Don't tell the truth about weight loss

I like to think that I can learn from my mistakes, but there is one mistake I that I am way too thick to learn from.

I tell the truth about healthy living, about weight loss, and how to get fit.  I keep up with coaching workshops and reading the most recent research.  I've been doing this since 1987.  I'm confident I have a good grip on what is currently understood, and make an effort to pass on what I know staying true to what's published rather than relying on my own theories.

At the risk of sounding trite I want to tell you about an experience I found personally disturbing.

I received an email from a small group of people working for a company that was having a weight loss contest to raise money for cancer research.  The group needed a coach or trainer who could do a legitimate weigh-in or body fat test and sign off on the measurement, providing third party proof of weight loss for the contest.

After a brief phone call a meeting was arranged.  I told the group of 5 or 6 people that my mother is a breast cancer survivor and so I am personally motivated to donate my time to the group for any help they need with losing weight.

That was my first mistake.  They didn't say they were looking for help in losing weight, they said they were looking for a certified coach or trainer to measure their weight loss progress and sign off on it. I wanted to offer more.

I started talking about the usual points; eat less, exercise, calories in, calories out.  The group told me that they were educated and had experience losing weight; they'd lost weight several times before.. they knew what they were doing.

I asked them since they were wanting to lose weight again, what was it that had them re-gain weight from previous weight loss..  They didn't have a succinct answer so I took that moment of ambivalence to talk about what causes people to regain weight, and how this occurs in nearly 95% of those who initially lose weight.

One fellow interjected that he knew where his weight gain came from; he was prescribed prednisone from his doctor, which caused 40 pounds of weight gain.  I asked him where the weight gain came from and he re-stated, "from the prednisone! My doctor told me I would gain weight from prednisone, that's why I gained weight."

When I told him that prednisone does not cause extra fat to appear in the body, but rather the weight gain he experienced was caused by increased appetite (a side effect of prednisone) and thus over eating to satisfy the increased appetite, he didn't believe it.

The man was very confident he had not over-eaten.. ever.  I mentioned that we can't gain weight without overeating.  We can't materialize fat from nothing, we have to introduce the extra mass into our bodies. When we eat more food than we need, the extra is stored as fat.

The prednisone increased his appetite, he overate, and gained weight.

Again he insisted that he was entirely certain he had never overeaten.  A co-worker vouched for him and said, "I know he hasn't overeaten."  I said that's impossible, 40 extra pounds can't come from nowhere, he must have overeaten but was not aware because he's not keeping track of what he's eating.

The group reacted quite negatively to me saying that it was impossible the man had not overeaten. I get where they're coming from. I'm saying something that is the exact opposite of what they believe.  From their perspective I'm attacking their intelligence and most likely their sense of self worth.  From my perspective I see a man who is completely oblivious to the fact he overate enough to gain 40 pounds.

Actually he may have gained about 35 pounds of fat. Prednisone also causes water retention so he will have gained some water mass as well.  I had no opportunity to get into that detail though.

So here's what I'm thinking.. This group of well meaning people told me they are educated about weight loss and know what to do, yet they were convinced that fat gain can occur without overeating.

The group was becoming upset and agitated with me.

The man on prednisone, in an irritated tone said, "ok so I overate.  Now what?"  I'm not sure if he said that to get off the topic and move me along, or if he suddenly realized his weight gain came from overeating.  I took it as the latter.

I started talking about how we're inundated with environmental stimulants that provoke us to overeat and that in general the population is in love with overeating, which makes it hard to feel rewarded by eating less.

One of the reasons why weight loss isn't successful in the long term is because most feel comfortable and rewarded with overeating, and feel restricted and unrewarded with healthy eating.  Most will constantly battle the feeling of being deprived from the absence of overeating and eventually willpower dwindles and they return to overeating and weight gain.

The group felt strongly that their chronic weight cycling was evidence that they were very experienced at successful weight loss and knew exactly what to do.

Before I had a chance to talk about how lack of sleep drives appetite and all the other stuff I usually talk about, I was given the boot.

I was cut off. "We know how to do this.  We're educated.  We have doctors and dietitians. We don't need any help in losing weight, we just need a certified trainer to weigh us and sign off on it".

I said I was concerned that they might be repeating previous mistakes and ultimately may not lose weight in a healthy way, or they will fall back into old habits and regain weight after the contest, and that this concern would bother me and I would be uncomfortable only doing a weigh-in.

I said I couldn't get behind doing weigh-ins only, they said that's fine, thanks for coming out.

Felt like someone punched me in the chest.

From my perspective I just had a conversation with people who had a chronic struggle with weight loss and weight gain cycling, who also believed that fat gain can occur without overeating, but who wholeheartedly believed they knew everything about healthy weight loss.  How their judgment of their predicament could be so clouded had me baffled.  The denial required to ignore their multiple failed attempts at maintaining a healthy weight is profound.

Weight gain, overeating, and weight loss are very sensitive issues and difficult to speak openly about.  The act of overeating is seen as an individual irresponsibility.  There is a negative judgment attached to overeating.  No one likes to hear or acknowledge that they eat too much. Yet most people love overeating. Most will talk about the act of overeating as something to be revered.  Looking forward to that extra big juicy burger with fries, a big steak dinner, or pizza after the game or other special occasion.

If we have only one serving at a family dinner we might be asked if we're feeling ok. That's right, we actually think there is something wrong with people when they don't overeat.

You can't tell a person they overeat, and a person who just over-ate is likely to say they don't overeat or at least that they do it rarely.  Someone who eats too much is (wrongly) seen as someone who can't get a grip on their behavior and we don't want to be identified as such.

Whenever I've really overdone it with overeating I've always felt lethargic, had indigestion, and had lousy sleep.  Because of the lousy sleep I feel like crap the next day as well.  For me, that makes it not worthwhile to pig out.  So yes, overeating is a mistake. And we all make mistakes.

I used to overeat a lot.  I used to weight cycle up and down 15 pounds.  I don't anymore.  Had I kept up that behavior I would surly be quite overweight by now, 25 years later.

The prednisone man was taken aback when I said he gained weight from overeating. He frowned, rolled his eyes and said, "I don't overeat", with a dismissive and firm tone. He definitely did not want to qualify as an over-eater.  And yet he overate. 

Studies have shown that most people underestimate the amount of food they eat, and overestimate the amount of physical activity they do.  Studies also show that people believe their weight gain is caused by some factor other than overeating, such as a 'slow metabolism'.  When investigated it has always been found that people overeat to gain weight and there is no such thing as a slow metabolism that causes fat gain.  Only overeating causes fat gain, and only a negative food energy balance, eating fewer calories than expended, causes fat loss.

Study: people underestimate food intake by 47% and overestimate physical activity by 51%

I was very troubled by the experience I had with the group. I left with the concern that most of the people I just spoke with will most likely continue to be in the 90-95% failure group.  Their lives and health will be negatively affected by weight gain and they will feel frustration and angst with yo-yo dieting and cyclic weight gain, while at the same time looking forward to the next high calorie meal.

Is it wrong for me feel my own angst knowing that people are going through these experiences?  Do I need to learn more professional detachment?  I think I could benefit from learning to cope with my own feelings more effectively, but it may be just as hard for me to not feel for people as it is for people to overcome overeating.  It's hard for anyone to overcome their natural tendencies.

I've always felt pretty awful after experiences like this and have lost sleep many a time after being told where to go when having a conversation about healthy choices.  It isn't that I feel personal rejection that much.  What I feel is despair for those who refute that which will surly improve their lives.  No, I don't believe that people have to live the way I say, for me it's more matter of fact.  Being overweight increases risk of disease.  It's harder to breath.  More difficult to get a good nights sleep.  Poor nutrition and lack of exercise reduce quality of life.. whatever a person likes doing they will be able to do it better, and do more of it for more of their lives if they are healthy and fit.

Even though most don't like to hear the truth about overeating and weight gain, and even though I would stand make a lot more money by selling fad diets and exercise plans, not telling the truth about weight loss in my mind is worse.  I'm not going to commit demagoguery and tell people what they want to hear. I can't live with that either.

So to hell with my headline.  I'm going to tell the truth about weight loss.

Eating too much is the only way to gain fat, but there are many things that drive appetite leading a person to overeat including social habituation, poor sleep, peer pressure, hormonal changes, some medications, eating large meals, yo-yo dieting.. All paths lead to overeating.

The only way to lose weight is to eat less.  Consuming fewer calories than expended.  Exercise helps expend energy and can prevent bone, muscle, and water loss that can occur when cutting calories without exercise.

And above all, the most important things to work on are how we think and feel about ourselves, food choices, and healthy VS unhealthy choices. It's making these difficult but rewarding internal changes that allow for permanent changes in our habits and behaviours.  It really isn't a bad thing to gain a realistic non-judgmental perspective of why overeating is done.  It's a good thing.  It's liberating. It's healthy.

Save yourself, quit smoking

It's national quit smoking week again.

I smoked most of the major brands, filtered and non-filtered.  Tried menthol, didn't really like those but I'd smoke one if I was desperate enough. Did the roll your own thing.  I could roll a smoke with one hand. I also had one of those mini automatic cigarette makers where you load a blank tube into one side and the soft, sweet smelling luxurious tobacco into the other. In a satisfying shick shick mechanical motion, not unlike cocking a gun, I would make myself my very own dart of death, and cheap too.

I had a pipe for a while.  A pipe is the ultimate portrayal of the educated smoker who has advanced their carbon monoxide connoisseurship beyond that of the pedestrian inhaler.  

Quitting smoking was one of the best things I've ever done, but it wasn't without challenge.

Rather than re-write my quit smoking experience, here are links to two posts where I relate what I went through..

Non-smoking week 

No safe level of cigarette smoke

Coffee and Cancer

Two studies investigating the connection between coffee consumption and cancer have received a lot of press coverage.  One on prostate cancer in men (1), the other on breast cancer in woman (2).

In both studies high coffee consumption, 5, 6 or more cups of coffee was associated with a significant decrease in prostate and breast cancers.

These aren't the only studies to show the chemo protective effects of coffee, there is a fairly large body of evidence supporting this.  So yes coffee drinkers, there appears to be strong evidence supporting anti-cancer benefits from coffee consumption.

The study on prostate cancer also tested decaffeinated coffee and the same anti-cancer effect was found.  Researchers believe that compounds in coffee, perhaps the antioxidants, are responsible for the possible cancer prevention effect.

Diet and exercise also have strong anti-cancer effects as well so let's not forget about that.  Diet and exercise overall have a more rewarding and profound positive effect on all aspects of health and fitness than coffee consumption does so if you're a regular coffee drinker but are lacking in the diet and exercise realm, start exercising.  Coffee does not make you more fit, stronger, more flexible, or increase bone density, but exercise can do all those things.

When we hear about coffee having positive effects we celebrate the news, but many of us lament hearing about the greater positive effects of healthy living.  We like habits that have a negative association, and tend to resist habits that are truly good for us.  I think the reason is healthy living ironically get's a bad rap: it's hard, it's boring, it's time consuming.  Really healthy living is invigorating, stress relieving, and very rewarding.  How many healthy fit people have you heard say they hate being healthy and fit?

Researchers aren't yet prepared to recommend starting coffee consumption to prevent prostate or breast cancer, conversely though, the pro's give the nod to starting exercise and making healthy food choices to reduce risk of cancer, and risk of other diseases such as type two diabetes and cardiovascular disease.

Recently I wrote about research that demonstrated coffee and fat consumption increases blood sugar response to sugar intake, with an endpoint recommendation for those with type two diabetes to abstain or at least reduce coffee consumption (3).

Anecdotally I can say that of those who I have known to either cut down or cut out coffee consumption completely, all of them have said they feel better.  They talk about being free from the daily cycle of feeling agitated and brain dead until they get their java fix.  Now they are naturally alert and are able to cope with daily stress better than they did when dependant on coffee.

I think the take home message here is that coffee does have some legitimate positive health effects, some legitimate negative health effects, and that comparatively, healthy diet and exercise have a far greater net positive effect on our health and well being.


(1) Coffee Consumption and Prostate Cancer Risk and Pr... [J Natl Cancer Inst. 2011] - PubMed result

(2) Coffee consumption modifies risk of estrogen-recep... [Breast Cancer Res. 2011] - PubMed result

(3) Live Healthy: High Fat Intake Increases Blood Sugar; Adding Coffee Doubles Blood Sugar Rise

Multivitamins No Benefit

Many people to choose to down a multivitamin daily because getting those extra vitamins and minerals is believed to offer some kind of health benefit.  However, to date there are no studies that show that long term use of multivitamins reduces risk of cancer, heart disease or any illness.

The promise of hope is a powerful motivator.

Even if there is strong evidence that multivitamins do nothing, many will be quick to dismiss the hard evidence and supplant it with traditional urban myth beliefs.  Kind of like believing in fairies.

Interestingly there is a lot of hard evidence that shows eating healthy food and exercising regularly does decrease risk of heart disease, cancers, and even the common cold.

So, pop a pill that does nothing at all, except increase the amounts of vitamins and minerals in your urine, or eat healthy and exercise?

If the outcome that motivates you is reduced risk of illness over a lifetime, then eating healthy and exercising regularly will provide you with that, but a multivitamin will not provide any additional benefits.

A recent study once again shows multivitamins do nothing. 182,009 study subjects were followed for 11 years.  28, 851 study subjects died during the 11 year follow up period.  There was no association with protection against cancer or cardiovascular diseases from use of multivitamins. (1)

There are definite exceptions for vitamin and mineral supplementation though.

We know that those living in northern latitudes, like us Canadians, will have reduced vitamin D levels as we progress into the winter season.  I take 4000 IU/ day of vitamin D between October and May every year.  I discussed my vitamin D intake with my physician.

Cancer Canada, Osteoporosis Canada, and Health Canada each have recommendations for vitamin D intake (click on links to find out).

As we age (generally above age 50-60) our GI may become less capable of absorbing some nutrients, like vitamin B12 and iron.  You'll have to talk to your physician about this.

Woman who may become pregnant are encouraged to take a folate and iron supplement; definitely talk to a physician about this.  Health Canada recommendations for prenatal nutrition.

Although athletes are a big target demographic to sell vitamin and mineral supplements to, eating healthy will provide all the nutritive needs of all athletes, generally a multivitamin will not help an athletes performance in any significant way (2, 3).  There may be an exception with ultra endurance athletes, those running huge volumes day after day in extreme competition (4)

Some endurance athletes who train too much can reduce iron and iron stores; this occurs more with female athletes than male athletes, but both genders are affected, and those who run are affected more than those who don't run. Running can cause destruction of red blood cells by literally pounding the crap out of blood cells in the capillaries in the soles of your feet.  Poor diet is also a contributor to what is referred to as "runners anemia" (microangiopathic hemolytic anemia).

This means some endurance athletes may need iron supplementation, but don't self prescribe, you need a doctor to do the appropriate blood work and dietary analyses in order to determine if you have anemia, what the cause is, and what course of treatment is best. Typical symptoms of runners anemia are fatigue and reduced performance that does not resolve with normal recovery periods.

It may be that many runners simply need to eat better and introduce more recovery into their exercise routines to prevent runners anemia.


(1) Multivitamin Use and the Risk of Mortality and Cancer Incidence

Multivitamins and athletes:

(2) The effect of 7 to 8 months of vitamin/mineral sup... [Int J Sport Nutr. 1992] - PubMed result

(3) Vitamin and mineral supplementation: effect on the... [Am J Clin Nutr. 1988] - PubMed result

(4) Multivitamin-mineral supplementation prevents lipi... [J Am Coll Nutr. 2007] - PubMed result