brownblonde
My hope
May 04, 2016
This has been an exciting week in the world of obesity justice. First, on Friday there was an article debunking the myth that calories burned during exercise should be given equal weight to calories cut through dieting in the weight loss equation. Essentially, the article held that exercise is not the best tool to fight obesity. See here: http://www.vox.com/2016/4/28/11518804/weight-loss-exercise-m yth-burn-calories
And secondly was an article that followed Biggest Loser contestants for 8 years and found that their metabolisms were greatly decreased. See here: http://www.nytimes.com/2016/05/02/health/biggest-loser-weigh t-loss.html?_r=1
If you are trying to lose a massive amount of weight on your own, I'll admit, these articles are pretty damned depressing. But to me they confirm what I already knew: obesity is a disease far more complex than "calories in, calories out", and about a lot more than lack of willpower or discipline. I hope that articles and studies such as these will make the public realize that there really isn't a viable solution to obesity, short of WLS. It's not the easy way out, it's the only way out.
So, that first article. The diet mantra that has been drilled into my head since about the time I could speak was "calories in, calories out." If you've spent any time dieting at all, you know that you must have a deficit of 3500 calories to lose a pound. The common thought has been that this can be achieved by some combination of cutting calories, and burning more calories in exercise. Aka, if you wanted to lose a pound a week, you could either a) consume 500 calories less per day, b) burn 500 calories during exercise per day, or c) do some combination of the two that equaled 500 calories. And, mathematically, you would theoretically lose 1lb. no matter which approach you chose. Not so suggests this article and the study to accompany it. Why? Well, it gets pretty complicated, but best I can understand is that essentially your body subconsciously compensates for the extra calories you burn during exercise. In our example, say a person decided he wanted to eat the same calories, so opted to burn 500 calories at the gym per day to reach his goal. He is unlikely to be as successful as the guy who combines exercise and diet, and the guy who does diet alone may be most successful. First, "macho man", as we will call him, may overestimate the calories he's burning. So while he may think he's burning 500 calories, he may in reality only be burning 300. Oops. Second, he may eat more to compensate--maybe a preworkout banana, or a protein shake--upping his overall daily calories, and decreasing his desired deficit. Or, most frighteningly, he may burn fewer calories thorughout the rest of the day. You see, while we have complete control over the number of calories we eat, we have very little control over the total calories burned by our bodies. Only about 10-30% of the calories we burn come from exercise. The remainder come from the functioning of the body, as well as just how much you "move" in a day. So what the researchers behind this study/article found was that people who are exercising to lose weight actually decrease their activity the rest of the day. The fidget less, they take the stairs less, and they probably go ahead and opt for that front parking space. Major calorie burning points lost here.
So, while exercise is good for health, it may not be the most effective tool for weightloss. And it certainly is no substitute for lowering calories by diet. One of my doctors said "the best exercise you can do is push away from the table." And in essence, that was the finding of this article. It concluded by suggesting that dieters exercise, but not count those calories burned toward their goals. Pretend like it didn't even happen.
I, loathing every minute I spend in a gym, rejoiced over this article. But not too fast. My husband was quick to point out "but but but....the Biggest Losers lose massive amounts of weight by diet and exercise. So exercise must work."
You cannot imagine how OVERJOYED I was when the second article came out not a few days later.
This second article followed Biggest Loser contestants. I think pretty much all of them had regained at least some weight. But I think they were all lower than they were to begin with. Were any of us shocked that they regained some weight? I don't think so. We all knew that it just isn't sustainable to continue to workout 6, 7, 8 hours per day. That sounds like you're just asking for an overuse injury, not to mention having absolutely zero life. However, the most frightening aspect of the article/study was that they found the contestants' metabolisms had decreased. Of course their resting metabolic rate would've decreased by a bit simply because they weigh less. But it dropped much more than that. As compared to a person of the same size, their metabolisms had decreased by 250-800 calories. In other words, if the man with the biggest metabolic screwup were to eat like his friend with the same stats, the metabolic screwup would gain nearly 1.6lbs. per week! Their bodies are truly fighting with them to get them to regain weight. And, as the article points out, this is one of the most successful subsets of dieters. One would think that these contestants have probably done it the right way, at least in terms of their metabolism. Right? We're always hearing how muscle burns more than fat (is this even true? I cannot seem to distinguish between myth and reality any more when it comes to dieting and weight loss!!!). And I've always been told that maybe my metabolism is low because I don't exercise enough, and I don't have enough muscle mass as compared to body fat. These contestants should be golden!
The second problem BL contestants had to face was that their leptin levels (decreased? increase? I cannot remember. Too technical) did something to make them ravenously hungry. I mean, not like c'mon have some willpower for god's sake hungry. I mean like hulk hungry. Huuuuuaaaangry. Biologically speaking, their bodies wanted them not to lose weight. And it was going to throw everything at them.
This is what I have been afraid of all along!!! I know I cannot eat what my peers eat. Yes, it's somewhat irrelevant--I cannot do anything about it other than eat less and be lean or eat the same and be heavy. Now before we get too far, I know what you're thinking "but Bonnie, you didn't lose the weight through diet and exercise--you had WLS." True, true. And a lot of WLS peeps are rejoicing at this article, hoping to find other articles that say that WLS does not affect metabolism as negatively as extreme diet and exercise. I'll be honest, I haven't had the time to try to pin down such studies. I don't know if they exist. But even if they did, all I want to say is that I did diet my entire life prior to WLS. I think the damage was already done. Maybe, if someone never dieted and had WLS, they would be good to go. But I did HCG diet, and liquid diet, and weight watchers, and cabbage soup diet, and grapefruit diet, etc., etc. It was very hard for me not to gain weight at 277lbs.!!! I think the damage was already done. That being said, I think their is ample proof that WLS does a great deal for grelin and leptin levels in terms of regulating hunger. And that has been my experience. Even in the past couple weeks going back to being really strict about my eating, I have honestly not been very hungry.
The takeaway for WLS patients: confirmation that we did the right thing. Dieting has about a 2% success rate for obese people to lose and keep off weight. Those are dismal odds. In truth, even WLS doesn't work all the time--the odds are far better at 50-60% (quoting support group leader on these stats). As far as I'm concerned, non-surgical means of controlling obesity is a technical failure. So why do we keep pushing this????!!! Why do doctors keep encouraging diet and exercise along? And well-meaning friends and family encourage you to "do it the right way." It just DOES NOT WORK. Even when you may be able to lose the weight, you are very likely to regain it. I have seen so many family members spend years in this purgatory of weight loss and weight regain. It's such a vicious cycle. It's not healthy physically (see above--screws up your metabolism). And it's certainly not healthy mentally. Any other disease that had one option with a 2% success rate, and another option with a 60% success rate--no one would choose the former! Again and again I will say, WLS is not the easy way out. It was the ONLY way out. I hope that family, friends, doctors, insurance companies will begin to "get it."
And why don't they get it? Because deep down we've all been fed this bologna about how weight is an outward sign of a serious character flaw. It's a lack of self discipline and willpower and it's vulgar. I know better. Even after WLS, the struggle. Is. Real. Sadly, I think some of us obese or formerly obese buy into this theory the most. We are so ashamed of ourselves. If we gain weight we start an inner dialogue of negative self talk. And some of us, even after having battled these own battles ourselves, seem to perpetuate the notion that weight gain is a sign of a character flaw by the way we counsel those who have experienced regain. It's not as simple as "work harder." that's like telling someone who's clinically depressed to "think happy thoughts." Or telling someone with asthma to "breathe in deeply." It's kind of insulting and I think in this instance, it perpetuates the very archaic thinking that weight gain is associated with a lack of effort or discipline.
My hope is that someday obese people are seen as having a genetic or metabolic disability. That obesity is a disease. And that it should be treated without regard to one's "character." I hope one day that we see WLS no different that open heart surgery--a very necessary medical intervention to a disease. And I would go one step further and say my greatest hope is that we just get over peoples' weights!! There is so much more to care about. So much more.
