Plateau set point revisited

The first fact you should tell your patient starting on a weight loss diet is the answer Dr. Mike Rosenbaum gave to the question:

"The plateau set point keeps going higher as patients get heavier but what can make the plateau set point go down?"


Dr Rosenbaum answered: "We have shown scientifically that the plateau set point can go up as the obese become leptin resistant.
However there is NO EVIDENCE that anything lowers the plateau set point once it has been elevated."

Thus for the rest of the reduced obese life their body strives to get back to the highest plateau set point from the past.

This is why Dr. Rosenbaum points out obesity is how humans evolved to survive famine, it is not about will power, sloth or gluttony.

Dr Rosenbaum did overfeeding experiments.
Lean people gained weight but not enough or long enough to reset their plateau set point higher .
These lean people easily lost the weight to go back to their old plateau set weight.

In my book, The Chronic Disease of Obesity,  I write about the Sponge Theory.
After I lost 80 pounds the traditional low calorie way I slowly gained back 50 pounds over 4 years despite 2.5 hours of exercise a day.

Of course I ate more than 1500 calories a day.  I thought 1,000 calories of exercise I did a day would prevent regain as the guidelines said.

The guidelines do not take into account that the fat cells shrink but the number of excess fat cells  remains the same.

In 2011 I postulated that it's the number of excess fat cells with low leptin levels that cause regain in the reduced obese.

Even with slight increase in the original 1500 calories on weekends the body uses that energy to create bigger fat cells for to survive the next famine as evolution made. I remain cold most of the time due to low leptin preventing my resting and exercise metabolism to return to normal.

Initially ketosis helps hunger.
 More protein helps hunger.
Caffeine helps hunger.
Once the reduced obese hit the point which they can't lose more weight (confusing as this is also described as another plateau) the numerous fat cells with low leptin bypass those 3 anorexiants.

Even one diet medication will soon fail as phentamine does after a year. 

We learned with Fen-Phen that at least two diet medications are needed. 

I am on Victoza, Metformin, Invokana, Belviq and Caffeine. 

Dr Aronne at the Houston Obesity conference 4-2019 presented several case studies where he showed how he maintained weight loss in these patients with multiple diet medications. 

In 2015 he said he uses multiple diet medications.  
I picked up on that statement and wrote about my use  of multiple medications to maintain a 70 pound weight loss from 2011.
 My book is the only book on the market titled The Chronic Disease of Obesity. 

 2015 Columbia University, Dr Rosenbaum talks about bilking the public link