Weight Loss Expectations
- POSTED ON: Apr 12, 2014

Here's some interesting information.

Managing Weight Loss Expectations
          by Dr. Arya Sharma, M.D. Dr. Sharma's Obesity Notes

While there are almost no limits to short-term weight loss goals (anyone can starve themselves thin) – the reality of long-term weight loss is rather sobering.

While diet and exercise generally provide an average long-term (3-5 years) sustainable weight loss of about 3-5% of initial weight, even bariatric surgery patients tend on average to sustain a weight loss of only 20-30% of their initial weight.

Surgery, although much safer than generally thought, still bears a risk of complications and the question is how much risk patients are willing to assume if they really knew and understood how much weight they are likely to lose with surgery.

This was the subject of a study by Christina Wee and colleagues, published in JAMA Surgery, in which they examined weight loss expectations and willingness to accept risk among patients seeking bariatric surgery.

The researchers interviewed 650 patients interested in bariatric surgery at two bariatric centres in Boston.

On average, patients expected to lose as much as 38% of their weight after surgery and expressed disappointment if they did not lose at least 26%.

In fact, 40% of patients were unwilling to undergo a treatment that would result in only 20% weight loss.

Most patients (85%) accepted some risk of dying to undergo surgery, but the median acceptable risk was only 0.1%.

On the other hand, some patients (20%) appeared more desperate, willing to accept a risk of 10% or greater.

As one may expect, there were important gender differences in these findings: while women were more likely than men to be disappointed with a 20% weight loss, they were also less likely to accept a greater mortality risk.

An important finding for clinicians was that patients with lower quality-of-life scores and those who perceived needing to lose more than 10% and 20% of weight to achieve “any” health benefits were more likely to have unrealistic weight loss expectations.

This study not only shows that most patients seeking bariatric surgery have rather unrealistic weight loss expectations but also that a substantial number may well be be disappointed with their weight loss after surgery.

It is also evident that many patients believe that they need to lose a rather substantial amount of weight to derive “ANY” health benefits, when in reality even ...

Energy In and Energy Out
- POSTED ON: Mar 02, 2014

Much of the weight-loss and maintenance information available to us is both inaccurate and unhelpful. Like Dorothy of Oz and Alice of Wonderland, during my lifetime of research on those issues, I've seen some "weird shit".

Here in my DietHobby online scrapbook I work to sort out and save reasonably accurate information that might prove helpful to me and perhaps to others.

The article below deals with the issue of Energy In and Energy Out, which is not as simple as most people believe.

People have different body weights because each of them has an individual physiology and psychology which ultimately determines their own individual levels of "energy in" and "energy out" AND which also determines how their own individual bodies respond to it. 

A snapshot of the unaveraged data contained in scientific research of Individual BMR or RMR (metabolism rates) bears a strong resemblance to a blood spatter pattern at a violent crime scene. Metabolism rates are all over the place, but these widely varying numbers are then averaged out to create the calculations we see formulas like Harris-Benedict, Mifflin, etc.  An Average is a Statistical number for mathematical convenience. It is not an accurate number for Everyone, and sometimes is not even accurate for Anyone ... similar to the following joke: 

A biologist, a chemist, and a statistician are out hunting.  The biologist shoots at a deer and misses fifteen feet to the left, the chemist takes a shot and misses fifteen feet to the right, and the statistician yells "We got 'em!"

People the same sex, age, and size can take in the same amount of "energy" and do their best to engage in the same amount of activity, but wind up with very different weight results. 

In tightly controlled feeding studies, the same absolute amount of extra calories can result in very different amounts of weight gain. Also, the exact same amount of caloric deficit will result in widely different amounts of weight loss. 

In general, this basic fact of human nature is overlooked, or ignored. 

Here is a recent article by obesity specialist, Dr. Sharma addressing this problem. 

Why The Energy Balance Equation Results In Flawed Approaches To Obesity Prevention And Management

The Future
- POSTED ON: Jan 17, 2014

Looking for Progress,
because there's NO Perfection


Designed to show a False Result? - Research Project of Gary Taubes / NUSI
- POSTED ON: Aug 28, 2013

Any reader who has paid attention to my posts here at DietHobby knows that...

I highly respect the work of Journalist, Gary Taubes, who wrote "Good Calories Bad Calories"  and "Why We Get Fat".  In fact DietHobby's section; BOOKTALK  features "Why We Get Fat", together with summaries of what I personally found in every single chapter.

Since these books were published, I have conducted quite a few personal Experiments-of-One with Low-carb eating. In fact,  I'm involved in one at present.

However, my own experience and education leads me to believe that this not a one-size-fits-all-world, and that while Every Diet Works for Someone, No One Diet Works for Everyone.

As a lay person with no biochemistry education,  I'm interested in Gary Taubes' Low-carb Theories, and am open to the issues involved in his alternative hypothesis ..., although I will admit at this point I am not convinced that the hormone "insulin" is the sole and ultimate answer. 

Based on my own personal Experiments-of-One, and life experience of observing others, I am still convinced that Calories matter. While I can see that the body processes macronutrients differently, and that additional processing differences exist between individual bodies due to genetic and/or hormonal differences etc., no matter HOW nutrients are processed within the body, it seems obvious to me that ultimately, fat gain, loss, or maintenance, is a matter of Energy balance in and out. This is despite whether, or not, one makes the choice to label that Energy with a caloric number. While body processing differences can make it difficult for one to know precisely how much energy each molecule of food possesses, I cannot help but think that Discounting this Truth as  "CICO garbage", as many people in the the low-carb community tend to do, is a rather stupid way to throw out the baby with the bathwater.

I also respect the work of the obesity specialist, Dr. Yoni Freedhof, M.D. and find his take on Gary Taubes NuSi's potential Research very interesting, so I'm sharing two of his related articles about it here at DietHobby. The first article he posted today, and the bottom one is from a year ago. 

 Here's the current one:

I Predict Gary Taubes' NuSi's First Experiment Will Show Dramatic Low-Carb Benefits 
             by Dr. Yoni Freedhof, M.D. 8/28/13 www. weightymatters.ca

Because that's exactly what it appears it's designed to do.

Taubes lays out the experiment in his recent NuSi promoting Scientific American piece. He's going to take 16 individuals with overweight and obesity and house them in a research facility so as to ensure careful and total control over their dietary intake. Next he'll feed them a diet that's 50% carbs, 35% fat and 15% protein. He'...

Interpretating Peptides, Food Intake, and Body Weight
- POSTED ON: Mar 31, 2013

Today I watched a technical, but interesting, video of a University lecture given on March 26, 2013 by Stephen C. Woods about Peptides, Food Intake and Body Weight: Problems of Interpretation.

Peptides are organic substances of which the molecules are structurally like those of proteins, but smaller. Peptide Hormones include insulin, leptin, ghrelin, glucagon, growth hormone, obestatin as well as many, many others.

For many years Dr. Woods has been involved in obesity scientific research, primarily re insulin.

He said that a key question is whether the Responses that counter drug/food effects are actually Unconditional, invariant and whether or not traditional concepts of Homeostatsis are viable.

In considering this question, note the following:

Homeostaisis --- Unconditioned stimulas equals Unconditioned Response.

There are ...

Homeostatic Controls - Hypothalamus (part of the brain primarily involved with involuntary stimulas and response of Peptides)


Non-Homeostatic Controls – Amugdala, Accumbens, etc ( parts of the brain involving Anxiety, social situations, learning, hedonics, etc.)

The process of Homostaisis can be disturbed by Non-Homeostatic Controls.

Food intake involves BOTH types of Controls at the same time. Food intake is a Behavior which involves BOTH (unconditioned) physiological and (conditioned) psychological factors: An Example of a Conditioned stimulas and Conditioned response is Pavlov’s dog.

Based on his many years of involvement with scientific research re Peptides, Dr. Woods states the following Conclusions:

Conclusion 1:
Different labs get different results when administering Peptides and assessing food inake.

Conclusion 2: 
Peptides alter food intake in some situations and not others.

Conclusion 3:
The ability of a Peptide to alter food intake varies within the same lab.

Conclusion 4:
Subtle, or not so subtle, environmental factors can determine whether a Peptide influences food intake, and can even reverse the direction of the response.

To watch the lecture click the following link: Peptides, Food Intake and Body Weight: Problems of Interpretation.


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