Science of Obesity: Not diet and exercise

                      3 ARTICLE LINKS

1-Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations

Christopher N Ochner


2-Physiological adaptations to weight loss and factors favouring weight regain 

Frank Greenway

3-Modern Way to Treat the Disease of Chronic Obesity 

Brian Edwards

Modern Way to treat the Disease of Chronic Obesity: A Case Study

12-30-15

An Obesity specialists opinion on how to treat chronic obesity.

“Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success.” (1)

HIGHLIGHTS

1-A new approach to maintain weight loss is to add diet medicine.

2-Low carbohydrate high fat high protein or “Atkins” is ad libitum and thus not calorie restrictive, making it more likely a patient can stay on it for life.

3-Literature reviewed on effect of low carbohydrate high fat diet in head to head trials with low fat diets.

4- Literature reviewed on quality of evidence that more exercise will maintain weight loss.

5- Comparison of diet and exercise advised to maintain weight loss with Ancel Keys Starvation Experiment.

6-Unique serial CIMT data over 5 years while on LCHF diet showing 

regression of atheroma.


Complete article without data here 

Contents links:

Introduction 

Discussion

Case Study 

Conclusions 

Final Comments 

Data while exercise one hour in nutritional ketosis 

Complete Data Lab sheet 

My six serial CiMT's with regression atheroma 

 My Basis Atkins Diet 

References

Advice to discuss with Doctor about Diet Medicine 

My co-morbidity of obesity went beyond diabetes and neuropathy and affected my walking in 2005

I was always athletic and able to carry my weight well.  I became type 2 diabetic in 1999.  Multiple attempts to lose weight again failed.   I would get so hungry I ended up gaining weight.  I eventually went on insulin and went from 260 lbs to 280 lbs here.  I was in Chicago and trying to walk several miles.  My feet prevented me from doing it.  This never happened to me before.  4 months later I tried to go skiing but as I prepared my knee became swollen.  Fortunately, I finally found a diet that worked for me: The 3 Hour Diet by Jorge Cruise.

It worked because I could have a 300 calorie snack between meals in my 1850 calorie diet.  I was not too hungry. 

I lost 80 pounds.  My colleagues wondered if I had cancer.  I exercised 2 hours a day.  One hour first thing in morning at the YMCA.  I used the weight circuit after warming up walking on the treadmill.  At lunch I walked 3 miles. 

The problem came when I hit the plateau at 200 pounds. 
My teaching from the National Lipid Society was that more exercise would maintain my weight loss. 
They advised 90 minutes a day. 
I did 120-180 minutes a day.  
I added water aerobics and had 2 physical trainers. 
I added low glycemic fruit and wine. 
I gained 1.5 pounds a month till I went up to 260 lbs from 210 lbs.  after 4 years.
Jorge Cruise in his book did write that I should increase my calories only 100 calories a day and see how my weight did.  That seemed too difficult to me after so much effort just to maintain weight. 

Now, I realize he was right. 
Exercise has little to do with maintaining weight loss.  
What is important is maintaining a low calorie count. 
The low calorie count that helped you lose weight is now the number of calories you need to maintain weight loss. 
This is how 10,000 people maintained weight loss more than 5 years 

The problem is a 1550 calorie diet with one hour exercise a/day is exactly the diet  Ancel Keys used in his Starvation Diet Experiment (one minute 33 second video)but he only did it to his men for one year.
  To maintain your weight loss you must do it the rest of your life.

10% of patients that undergo Bariatric surgery regain all their weight loss in 10 years. 

Look Ahead Trial

Quote from the NEJM paper:
"Weight loss was greater in the intervention group than the control group throughout
 (8.6% vs. 0.7% at 1 year; 6.0% vs. 3.5% at study end)." (10 years)

My Solution to my Chronic Obesity

The Modern Way to Treat Chronic Obesity 










 

Gained weight with nutritional ketosis and one hour exercise a day on Atkins

I gained 4 pounds of muscle on Low Carb High Fat diet with one hour exercise. 

On 6-63-15 I started Qsymia and decreased my exercise to one mile walking 5 days a week with same LCHF diet plus avg 4 oz ETOH a day. 

I also did Body Composition comparsion.  I lost 5% body weight.  I lost 4 pounds muscle.  I decreased body fat by 3%.  I increased total body water by 3%. 

This is the Modern Way to Treat the Chronic Disease of Obesity

Date	Weight	Fast Glucose	Ketones	HgbA1c
5-3-15	238
5-4-15	240	120
5-8-15	236.5	148		6.5
5-14-15	239.5	127	1.6
5-15-15	239	141	1.1
5-16-15	238	141	0.9
5-17	238.5	137	1.2
5-18	238	130	1.5
5-19	238	127	2.4
5-20	238	131	1.7
5-21	239	131	0.8
5-22	240	130	2.2
5-23	241.5	121	1.7
5-25	241.5	124	1.2
5-26	241.5	134	1.4
5-27	241.5	133	1.5
5-28	239.5	143	0.6
5-29	241.5	143	1.3
5-30	242.5	133	1.8
5-31	242.5	125	1.7
6-1	241	119	1.7
6-2	241	155	0.4
6-3	242	129	1.5
6-4	239.5	134	0.7
6-5	238.5	134	1.1
6-6	240	126	1.8
6-7	240	123	2.3
6-8	241	129	1.9
6-9	241.5	132	1.4
6-10	244.5	125	0.9
6-11	242.5	141	1.7
6-12	243	145	1.7	Vacation
6-13		143	0.2	In Branson
6-14		131	1.1	In Branson
6-15		160	0.3	In Branson
6-16		151	1.2	In Branson
6-17		157	0.6	In Branson
6-18		163	0.6	In Branson
6-19		164	0.8	In Branson
6-20	243.5	143	0.9
6-21	241	155	0.3
6-22	241.5	156	1.3
6-23	241.5	134		Obesity Clinic
total H2O 49.9%	244.8 w clothes	total body fat 31%	FF mass 68.9%	Muscle Mass 46.1 lbs
6-24	started	Qsymia	3.75/23 mg	stopped wt lifting
7-28	238 lbs	Qsymia	7.5/46 mg
12-1-15		Withheld Qysmia for Boards (10 days)		Started Victoza
12-11-15		On Victoza 1.2 mg Invokana 300 mg Metformin 2,000 mg		Obesity clinic
total H2O 52.8 %	222.2 w clothes	total body fat 28.1%	FF Mass 71.8 %	Muscle Mass 41.8 lbs
12-12-15		resumed Qsymia	5 diet meds	Lifelong Rx.
12-15-15	217.8 lbs	glu 127	ketones 2.6	off Actos Insulin