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.

Eating less of anything causes weight loss

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A study published in the January 2012 issue of the American Journal of Nutrition (1) compared 4 weight loss diets for the affects on fat and muscle.

The diets:

• 25% and 15% protein
• 40% and 20% fat
• Combined with 4 different carbohydrate amounts (35% to 65%)

The total calories of each diet were identical.  Does it matter what you eat to lose fat?  Or do you simply need to eat less?

At six months study subjects had lost an average of 4.2 kg (9.3 lbs.) of fat and 2.1 kg (4.6 lbs.) of lean muscle mass.  Using DEXA, a special kind of X-Ray, researchers wanted to see if the diets had an influence on where fat mass was lost; subcutaneous (under the skin), or visceral fat (fat in and around internal organs).

There was no difference between diets for where fat loss occurred although woman in this study lost slightly more visceral fat than men.

At 2 years participants had regained 40% of their initial weight loss, which was equal amongst the four diets.  The regain of weight was through the study subjects not staying within the total calories prescribed and gradually returning to overeating.

Conclusions?

No matter what you eat less of, if you have a caloric deficit you will lose weight.  No matter what you eat more of, if you eat more calories than you burn off, you will gain fat. Fat loss and gain is solely determined by calories in - calories out.  Doesn't matter if you're a meat eater, vegetarian, vegan, or breathairian; if you overeat you gain fat, if you have a caloric deficit, you'll lose fat.

In case you're really curious, "breatharians" believe that food and water are not needed to stay alive, and as the quaint same suggests, you can get everything you want at Alice's Restaurant so long as you order air, with a side order of light. Reports of breatharians dying from starvation are not exaggerated.

Humanity is capable of believing some questionable ideas, like breatharianism, and that something other than overeating causes body fat gain, or that a special combination of foods is required to lose weight.

However studies like this one have shown for decades that the singular cause of fat gain is eating too much, and the singular cause of fat loss is eating less.

Other studies (2,3,4) have shown that loss of lean muscle can be reduced or halted by including strength training and/ or cardio training while reducing calories to lose weight.

Another study demonstrated that long term success was better for fat loss when moderate reductions in calories were combined with regular exercise compared to a large decrease in calories without exercise (6).

What about hormonal changes and metabolism?  Aren't these the real culprits behind overeating?  Haven't you written about hormones and appetite before?

Yes, go here Live Healthy: Fat Loss Pill With Leptin- A New Reality?

And here  Live Healthy: Anyone Can Lose Fat

Or use the "search this blog" bar at the top of this page type in "weight loss"

Hormones, implicated for sure, but the sole cause of weight gain, even without overeating?  It can't be. Only overeating causes weight gain.  We have to introduce the extra calories to the body to be stored as fat.  No extra calories means nothing extra to store. The disconnect is that while it is definitely true that changes in hormones that regulate hunger cause us to feel hungry when we're not actually hungry, many have been lead to believe that the hormonal changes alone cause weight gain. Under these conditions of increased ghrelin and leptin most people don't contemplate what they are eating or why, they simply follow their hunger stimulus and.. eat more food, but rationalize that they are not overeating and that it must be their hormones or metabolism causing weight gain.

So whatever our motivation to eat more may be; habitual, hormonal changes, addiction, in the end these variables influence us to choose to eat more.  So yes, simply eating less without addressing the underlying motivation or physiological variables that drive us to overeat is asking for the standard failure in weight loss.

The two most important steps in losing weight are the combination of eating less and exercising more, along with making the emotional and psychological changes necessary to change how we perceive reward from eating and exercise.

BTW.. my whimsical line at the begging of this article, "look and feel better in a matter of hours".. is true, I just didn't say how many hours..  Turns out to be, according to research, at least 90 minutes each week of moderate to vigorous exercise. Get started with working up to 10,000 to 12,000 steps per day (buy a pedometer or download a pedometer app to your smartphone).

Eat less, exercise more; get healthy and feel great.  It's all about feeling good.


1) Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial

2) Moderate exercise attenuates t... [J Gerontol A Biol Sci Med Sci. 2009] - PubMed - NCBI

3) A systematic review of the separate and combined ef... [Nutr Rev. 2010] - PubMed - NCBI

4) Changes in fat-free mass during significan... [Int J Obes (Lond). 2007] - PubMed - NCBI

6) Effect of dietary adherence with or ... [J Clin Endocrinol Metab. 2009] - PubMed - NCBI