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Lose Slow—or Regain Fast

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Mother Nature Made You Eat Those Donuts

Seventy-five to 95 percent of those who lose weight gain it all back. Those are the dismal statistics. You’ve probably wondered why it’s so hard to keep weight off. Why don’t we have more control over how much we eat? Researchers at Columbia University Medical College helped explain the problem by observing changes in brain activity after obese subjects reduced their body weight by about 10%. Their findings are reported in The Journal of Clinical Investigation (July, 2008). The details are quite revealing and instructive. I’ll tell you upfront that willpower has surprisingly little to do with the appalling rate of recidivism.

In their introduction, the researchers explained that previous studies have shown that weight loss of 10% or more causes a rapid decline in circulating leptin, a hormone secreted by fat cells. Leptin is known as the satiety hormone, because it controls hunger; when it drops hunger increases and metabolism slows. In other words, weight loss sets off powerful physiological changes that practically mandate that we eat and put the weight back on. It’s nature’s way of responding to food shortages and insuring survival. The catch is that famine is extremely rare in the Western world; food is readily available to just about every one. A response that once helped us endure hard times now serves primarily to make us fat and keep us that way.

The researchers hypothesized that weight loss leads to “leptin-mediated changes in areas of the brain known to [control] feeding behavior.” And that’s what they found. They observed hunger related changes in brain activity--and found that “many of [the changes] were reversed by [injecting] leptin.”

Losing weight made leptin drop and hunger rise. Injecting leptin made the hunger go away. 

I believe there's an alternative to hormone injections, one available to just about every one. We’ll discuss that option in the next section.

First, let’s look at the study details.

The Columbia researchers admitted six obese subjects to the hospital, where they were fed a liquid formula diet with enough calories to keep their weight stable for at least 2 weeks. After the weight plateau, daily calories were reduced to 800 until they lost 10% of their weight. (Sounds like fun.) The weight loss phase ranged from 36 to 62 days. Once 10% weight loss was achieved, calorie intake was increased enough to maintain the weight loss. They then gave each subject replacement leptin or a placebo for 5 weeks; subjects were blindly rotated (after a 2 week washout period) so that each received leptin and the placebo.

At each stage (initial weight, weight reduced-leptin, and weight reduced-placebo), the researchers observed brain activity using functional MRI as the subjects were shown food and non-food items.

The MRI scans showed that in the weight reduced state the subjects had more blood flow to areas of the brain that govern emotional and sensory response to food, and less to areas involving control of food intake. After leptin was restored, however, blood flow returned to what it was initially, before they lost weight. In effect, leptin restoration allowed their bodies to ignore the weight loss. (So far, at least, leptin injections have not worked for weight loss; the benefit appears to be limited to keeping the weight off.)

Wall Street Journal health columnist Melinda Beck discussed the study with co-author Rudolf Leibel. (He also helped to discover leptin.) While there are still many unknowns about the connection between blood flow in the brain and behavior, he told her, brain images provide further evidence of the powerful biological forces that send humans into survival mode when food is scarce and fat stores decline. “These people act as if they are hungrier and combined with reduced energy expenditure, that’s the perfect storm for gaining weight.” (July 8, 2008)

How do some people manage to lose weight and keep it off? By watching what they eat very carefully and exercising more, according to Melinda Beck. Michael Rosenbaum, lead author of the Columbia study, agreed: “Anybody who has lost weight and kept it off will tell you that they have to keep battling. They have essentially reinvented themselves, and they are worthy of the utmost admiration and respect.”

I’d like to suggest another way to bypass the leptin effect.

Don't Alarm Mother Nature

Studies like this help us realize that the body is very logical in how it works. The key is to understand that the main objective is survival.

The results of the study might have been different if the subjects had been put on a reasonable exercise program, fed a balanced diet of whole or minimally processed foods, and most importantly allowed to lose weight at a rate that did not leave them hungry or feeling deprived. This generally means losing a maximum of one pound a week, or better yet one-half pound. The subjects in the study were healthy and had no burning need to lose 10% of their weight in 36 to 62 days. Losing slowly might not have been practical for the researchers, but it would’ve been much more acceptable to the subjects—and their genes.

Unless rapid weight loss is a medical necessity, no one should be subjected to an 800-calorie diet. Such diets make people extremely uncomfortable—and practically assure rapid regain. As a matter of fact, I’ll wager that the subjects in the study regained the 10% they lost—and more—when the injections stopped. Their bodies were essentially under assault. It was logical to assume that something needed to be done promptly to repel the attack, to assure survival

Under the conditions in the study, Mother Nature was entirely justified in setting off alarm bells and pulling out all the stops to restore the subjects to their original weight. Eat or risk extinction.

It does not have to be that way, however. Ask my friend and photographer Laszlo Bencze.

He wrote a piece for my book, Great Expectations, called “My Week with the Basses.” Among other things, he tells about experiencing our eating style first hand.

 “I’m continuing to do it myself here at home and I can tell you it’s working,” he wrote. “I’m eating less than I used to and slowly, slowly, very slowly losing weight.” Continuing he says, “Clarence suggested going down an average of half a pound a week to reach my target weight of 225. Starting from 252, that should take me about a year which is just right. Slow weight loss doesn’t upset the body and push it into the starvation response which changes metabolism and packs on flab.”

He certainly understood the concept, but did it work? I asked him as I was writing this.

Laszlo tells me that he got down to 225 in about six months, losing roughly a pound a week, but that he has drifted back up to between 235 and 240. He admits to losing his focus in the last few months—eating larger portions—but reports that he’s still wearing trousers that didn’t used to fit; he also had to buy a smaller belt.

I guess we can say that he bypassed about half of the leptin effect. Importantly, hunger didn’t seem to be a factor. He simply let his food intake drift higher. He also blames eating in unfamiliar places while traveling the world in his profession as a commercial photographer.

From having used the system for more than 30 years, I can tell you that it works. (Did you know that I once weighed 200?) I am not hungry and have no problem keeping my weight down. As I told Laszlo, you do have to keep your eye on the ball—or should I say the mirror and the scale. If your weight starts to drift up, you have to make course corrections. The key is to make small changes (in food intake and activity level) that don’t alarm Mother Nature.

So, Melinda Beck is correct. You do have to pay attention to what you eat.    

It works. I guarantee it.

(See also Uniform Eating Goes Mainstream http://www.cbass.com/UniformEating.htm and Rethinking Thin http://www.cbass.com/RethinkingThin.htm )

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