I've seen the term "starvation mode" thrown around a bunch on the boards before with varying degrees of eye rolling, so I though some of you might find this YouTube video interesting/informative.
Obviously the video is geared towards people who haven't had WLS, so some of the takeaways don't completely apply, but I thought it was a good breakdown of where the myth of Starvation Mode came from (and why it's not real). It's from Jeff Nippard's "Myth Bust Mondays" series where he takes on common nutritional and exercise myths and explains why they aren't true based on scientific research. I really like the series a lot, as many topics he covers are misconceptions/questions that I've seen crop up in the WLS community.
As a side note, his girlfriend, Stephanie Buttermore also has a YouTube channel and recently published the below science-based video on the safety of the various artificial sweeteners, which I also found really informative and particularly helpful for WLS patients. Lots of actual science, but broken down in a way that's easy to understand.
I really appreciated the artificial sweetener video. I diverged and watched a couple of her other videos. I like that she's a thin, healthy, intelligent person who also shops at Walmart and likes dessert.
Yeah, I thought the sweetener video was really excellent! I definitely enjoy watching her videos. She's fun and knowledgeable but doesn't come across as perfect or preachy.
I have a daughter whose major is kinesiology, and she is being taught that "starvation mode" is a real thing, but not to the extent that some people think. The video actually seems to confirm what she's been taught rather than "proving" that starvation mode is a myth.
He clearly discusses thermogenic adaptation, and specifically relates more downregulation to what he terms "crash diets" which is much closer to what we do with WLS than what he terms "low calorie" diets. He's considering 1500 cal/day (probably for men) to be "low calorie" diet. Whereas most of us at least for the first few months are taking in around 600 cal/day.
I've heard a lot of people say that with WLS they need to keep their intake in the 600-800 cal/day range to lose, and many claim they cannot eat more than 1,000 cal/day in maintenance. (Of course, much of this depends on the stature of the person.)
Those caloric levels for most adults would fall into his classificaton of "crash diets" which DO create thermogenic adaptation which means metabolic downregulation.
My surgeon cited this in her goal for me to be up over 1,000 cal/day by about 6 months post-op. Now, I'm also 5'9" so I would expect my caloric intake to be slightly higher than someone who is a half a foot shorter than I am. But she said there's quite a bit of evidence for this metabolic downregulation if you severely restrict calories for a long period of time. Now, it's never to the extent that you completely stop losing weight, but she says it can make a difference in where your maintenance intake ends up, at least without doing some very serious recovery.
Following my surgeon's advice, I was eating right around 1,000 cal/day at 6 months, and by a year out up to about 1,200 cal/day. Right now at about 18 months post-op, my maintenance level appears to be in the 1,800 cal/day range. I can lose slowly at about 1,500 cal/day and lose fairly briskly at 1,200 cal/day. That's a LOT higher than many here report for their maintenance and losing rates.
So based on my research, what my daughter is learning in college, and my surgeon's experience and research is that there IS a certain amount of thermogenic adaptation that causes metabolic downregulation when extremely low calorie diets are used for a long period of time. I suspect that yo-yo dieting may also cause a certain amount of downregulation, but I don't have a lot of evidence to back up that suspicion.
Now, I don't think it's nearly as powerful as some think. I believe that most people who say they cannot lose weight at 800 cal/day or 1,000 cal/day more likely aren't very good at measuring & documenting their actual intake. It's also important to realize that calorie counts for foods have a margin of error that can accumulate into a really significant difference between what our calculations show and what calories are actually being processed by the body. So even those who ARE very good at measuring/documenting can still be WAY off the actual calories in their diet.
But for me, it means a great deal to be able to maintain at 1,800 cal/day than having to forever restrict myself to 1,200-1,500 cal/day. Of course, I can't prove that eating higher calories is responsible, but it matches the science my surgeon, my daughter, and I have found.
So I would say that starvation mode as most define it is not a real thing. But it's important to recognize that it's not 100% a myth.
Yup. As you said, the video does confirm that there is an aspect of truth to the concept. But the important takeaway is that the degree to which people take the idea of "starvation mode" is really what the myth is busting, and very likely the reason for stalling etc. is due to margin of error in food tracking/calorie burning estimates, not because your body has gone into "starvation mode" because your calories are too low.
I know that a lot of cut/tapering programs for fat loss often involve first increasing your calories before you begin to gradually lower them, particularly if you are already eating at a significant deficit. For me, I don't know that I would really classify this phenomenon as my body being in starvation mode, so much as I would think of it more as my body adapting to the nutrient levels I've been consistently giving it. The two ideas are probably related, but for me, I tend to view the concept of starvation mode as really the people who view it to extremes, and it seems like starvation mode as most people think of/use the term isn't really a thing, or at least doesn't have a significant enough impact to really jack up calories etc.
I'm 5'7" tall and I stayed at 600-800 calories until about 8 months and I'm eating 1,800-2,000 calories to maintain 125-130lbs (the last 5 weeks that hasn't included any exercise). My resting metabolic rate was 1,540 calories the last time I had it checked.
So, I'd say my personal experience points to any thermogenic adaptation being temporary. Per the RR testing, I had done my metabolism is 8% faster than the 'norm' for my height/age/weight/gender.
Of course adaptive thermogenesis is a factor. But none of those I've seen talking about "starvation mode" are actually talking about adaptive thermogenesis. They are making excuses for failing to lose weight, because they are eating far more than they think they are. Starvation mode as it's ever been used in these forums is not true at all.
As far as metabolic damage from obesity and years of yo-yo dieting, that is also a major problem. It's why most of us had trouble maintaining weight loss before surgery -- but also why we are able to maintain weight loss after surgery. Because all of those studies that talk about metabolic damage from very low calorie diets were done on those WITHOUT weight loss surgery. There is a reason they refer to this as Metabolic and Bariatric Surgery. We just don't suffer from the same issue. I have personally known countless people here who have kept to a very low calorie diet until all of their excess weight was lost, and then maintained on a "normal" level of calories. Many who eat the number of calories you do are well within the normal BMI category. Many others who eat a fair number of calories, however, are still in the overweight and even obese categories. You can't really compare those people to those with 100 percent excess weight lost. I myself maintain just fine on over 2600 calories a day, and during my weight loss phase I kept my calories as low as others here -- even though I am a foot taller than many of them. It did my metabolism no harm whatsoever.
The vast majority do not weigh their food, and do not track closely, either. When one of those people tells me they are eating 800 calories, or 1200, or 1800, I ignore their numbers. In reality, they have no idea how much they are eating. And 99.5 percent of them are eating a lot more than they think. It's what the morbidly obese (and formerly morbidly obese) do.
6'3" tall, male. Maintaining a loss of 280 pounds.
Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.
M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.
I agree that people use it as an excuse and that most people don't really know what they're eating. They eyeball their portion sizes, forget to track some things they eat, etc. Add in the allowable variance for the calorie determination for various foods and you can end up eating thousands more calories than you think you do.
I think it's possible to stay on an extremely low calorie diet and then because of the way you ramp up the calories it recovers any adaptation that might have been at play due to the very low calories. I also think it's possible that some people don't recover from the adaptation as well or as fast as others.
I know that I ate a LOT more calories than many of my cohort during my weight loss phase, at least after the first 4-5 months or so. And a LOT more than the vets here advise. My weight loss wasn't quite as fast as some of my cohorts but it was steady. Now I'm hearing a lot of them saying they can't go above 1,000 or 1,200 calories or they gain weight. They may be eating a lot more than they think, but some of them I know are measuring and documenting everything.
I followed my surgeon's instructions, which were to get up a little over 1,000 cal by 6 months and target 1,000 - 1,200 a day after that. She said that it was important to not let my body adapt to the extremely low calorie diet, or it would be hard to not get stuck at those very low calories for maintenance. My results so far are excellent following her instructions.