Sunday, June 26, 2016

Biggest news about Biggest loser



The Big News:

Reduced metabolism persist for 6 yrs 



Reduced obese regain weight because of billions of shrunken fats cells that never disappear.  This is like a sponge that is ready to put on fat for the survival of the human.
Thus even at a low calorie diet these fat cells will take on fat.
Only a sub-starvation diet diet can maintain weight loss in the reduced obese.
 This is how 10,000 people have done it at National Weight Control Registry.

This article from Market Watch tells the story of two winners of biggest loser from 2011 who have maintained their weight loss for 5 years.

Excerpt from Emma Court article:

‘What you’re dealing with’
"For “The Biggest Loser” contestants who regained much of the weight, the May 2 study found that their metabolism — slowed from weight loss — remained “suppressed at that same average level as at the end of the weight loss competition.”

This is the really big scientific news. 
 When studying for the American Board of Obesity Medicine that I passed in December 2015,  the lectures I attended in preparation for the exam showed different slides with different opinions as to the length of time on metabolic suppression. 
Indeed I questioned Frank Greenway about his chapter in the text Handbook of Obesity by Bray on adaptive thermogenesis. 
He wrote back and said the chapter was written before the data on The Biggest Loser came out. 
 He corrected this in 2015 with:  Frank Greenway review


Again from Emma Court article:

"But in fact, the Obesity study concluded that, despite contestants’ weight regain, they were “overall quite successful at long-term weight loss compared with other lifestyle interventions.”

"Like Ward and Curlee, the authors concluded that weight loss wasn’t impossible.
Rather, they said, “long-term weight loss requires vigilant combat against persistent metabolic adaptation that acts to proportionally counter ongoing efforts to reduce body weight.”


Commentary on final paragraph
“Weight loss wasn’t impossible”
Kevin Hall et al

Millions of people know they can lose weight, they just can’t maintain the weight loss.


“Long-term weight loss requires vigilant combat against persistent metabolic adaptation”
Kevin Hall et all

Very true but if diet and exercise are the only tools in your toolbox 90% of your patients will not accomplish it. 

The two ladies in the Biggest Loser who maintained their weight loss are not typical patients.

Case One
Ward 40 years old

Quoted from Emma Court's article: 

“For Ward, who’s 40 and lives in New York City, that means what she eats is “maybe not the normal amount of calories a normal 150-pound woman would eat.”
She works within that by eating like a nutritionist’s favorite client — think lean protein, fruit and vegetables — and avoiding simple carbohydrates.
When she does indulge, it feels more decadent than it used to in her pre-TV show days, when it was a far more common and less savored event, she said.

Not to mention, she’s a spin instructor, so she works out a lot — as many as three times in one day.”


Case Two
Curlee 37 years old

“But does fitness have to become your day job to maintain weight loss? That hasn’t been the case for Curlee, 37, who lives in Nashville, Tenn., and does corporate communications for HCA Healthcare HCA.
Though much of her job involves planning wellness programs for HCA, Curlee said that, like most people, she still spends most of her day sitting at a desk.

That means going to the gym at lunchtime, for example, and other kinds of life changes, said Curlee, who is married to a personal trainer.

“When I work, my metabolism does,” she said.

“When I exercise, feed my body what it needs to be fed, when I’m eating 75% to 80% clean, my body does respond. It’s a hard lesson to put in every day... and it doesn’t mean I never have a cheat meal or veer off. I just don’t veer off nearly as much as I used to.”
 
 
I agree that diet and exercise has worked for these two ladies just as I believe diet and exercise alone work for the people in the NWCR. 
I suspect these ladies are at less than a net of 1,000 calories a day. 
The rest of the story for Emma Court is to follow this ladies for a few days in their diet and exercise and try to keep up. with normal Leptin levels.
I know I couldn't do it without tremendous effort and suffering. 
 
To offer this false hope to the rest of society without the help of diet medicine to fight the effect of low Leptin is blind to the science of the disease of Chronic Obesity.  


I analyze Emma Courts excellent article here:
 The rest of the story on Court's article






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