Although almost every weight-loss expert seems to have something to sell,
...... despite the marketing hype ,...... there are kernals of truth in many of the basic things they say.
 

"Science has failed us in the weight loss department.
It literally gets an “F.”

The culture has failed us as well. Far too many people have intense moral judgments towards anyone with excess pounds, which contributes to the hidden epidemic of social disconnection, apathy, and plain old sadness.

Let’s face it: when it comes to the subject of weight gain and weight loss, we’re clueless.  And from that place of cluelessness we tend to flail around, we try our hand at the most inane weight loss strategies, we diet for decades, we consume diet foods ...that are, if you care to closely study the scientific literature ... toxic."

                    Marc David - Psychology of Eating

                             
It's hard not to binge on delicious food. For more about that experience, go to the bottom of the page, and Watch an entertaining video at the end of this article.

However, that is NOT the ONLY reason why weight-loss is hard.  I've been reading about "Adaptive Thermogenesis" .  Physical systems (like machines) stay the same.  Biological systems (like humans) adapt.

Weight-loss and maintenance have less to do with motivation and will-power than most people think. In fact it has far more to do with how your body adjusts to, and is capable of, resisting a calorie deficit. Putting less fuel in the tank of one's car will always cause the car to drive a shorter distance.  However, the human body adapts to less fuel ....meaning eating fewer calories.... by becoming more ‘efficient’ and running the same distance on less fuel than before. That is the big difference between simple physics and biology

For a better understanding of the issue of energy-in/energy-out, read my Summaries of what Gary Taubes has to say about it. 
WWGF - Chapter 6 Thermodynamics for Dummies, Part 1
and Chapter 7 Thermodynamics for Dummies, Part 2.

Here is a great article by Dr. Arya Sharma M.D. on this issue:

The Role of Adaptive Thermogenesis in Resistance to Weight Loss

No intentional weight loser continues to lose weight till she disappears.

Sooner or later every diet, every medication, or every type of bariatric surgery will result in a weight loss ‘plateau’ (better referred to as a ‘floor’) - a weight, beyond which losing even more weight (and keeping it off) becomes an almost ’super-human’ feat.

However, there is considerable variation in how much weight people can lose and keep off. Although the average sustainable weight loss with ‘eat-less-move-more’ (ELMM) approaches is about 3-5% of initial weight, some folks manage to lose considerably more, while others struggle to even simply stop gaining weight.

This has less to do with motivation or will-power than most people think.
In fact, it has far more to do with how your body adjusts to and is capable of resisting a calorie deficit.

While putting less fuel in the tank of your car will consistently decrease the distance that you can drive, our bodies adapt to less fuel (i.e. eating fewer calories) by becoming more ‘efficient’ and running the same distance on less fuel than before. That is the big difference between simple physics and biology.

Biological systems adapt - physical systems (like your car) stay the same.

In the case of humans (and animals) we call the adaptation of energy needs and expenditure ‘adaptive thermogenesis’. Exactly how adaptive thermogenesis is regulated and how differences therein can largely determine both weight loss and weight regain, is the topic of a paper by Angelo Tremblay and colleagues from the Universities of Laval and Ottawa, published in the International Journal of Obesity.

As the authors point out,

“The decrease in energy expenditure that occurs during weight loss is a process that attenuates over time the impact of a restrictive diet on energy balance up to a point beyond which no further weight loss seems to be possible. For some health professionals, such a diminished energy expenditure is the normal consequence of a progressive decrease in the motivation to exercise over the course of a weight-reducing program.”

Many studies have now documented the process of ‘adaptive thermogenesis’, whereby weight loss is associated with a ‘greater-than-predicted’ decrease in energy expenditure. This occurs both through a reduction in metabolic rate as well as through an often remarkable increase in ‘fuel efficiency’ related to physical activity, whereby individuals, who have lost weight burn far fewer calories for the same amount of physical activity than before losing their weight (far more than can be explained simply by considering that they are also moving less weight around).

As the authors discuss, not only do people, who demonstrate the greatest decrease in adaptive thermogenesis in response to weight loss tend to lose less weight (for the same level of caloric restriction) but they also tend to have a greater increase in hunger and appetite.

Also, it does not appear that these ‘adaptive’ responses to weight loss diminish over time, which means that the resistance to further weight loss and the propensity to weight regain persist till the weight is eventually regained (i.e. they once again ‘fail’).

Together, these factors can easily explain why losing weight and keeping it off is far more difficult for some folks than for others - irrespective of motivation or will power.This basic biological fact is not only important to ‘dieters’ (even if it seems demotivating) - but perhaps even more important for all health professionals to be aware of.

Simply ‘blaming’ people who find it harder to lose weight or keep it off for their lack of will power or motivation, is neither fair nor helpful. You can only fight your biology so far before life is no longer fun - this is when you need to realize that you are now living below your ‘Best Weight’.

AMS
Edmonton, Alberta

Tremblay A, Royer MM, Chaput JP, & Doucet E (2012). Adaptive thermogenesis can make a difference in the ability of obese individuals to lose body weight. International journal of obesity (2005) PMID: 22846776

Dr Arya Sharma, M.D. 
Dr. Sharma’s Obesity Notes   www.drsharma.ca

 

                           
I've been feeling frustrated by my current maintenance results, a web search about that issue turned up an article about a study of literature on the subject, which I found interesting, even though it wasn't particularly helpful to me.

Below is part of that article, originally published in Medscape on 1/6/2012

Psychological Factors Influencing Weight Loss Maintenance

Background.
It is well recognized that most individuals who lose weight are unable to maintain that weight loss. However, the lack of evidence about the factors that cause this regain is surprising. The purpose of this study was to review the available literature to try and identify the factors that are most consistently linked with weight regain and propose strategies to assist patients to maintain their success.

Methodology.
An electronic search identified studies of patients whose weight loss had been achieved through behavior modification and who were then followed for the subsequent 12-18 months. Included studies were determined to have good methodological rigor and relevant data.

Results.
The literature on factors potentially contributing to weight regain were examined and clustered into 8 categories:

1. Unrealistic weight loss expectations -- studies were mixed and it cannot be concluded that this issue is a consistent predictor of weight regain.

2. Failure to achieve weight loss goals -- satisfaction with one's initial weight loss was identified to be an important factor. Those able to reach their goal weight or, alternatively, those who were satisfied with their weight loss even if it was less than their original goal were more likely to maintain this loss.

3. Dichotomous thinking -- this is defined as a "black or white" thinking pattern that leads to difficulty in accepting anything less than the original goal. This type of thinking pattern was strongly predictive of unsuccessful weight maintenance.

4. Eating to regulate mood -- another strongly predictive factor identified in this review was use of food to relieve emotional distress.

5. Disinhibition vs dietary restraint -- higher levels of disinhibition, which led to more uncontrolled eating, were associated with weight regain. In contrast, those able to maintain weight loss were better able to exercise restraint in their eating.

6. Perceived cost vs benefit -- individuals able to successfully maintain weight loss continue to find that the benefits of weight loss, whether defined as improved appearance, better health, or some unique combination of benefits, outweighed the perceived costs of weight maintenance strategies such as regulation of diet or exercise.

7. Depression -- although depression has clearly been linked to obesity, its relationship to successful weight loss maintenance is less clear. Baseline depression was not necessarily a factor, but increasing levels of depression over the time of weight maintenance did predict regain.

8. Body image -- no surprise, individuals who were more satisfied with their appearance, with steady improvement in body image throughout the time period studied, were more likely to maintain their weight loss.

None of this is really news, but it's worth thinking about again. I found their Viewpoint summary to be rather standard and uninteresting. I found the following statement particularly uninspiring….

"A number of factors associated with unsuccessful weight maintenance
are the same as those seen in patients with binge eating disorder."

 Like DUHHHH!! Don't even get me started on what I think about the way every single "non-healthy" eating behavior is now being labeled an "eating disorder".

Uh Oh, 
I think my frustration is clearly showing here again, and so now I'm going to spend some time working on my Positive Thinking.
 

I believe that each person needs to choose their own individual diet or food plan. Every diet works for someone,but every diet doesn’t work for everyone.

The choice of a diet, or food plan, needs to be based on the food and information that is available to each person, as well as a person’s personal preferences. Cultural issues and one’s tolerance for hunger are also important.

My own food and diet choices are a continual “experiment-of-one”. Dieting is my Hobby, and I am always learning more about it. I read diet books, I think about the information in them, and I try out different diets, and different food plans.

I’ve learned something new about myself from every diet I’ve used, and many of the new foods and recipes have become favorites that stay with me long after a particular diet is History.

 This is the process I used for weight-loss, and it is the way I maintain that weight-loss.

The choice of a food plan might seem to be an obvious or easy one, but each of us has a cultural and family food history that strongly influences what foods and eating patterns we can tolerate.

Also a great deal of misinformation exists about nutrition, dieting, weight-loss, and how the body processes energy. This often makes that food and diet choice difficult and confusing.

According to the American Dietetic Association’s (ADA) Nutrition and You: Trends 2000 survey, one in five consumers report being confused by news reports that give dietary advice.

Ten Red Flags of Junk Science

The Food and Nutrition Science Alliance (FANSA), a partnership of the ADA, American Society for Clinical Nutrition, and the American Society for Nutritional Sciences and the Institute of Food Technologists, has developed the “Ten Red Flags of Junk Science” to help recognize nutrition misinformation:

• Recommendations that promise a quick fix
• Dire warnings of danger from a single product or regimen
• Simplistic conclusions drawn from a complex study
• Recommendations based on a single study
• Dramatic statements that are refuted by reputable scientific organizations
• Lists of “good” and “bad” foods
• Recommendations made to help sell a product
• Recommendations based on studies published without peer review

Recommendations from studies that ignore differences among individuals or groups

 So, my advice is to continually gather and process information, and make your food and diet choices based on your body’s needs, together with your own personal preferences and tolerance for hunger.

                
  The dictionary definition of bingeing is:

to be immoderately self-indulgent and unrestrained;
to engage in excessive or uncontrolled indulgence in food or drink.

I personally agree that Bingeing isn’t usually because of lack of self control and weakness.
We binge because of a complex interaction of habit, brain chemistry, and external cues that signal us to eat. This interaction can be overcome, but it's harder to do and takes longer to change than most of us realize.

In the 1960s the Health Profession began attributing psychological reasons, rather than physiological reasons to people who overeat to the point of obesity. Since that time, there has been a tendency on the part of Health Professionals to classify every kind of eating outside “moderate eating” as an “eating disorder”. There are many reasons for this…and one of them is financial motivation. Unless a behavior is labeled a “disorder” or and illness, health insurance won’t pay for treatment.

You may call me cynical, but since “Binge Eating Disorder” is far more common than anexoria and bulimia. It has a much larger population base. This means more patients to treat with Therapy, and/or Eating Disorder programs, and more money and more profit for that specific Health Industry field.

Binge eating disorder first appeared in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM, in 1994. Until recent times, “Binge Eating Disorder” has been categorized under the umbrella term 'eating disorders not otherwise specified”, or EDNOS for short. EDNOS includes a wide variety of disordered eating patterns.
It's often used for people who meet many of the symptoms of anorexia or bulimia but not all. For example, a woman who meets all of the symptoms for anorexia,  but still menstruates regularly -- a criteria for an anorexia diagnosis -- would be diagnosed with an eating disorder not otherwise specified.

Health professionals admit that a Binge Eating Disorder is more than simply eating too much food, and that many obese patients don't have it. However still they claim that up to 5 percent of obese patients and 30 percent of patients participating in weight loss programs meet the criteria for binge eating disorder.

"It is important that clinicians and the public be aware that there are
substantial differences between an eating disorder such as
binge eating disorder and the common phenomenon of overeating,"
says B. Timothy Walsh, chair of the DSM-V Eating Disorders Work Group,
in a press release. "While overeating is a challenge for many Americans, 
recurrent binge eating is much less common and far more severe and
is associated with significant physical and psychological problems."

Proposed changes in the upcoming DSM-V, to be released in May 2013, would categorize BED as a specific eating disorder.
The proposed criteria require that episodes of binge eating, defined as:

“the consumption of unusually large amounts of food,
accompanied by a sense of loss of control
and strong feelings of embarrassment and guilt”

occur a minimum of once a week over the last three months for a diagnosis.

Such a diagnosis would fit almost every obese person that I’ve even known.….I’ve been one myself and I’ve known many, many others… Almost every obese person…and some of those who are not obese… experiences a sense that they have lost control of their behavior, and has strong feelings of embarrassment and guilt after eating an “unusually large amount of food”.

Weekends come every week, vacations and holidays come rather frequently, other celebrations and special events happen frequently as well.  Plus, most of us experience times of sadness, anxiety, or crisis more frequently than we like. It is common for an obese person to engage in excess overeating on these occasions. In fact it is also a very common occurrence for an obese person to “binge out” at least once a week for months at a time.

The disgust and aversion that modern Society has for fat people pretty much guarantees that fat people will feel embarrassment and guilt due to their failure to keep from engaging in behavior that contributes to their fat condition.

It is my opinion that, despite the “conditions” that psychologists attach to the “Binge Eating Disorder”, by their proposed definition, almost everyone who engages in excessive or uncontrolled indulgence in food, which is the dictionary definition of Bingeing, could easily fall into thecurrent medical classification of having an “eating disorder”.

I find something really wrong with this reasoning, and it is one of the reasons I was drawn to Gary Taubes’
research and theories about obesity having a physiological cause, with the psychological problems being a RESULT of the condition, not a CAUSE of the condition.

Taubes makes a compelling argument. My own experience and my observation of the dismal long-term success rate
of “eating disorder” treatments, especially those that include the use of “Intuitive Eating” as a tool of recovery tend to support my belief that while Therapy is helpful to gain self-understanding of one’s behaviors, and can help one learn alternative behaviors, the underlying conditions causing obesity are not cured through that process.

So…my position is that, for those who are obese, bingeing is normal, and not abnormal, eating behavior.

Society’s current label of “eating disorder” and suggested “treatment” is simply another attempt to shame fat people into believing that they need not starve themselves to become thin and stay thin. This is a misplaced effort, because an obese body wants to maintain itself, and this is a survival instinct that will never leave, no matter how thin one becomes, or how much therapy one has.