solution is simple, don’t diet. But that doesn’t mean eat like a pig! It means focusing on wholesome healthy eating, embracing organic fruits and veggies, wild fish, pastured meats and eschewing processed foods, sugar, commercial dairy, commercial soy, table salt, flour and vegetable oils. And then you will slowly revert to your body’s more natural set point and stay there.

One of the most commonly overlooked satiety symbols that your body needs to decide that it’s full is the amount of vitamins and minerals absorbed and NOT how much you filled your stomach up. You wonder why it is that you ate that large Big Mac, fries and milk shake and 1 hour later you’re still hungry? It’s because it’s devoid of a full compliment of minerals, vitamins and phytonutrients. Yes, you stretched your stomach but you didn’t nourish your body. The answer here is the complete opposite of what the diet dictocrats would tell you. Eat high quality nutrient dense foods including wild fish, pastured meats, egg yolks, organs, high quality dairy, foods high (yes high) in cholesterol, shellfish, grass fed butter, bone broths and lacto-fermented veggies.

So looking at this problem from a physical exercise perspective, we start off with endurance exercises such as running, marathoning, spinning, body pump and gym classes that raise your heart rate to quite a high level for 60 minutes or more. Endurance sports rarely work for people that are already overweight or do not have a great diet to begin with. When you burn a bunch of calories in the form of some kind of intensive, sweaty exercise regime your body decides to ramp up your hunger hormone, ghrelin, in response to the exercise. Yes you may finish your session and have a salad but later on that night when grehlin is through the roof and willpower is floundering on the floor your body fights back and reaches for whatever high carb snack it can find in the house!

For those that are lean and do run a lot the main problem stems from 2 angles. The first is that a lot of cardio exercise causes the body to cannibalise the muscles (type IIa and IIb fibers responsible for strength and power) in order to keep the total body weight low. And strength directly correlates to insulin sensitivity and longevity so we now have a far less forgiving metabolism if we do deviate from a strict dietary path. Secondly, as you become more efficient and adapted to the cardiovascular exercise the body increasingly requires more and more time spent in the high heart rate cardio zone in order to burn the same amount of calories.

To be honest you’ll know if you fall into this category pretty easily. Did you stop doing any exercise for a week or two and suddenly start putting on weight? If so then that ain’t sustainable!

High intensity interval training is 20 to 30 mins of hard core exercises that max out your heart rate and have you dripping buckets. The advantage with this is that it boosts your metabolism so you burn more calories than normal for the rest of the day well after you’ve stopped exercising. The disadvantage is that it’s exceedingly stressful on the body which basically thinks it’s running away from a lion for 30 minutes straight. Digestion is shut down, the immune system is shut down, fertility is shut down, in fact every non essential function is shut down apart from pumping blood to your arms and legs to complete the exercise regime. If you are not primed to handle this stress, (and most working professionals are not), then your body goes into “fat storage mode”. So in the short term you burn a few extra calories but in the long term your metabolic rate decreases as your body thinks you’re in a war zone and it’s best to conserve fat.

Likewise,  unscrupulous gym owners will often sell you the before and after pictures solution that promises flat stomachs, ripped abs and the body of your dreams as evidenced by all these people. What they don’t tell you is two things. (1) That this is only a small % of their total number of clients and (2) They don’t show you the 12 month later pictures when all the weight has come back on! If a regime requires you to work out hard 3 to 4 times a week the chance of sustaining that for most people over the long term is highly unlikely due to time, expense and motivation commitments.