Suppose again that the premise of my post earlier this week (Well intentioned lies, doctors, and the diet industry) is right that very few people who lose weight keep it off. Most regain it, some regain more and only a teeny tiny few manage to maintain the new low weight.
You might well ask, why can’t I be one of the few? Why can’t I be one of those rare, mythical creatures, the weight loss unicorns?
In my case, I’m a classic type A personality, a lover of plans, structure, and schedules. I’m an analytic sort, a researcher and problem solver by temperament, and I’m highly motivated to achieve my goals.
So maybe I should just find out what those who’ve succeeded in the past have done and try be like them.
According to Canadian health researcher Timothy Caulfield, author of The Cure for Everything: Untangling the Twisted Messages about Health, Fitness and Happiness (I reviewed his book here) people who keep off the weight they have lost are a pretty special breed.
Members of this group all have some traits in common and because they’re rare, have been studied closely. First, constant vigilance. They remain as focused and determined as they were when losing weight and they log and track just as carefully as when they started. Second, they exercise a lot. Third, they also don’t eat very much. Yikes. One of the women profiled in Caulfield’s book hasn’t eaten a full size entree since she began losing weight. She eats appetizers only and shuns all desserts and alcohol.
The Center for Disease Control which maintains the weight loss registry for people who’ve kept weight off long term also describes the traits that people who maintain a weight loss, long term, have in common. They exercise 60-90 minutes most days, they eat breakfast, they weigh themselves regularly, they track food intake, and they plan meals.
In an Atlantic article from a couple of years ago, What do we really know about losing weight? you can read a profile of one person who maintained a new lower weight. I’ll excerpt a bit here but it’s worth going to read the entire thing.
During the first years after her weight loss, Bridge tried to test the limits of how much she could eat. She used exercise to justify eating more. The death of her mother in 2009 consumed her attention; she lost focus and slowly regained 30 pounds. She has decided to try to maintain this higher weight of 195, which is still 135 pounds fewer than her heaviest weight.
“It doesn’t take a lot of variance from my current maintenance for me to pop on another two or three pounds,” she says. “It’s been a real struggle to stay at this weight, but it’s worth it, it’s good for me, it makes me feel better. But my body would put on weight almost instantaneously if I ever let up.”
So she never lets up. Since October 2006 she has weighed herself every morning and recorded the result in a weight diary. She even carries a scale with her when she travels. In the past six years, she made only one exception to this routine: a two-week, no-weigh vacation in Hawaii.
She also weighs everything in the kitchen. She knows that lettuce is about 5 calories a cup, while flour is about 400. If she goes out to dinner, she conducts a Web search first to look at the menu and calculate calories to help her decide what to order. She avoids anything with sugar or white flour, which she calls her “gateway drugs” for cravings and overeating. She has also found that drinking copious amounts of water seems to help; she carries a 20-ounce water bottle and fills it five times a day. She writes down everything she eats. At night, she transfers all the information to an electronic record. Adam also keeps track but prefers to keep his record with pencil and paper
Now some of you might find this horrifying. You might read about it and want to scream, “These are not my people” and run fast in the opposite direction.
But my reaction isn’t that extreme. I’m a fan of planning and tracking. I weigh myself regularly. I always eat breakfast and as readers of this blog well know, I get lots of exercise.
So maybe it’s not all bad. Consider Canadian obesity researcher Yoni Freedhodf’s view in Is It Really Scientifically Impossible to Keep Your Weight Off?.
In responding to the same piece that prompted this blog post, he suggests that we might be able to rebrand “constant vigilance” as “mindfulness” and think more positively about it.
Says Freedhoff, paying attention to every calorie, spending an hour a day on exercise, and never not thinking about weight does sound like not much fun.
“That does indeed sound rather severe, and she definitely writes about it with the spin of negativity. What do I think? I think negative depends on approach and attitude. For instance where Tara might use the word vigilance, I’d use the word thoughtfulness and that being aware of every calorie doesn’t mean you’re not eating indulgent ones.”
Okay, whatever we call it, vigilance, awareness, thoughtfulness, it seems required for keeping off weight. So is a commitment to lifelong mindfulness about food enough to stave off weigh regain? But my suspicion is that it’s not enough. My experience is that I’ve sometimes started to regain weight through practising the exact same habits that earlier resulted in weight loss. I’ve tracked food and exercise very carefully through periods of gaining pounds.
The problem is that these traits, mindfulness, tracking, weighing and on, might be necessary but not sufficient for keeping weight off, once you’ve lost it. That is, everyone who keeps weight off lives this way but not everyone who lives this way keeps the weight off. Tracy in her blog post yesterday about weight loss wondered how much weight regain can attributed to changing habits and how much to biology. I think there’s a significant biological component and that even vigilant people face further obstacles. Here are just four of them.
1. Changed body chemistry, Biological Changes Thwart Weight Loss Study Finds.
For years, studies of obesity have found that soon after fat people lost weight, their metabolism slowed and they experienced hormonal changes that increased their appetites. Scientists hypothesized that these biological changes could explain why most obese dieters quickly gained back much of what they had so painfully lost.
2. Smaller bodies use fewer calories: This is one of the tougher things to get used to. At my largest I’ve weighed 235 lbs and at my smallest 155 lbs (all adult weights). The thing is that my 235 lb body uses a lot more calories just getting about in the world than its lighter cousin does. (Using a standard base metabolic rate calculator and plugging in my age and activity level, I see I need just under 3000 calories a day to sustain my weight at 250 lbs and just over 2300 calories a day if I weighed 150 lbs.) Thus, I need to eat less and less as I lose weight. That’s not easy.
3. Fitter bodies use fewer calories too: When I first ran 5 km at 235 lbs, that was really tough going, not just because of my weight. I was also not used to running. As I got fitter, running 5 km got easier and easier. I burned fewer and fewer calories running 5 km.
Outside Online answers the question about fitness resulting in fewer calories used in this article, Do Seasoned Runners Burn Fewer Calories Than Newbies?
“One study published in the Journal of Applied Physiology determined that well-trained runners burn five to seven percent fewer calories than their nonathletic counterparts. A run you did as a newbie athlete that burned 500 calories, for example, might burn 465 to 475 calories when you’re better trained, assuming you’ve stayed the same weight.”
And there’s the rub. If you’re getting both fitter and smaller (both the goal of many people) you’re also now using fewer calories for an equivalent workout.
Yes, in theory you could making it equally hard. You could run more distance or run faster or add intervals. The reality is that few of us push ourselves as hard as we did when we started. Getting more efficient just is what getting fit is all about. And that’s great but it terms of calories, efficiency isn’t our friend.”
4. Age and metabolism: I’ve written about this one before. See Monday morning, perimenopause, and metabolism.
For runners, you need to run further and faster each year to burn the same number of calories. Getting fitter just means it takes less effort, hence fewer calories, to do the same thing. That’s just what fitness is. Ignore the calorie counters on exercise equipment at the gym.
And no matter what else you do, you’re aging and your metabolism is slowing down. And truth be told, few people run more or run harder as they age. Why that’s so was the subject of an earlier blog post, Is Aging a Lifestyle Choice?
There’s a sad funny story in Timothy Coalfield’s book The Cure for Everything: Untangling the Twisted Messages about Health, Fitness and Happiness about a colleague who ran 18 marathons, one a year, and gained one pound per marathon.
So getting fitter and thinner and older means eating less and less, and working out more and more, to stay the same weight. Behavior and habits that at one point in one’s weight loss journey led to a loss on the scale, can, at a later point on the journey, lead to weight gain. Not exactly inspirational!
Caulfield’s book, like Gretchen Reynolds’ book The First Twenty Seconds, makes it clear that the truth doesn’t provide much fodder for catchy motivational slogans: Exercise intensely for long periods of time and you might just stay the same! Both cite the same study showing women who exercise a lot, and regularly, still gain weight as they age. They just gain less. That’s good health news but won’t exactly make for a very good poster at the gym.
I’ve got one more post on this subject left to go–it’s in the draft folder and is called “Impossible Weight Loss: Questions and Quibbles”–and after that I promise I’ll return to fitness, which I don’t actually think is connected to fatness at all.