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TOPIC: "Why it is Hard For Obese People To Lose Weight..."

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February 5, 2013 6:12 PM
After reading all the success stories in MFP one could be excused for thinking it can't be that hard to lose weight. But, for those of us that have tried, we know how tough it can be.

The Garvan Institute of Medical Research (one of Australia's largest autonomous medical research institutions) put out a media release today reporting they have "pinpointed the exact brain circuitry" that makes it so hard for us to lose weight quickly.

A news report of the findings can be read here: http://www.smh.com.au/lifestyle/life/why-obese-people-dont-lose-much-weight-when-they-diet-20130206-2dxd6.html
The Institutes media release can be read here: http://www.garvan.org.au/news-events/news/the-brain-circuit-that-makes-it-hard-for-obese-people-to-lose-weight.html

Bottom line.... "Professor Herzog said it was important to note that the study showed that fad diets simply did not work.
- Weight loss needs to be done over a long period of time and that's what people underestimate," Fast weight loss is not enduring.

Of course we all knew that but now we know exactly what causes this and can understand the importance of not losing weight too quickly. So this brings up the obvious questions. How fast/slow should we lose weight to make it enduring? Now that they know what to target, how soon before drugs are developed to control the effects of "this NPY circuit" - for those that need them? This could replace gastroplasty (stomach stapling).
  18303666
February 5, 2013 6:14 PM
Strange, I just read something recently claiming to debunk that 'you have to lose it slow to keep it off' theory. Then again the study it was based off of seemed to involve some kind of liquid low calorie diet so maybe it's the one that is wrong.
February 5, 2013 6:16 PM
For me personally, it's because I love stuffing my fat face with big macs, pizza and liquor.
February 5, 2013 6:45 PM
When morbidly obese its hard because its simply just a long, hard road ahead. I will never forget thinking..."holy crap i have to lose 100 kilos/220 pounds" and you are filled with self doubt that you can do that...its such a imaginable mountain that you need to climb. I have lost 82 kilos/182 pounds so far....and I did it very slowly....took me over 6 years so far and will prolly be over 7 years by the time I reach goal. But it is honestly the best thing I have ever done :)
February 5, 2013 6:50 PM
I did not read the links you posted. So, I will only speak for myself.

I gained 90 pounds over the course of 20 years. I wanted the weight off in ONE day. Once I came to the realization that it would take ALOT longer than that, I had the issue licked.

I took my time, worked hard, changed my lifestyle and within a year, I was back at my High School weight.
  14733344
February 5, 2013 6:55 PM
One of my college professors did research on this for a few years, many people believe that there is a genetic predisposition to becoming overweight due to a hormonal issue between the stomach and the brain. Simplified there are two hormones, let's call them the "hungry" and "satisfied" hormones, that are responsible fore when we start and stop eating. It's been found that in some people the "satisfied" hormone either is not released by the body in large quantities, or it is interfered with on the way to the brain to suppress the "hungry" hormone.
Obviously, this isn't what some people may call an excuse to be fat, but it is definitely something that can inhibit weight loss.
Just food for thought from a friendly biologist.
Edited by baxterl14 On February 5, 2013 6:55 PM
February 5, 2013 6:57 PM
My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.
February 5, 2013 6:58 PM
QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.


Agreed
  14733344
February 5, 2013 7:02 PM
QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.


yeah, it confuses me too. i got to 140 pounds and had an oh ****, i'm 5 pounds from being overweight and better lose it now moment. but i figure that everyone is different, especially people who have been overweight their entire life and that's all they know. i was skinny until i hit my mid 30's, so i can't really relate to that.
Edited by Aviva92 On February 5, 2013 7:04 PM
February 5, 2013 7:05 PM
Well, here is a natural gut bateria that we pretty much all have that helps us to digest fat that we eat. Those of us that have fed the shtick out of these specific bacteria have much more of the bacteria living inside of us, making fat a lot easier for our bodies to store. As we lose weight, these bacteria eventually go back to normal sized colonies, and that is no longer an issue. So that is a minor factor that makes it harder to lose weight than it seems it should.
  29381858
February 5, 2013 7:06 PM
QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.


I think for the most part people know. I mean 100 pounds over 10 years is only 10 pounds a year. That is only a size a year. After a certain point you know you're fat but you see the same person in the mirror. Just like when you lose the weight, you don't think you look smaller because you just see you. "Sneak up" is a bad term because obviously it doesn't, but you just don't think about it until one day you see a picture and don't even recognize yourself
February 5, 2013 7:07 PM
QUOTE:

QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.


I think for the most part people know. I mean 100 pounds over 10 years is only 10 pounds a year. That is only a size a year. After a certain point you know you're fat but you see the same person in the mirror. Just like when you lose the weight, you don't think you look smaller because you just see you. "Sneak up" is a bad term because obviously it doesn't, but you just don't think about it until one day you see a picture and don't even recognize yourself
This!
  29381858
February 5, 2013 7:08 PM
Simple. Imagine becoming severely depressed and turning to food as the one thing that provides a bit of relief (and as we now know there is a biochemical process at work for this that is very real). Inherent to depression is a general paralysis about life - sometimes even getting out of bed is too much, as one feels so emotionally awful they wish they weren't even awake. Paradoxically, the one thing that provides relief soon adds to the depression as weight mounts, but one knows no other way to feel better and keeps going.

While it may not have "snuck" up on them, emotional obstacles can prevent people from reacting healthily to adversity.
February 5, 2013 7:09 PM
It's going to vary from person to person. No two people are wired exactly the same, though some will obviously be closer than others.
Edited by Gallowmere1984 On February 5, 2013 7:09 PM
February 5, 2013 7:09 PM
QUOTE:

QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.


yeah, it confuses me too. i got to 140 pounds and had an oh ****, i'm 5 pounds from being overweight and better lose it now moment. but i figure that everyone is different, especially people who have been overweight their entire life and that's all they know. i was skinny until i hit my mid 30's, so i can't really relate to that.


I was always a bit bigger and quit weighing myself my senior year of high school (read: my last sports physical). After that, I never thought about it. I guess because I knew I was bigger, I didn't want to deal so I just never stepped on a scale. After I grew out of my jeans, I bought a lot of sweats, stretchy banded pants and cotton shorts. It let my waist expand without my clothes getting tight on me.
February 5, 2013 7:12 PM
Thanks for posting this!smile
  34773897
February 5, 2013 7:15 PM
QUOTE:

Of course we all knew that but now we know exactly what causes this and can understand the importance of not losing weight too quickly. So this brings up the obvious questions. How fast/slow should we lose weight to make it enduring? Now that they know what to target, how soon before drugs are developed to control the effects of "this NPY circuit" - for those that need them? This could replace gastroplasty (stomach stapling).



It's about habits, as the article said "quick weight loss doesn't work." the reason why people who are obese have a difficult time is because they can't do a 180 with their diet. I would eat Tacobell and mcdonalds almost daily, never ate home cooked food. You thin I can suddenly eat "healthy" it doesn't work that way. You have to make gradual changes and really "understand weight loss." You can eat your favorite foods, just not as much. You don't have to eat like a rabbit. A lot of people miss this.

To keep it off it goes back to the habits. If someone starves themselves and loses 30lbs in 2 months, and another person loses 30lbs in 6 months. Who will most likely keep it off? The person who has PRACTICED(HABITS) the most. This is another reason why quick weight loss doesn't work.

Keep it simple, don't get emo on your bad days, and be consistent. that's it.
Edited by Pu_239 On February 5, 2013 7:16 PM
  11390926
February 5, 2013 7:16 PM
I love food. I love eating unhealthy amounts of unhealthy food. I love eating until I'm sick and then eating some more. That's why I got fat and that's why it's hard for me to lose weight. When I control my eating I can lose weight just fine.
February 5, 2013 7:16 PM
my problem is i love food and so it is very tough exspecially when you live with ppl who eat the worst food ever and your trying to cont your calories its very tough i mean i try to think of ways to eat healthier and there eating fatening ass food right in front of me
  36846090
February 5, 2013 7:17 PM
Honestly Obese people have issues about themselves and we lose weight for other people... once you realize you need to lose weight for yourself, it because a purpose in life and you have STRONG will power.. WILL power is the answer...
February 5, 2013 7:19 PM
Thats a good point...and I believe this is often the case for ppl who have gained 100 + pounds.
  34773897
February 5, 2013 7:19 PM
QUOTE:

QUOTE:

Of course we all knew that but now we know exactly what causes this and can understand the importance of not losing weight too quickly. So this brings up the obvious questions. How fast/slow should we lose weight to make it enduring? Now that they know what to target, how soon before drugs are developed to control the effects of "this NPY circuit" - for those that need them? This could replace gastroplasty (stomach stapling).



It's about habits, as the article said "quick weight loss doesn't work." the reason why people who are obese have a difficult time is because they can't do a 180 with their diet. I would eat Tacobell and mcdonalds almost daily, never ate home cooked food. You thin I can suddenly eat "healthy" it doesn't work that way. You have to make gradual changes and really "understand weight loss." You can eat your favorite foods, just not as much. You don't have to eat like a rabbit. A lot of people miss this.

To keep it off it goes back to the habits. If someone starves themselves and loses 30lbs in 2 months, and another person loses 30lbs in 6 months. Who will most likely keep it off? The person who has PRACTICED(HABITS) the most. This is another reason why quick weight loss doesn't work.

Keep it simple, don't get emo on your bad days, and be consistent. that's it.


This for sure. Some of my very first changes were ordering regular hamburgers instead of big macs at mcdonalds. Also, trading chalupas for regular tacos at taco bell. I probably lost my first 30 pounds doing just that.
February 5, 2013 7:20 PM
QUOTE:

My question would be how you get to be 100's of pounds overweight without having any concern about it in the first place. It's not like you wake up one morning and you're obese. Is there not a point where you're getting a bit overweight that you notice and think "Wow, I need to lose a few pounds"? It always amazes me how people can go so off the rails that they are morbidly obese and seem to have no clue how that happened, like it snuck up on you.

No one ever said we didn't know we were fat. There are a lot of things and time that come into play with weight gain. Things happen in life. Denial happens. The hope is that we will wake up and realize we need to change. That is what this site is for. At least I thought so.
Edited by tbetts23 On February 5, 2013 7:24 PM
  17907883
February 5, 2013 7:22 PM
QUOTE:

just copying an old post.

QUOTE:
While I'm not keen on the entire set - point theory, I do think genetic inheritance plays a very important part in the body returning to a "comfortable" weight. I really think weight is due to a combination of both genes and environment. After reading articles like the following I can't help but wonder if dieting is just too hard for some. My thinking (at the moment ) leans towards the possibility that people who relapse are just tired of the struggle to maintain the constant vigilance. Maybe it's due to a shifting of values where remaining thin is no longer a top priority in life, or counting calories and thinking about food becomes too time consuming and starts taking away from someone's life instead of adding to it. It's nice to be free from analyzing your options every time you eat something, to be able to eat something because that's what you "want", and not what you "should" have.


I'm sure there are many reasons, just throwing some possibilities out there...
May 8, 2007
Genes Take Charge, and Diets Fall by the Wayside

By GINA KOLATA
Correction Appended

It was 1959. Jules Hirsch, a research physician at Rockefeller University, had gotten curious about weight loss in the obese. He was about to start a simple experiment that would change forever the way scientists think about fat.

Obese people, he knew, had huge fat cells, stuffed with glistening yellow fat. What happened to those cells when people lost weight, he wondered. Did they shrink or did they go away? He decided to find out.

It seemed straightforward. Dr. Hirsch found eight people who had been fat since childhood or adolescence and who agreed to live at the Rockefeller University Hospital for eight months while scientists would control their diets, make them lose weight and then examine their fat cells.

The study was rigorous and demanding. It began with an agonizing four weeks of a maintenance diet that assessed the subjects’ metabolism and caloric needs. Then the diet began. The only food permitted was a liquid formula providing 600 calories a day, a regimen that guaranteed they would lose weight. Finally, the subjects spent another four weeks on a diet that maintained them at their new weights, 100 pounds lower than their initial weights, on average.

Dr. Hirsch answered his original question — the subjects’ fat cells had shrunk and were now normal in size. And everyone, including Dr. Hirsch, assumed that the subjects would leave the hospital permanently thinner.

That did not happen. Instead, Dr. Hirsch says, “they all regained.” He was horrified. The study subjects certainly wanted to be thin, so what went wrong? Maybe, he thought, they had some deep-seated psychological need to be fat.

So Dr. Hirsch and his colleagues, including Dr. Rudolph L. Leibel, who is now at Columbia University, repeated the experiment and repeated it again. Every time the result was the same. The weight, so painstakingly lost, came right back. But since this was a research study, the investigators were also measuring metabolic changes, psychiatric conditions, body temperature and pulse. And that led them to a surprising conclusion: fat people who lost large amounts of weight might look like someone who was never fat, but they were very different. In fact, by every metabolic measurement, they seemed like people who were starving.

Before the diet began, the fat subjects’ metabolism was normal — the number of calories burned per square meter of body surface was no different from that of people who had never been fat. But when they lost weight, they were burning as much as 24 percent fewer calories per square meter of their surface area than the calories consumed by those who were naturally thin.

The Rockefeller subjects also had a psychiatric syndrome, called semi-starvation neurosis, which had been noticed before in people of normal weight who had been starved. They dreamed of food, they fantasized about food or about breaking their diet. They were anxious and depressed; some had thoughts of suicide. They secreted food in their rooms. And they binged.

The Rockefeller researchers explained their observations in one of their papers: “It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.”

Eventually, more than 50 people lived at the hospital and lost weight, and every one had physical and psychological signs of starvation. There were a very few who did not get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and, always, counting calories and maintaining themselves in a permanent state of starvation.

“Did those who stayed thin simply have more willpower?” Dr. Hirsch asked. “In a funny way, they did.”

One way to interpret Dr. Hirsch and Dr. Leibel’s studies would be to propose that once a person got fat, the body would adjust, making it hopeless to lose weight and keep it off. The issue was important, because if getting fat was the problem, there might be a solution to the obesity epidemic: convince people that any weight gain was a step toward an irreversible condition that they most definitely did not want to have.

But another group of studies showed that that hypothesis, too, was wrong.

It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.

His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.

Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.

When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.

The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.

That, of course, was contrary to what every scientist had thought, and Dr. Sims knew it, as did Dr. Hirsch.

The message never really got out to the nation’s dieters, but a few research scientists were intrigued and asked the next question about body weight: Is body weight inherited, or is obesity more of an inadvertent, almost unconscious response to a society where food is cheap, abundant and tempting? An extra 100 calories a day will pile on 10 pounds in a year, public health messages often say. In five years, that is 50 pounds.

The assumption was that environment determined weight, but Dr. Albert Stunkard of the University of Pennsylvania wondered if that was true and, if so, to what extent. It was the early 1980s, long before obesity became what one social scientist called a moral panic, but a time when those questions of nature versus nurture were very much on Dr. Stunkard’s mind.

He found the perfect tool for investigating the nature-nurture question — a Danish registry of adoptees developed to understand whether schizophrenia was inherited. It included meticulous medical records of every Danish adoption between 1927 and 1947, including the names of the adoptees’ biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.

Dr. Stunkard ended up with 540 adults whose average age was 40. They had been adopted when they were very young — 55 percent had been adopted in the first month of life and 90 percent were adopted in the first year of life. His conclusions, published in The New England Journal of Medicine in 1986, were unequivocal. The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.

The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”

In other words, being fat was an inherited condition.

Dr. Stunkard also pointed out the implications: “Current efforts to prevent obesity are directed toward all children (and their parents) almost indiscriminately. Yet if family environment alone has no role in obesity, efforts now directed toward persons with little genetic risk of the disorder could be refocused on the smaller number who are more vulnerable. Such persons can already be identified with some assurance: 80 percent of the offspring of two obese parents become obese, as compared with no more than 14 percent of the offspring of two parents of normal weight.”

A few years later, in 1990, Dr. Stunkard published another study in The New England Journal of Medicine, using another classic method of geneticists: investigating twins. This time, he used the Swedish Twin Registry, studying its 93 pairs of identical twins who were reared apart, 154 pairs of identical twins who were reared together, 218 pairs of fraternal twins who were reared apart, and 208 pairs of fraternal twins who were reared together.

The identical twins had nearly identical body mass indexes, whether they had been reared apart or together. There was more variation in the body mass indexes of the fraternal twins, who, like any siblings, share some, but not all, genes.

The researchers concluded that 70 percent of the variation in peoples’ weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease.

The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight.

The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true — each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks.

The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.

He published it in the journal Science in 2003 and still cites it:

“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”

This is an excerpt from Gina Kolata’s new book, “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting” (Farrar, Straus & Giroux).

An article in Science Times on Tuesday about the role of genes in weight gain misstated the publication date for an article in the journal Science describing the biological controls over body weight. The article was published in 2003, not 2000.


Lots of comments after this article at the New York Times if you're interested - most not as depressing as this article and a few by readers that are maintaining a large loss of weight.

February 5, 2013 7:26 PM
Is there a tl;dr version of that ^ ?

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