Happily Ever After & Neuroscience

- POSTED ON: Feb 20, 2017

Once upon a time, there was a fat woman who wanted to become thin.  She began eating less food than her body used day after day, and eventually her body became a size “normal”. 

After she crossed the “finish line” to her weight goal, she slightly relaxed her rigid eating behaviors, but in order to maintain her weight-loss, she paid close attention to the hunger signals from her body, working to eat only when she felt hungry, and to stop as soon as she stopped feeling hungry.

And she lived happily ever after…..
…........... NOT exactly .......….

I advise anyone struggling with - or interested in - maintenance issues to go to DietHobby’s
BLOG CATEGORIES, Research - Science and read the articles that have been scrapbooked there.

The following article was written by Sandra Aamodt, a neuroscientist, author of  “Why Diets Make Us Fat: The Unintended Consequences of Our Obsession With Weight Loss” (2016). It was posted in the New York Times in May 2016. 

Dr. Aamodt makes the point that the problem with Dieting is not Willpower. It’s neuroscience.  I found her book to be well researched, and I believe she accurately states the basic problem.  Dr. Aamodt’s information is extremely valuable, and I recommend her book for people working to maintain weight-loss.  However, although the “solution” to the dieting and maintenance struggle that she proposes could be effective for some people, it is not one …. for various reasons … that I find personally acceptable or one that I’m willing to adopt. 

Why You Can’t Lose Weight on a Diet
                  by Sandra Aamodt

SIX years after dropping an average of 129 pounds on the TV program “The Biggest Loser,” a new study reports, the participants were burning about 500 fewer calories a day than other people their age and size. This helps explain why they had regained 70 percent of their lost weight since the show’s finale. The diet industry reacted defensively, arguing that the participants had lost weight too fast or ate the wrong kinds of food — that diets do work, if you pick the right one.

But this study is just the latest example of research showing that in the long run dieting is rarely effective, doesn’t reliably improve health and does more harm than good. There is a better way to eat.

The root of the problem is not willpower but neuroscience. Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range, called the set point. The range, which varies from person to person, is determined by genes and life experience. When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.

The brain’s weight-regulation system considers your set point to be the correct weight for you, whether or not your doctor agrees. If someone starts at 120 pounds and drops to 80, her brain rightfully declares a starvation state of emergency, using every method available to get that weight back up to normal. The same thing happens to someone who starts at 300 pounds and diets down to 200, as the “Biggest Loser” participants discovered.

This coordinated brain response is a major reason that dieters find weight loss so hard to achieve and maintain. For example, men with severe obesity have only one chance in 1,290 of reaching the normal weight range within a year; severely obese women have one chance in 677. A vast majority of those who beat the odds are likely to end up gaining the weight back over the next five years. In private, even the diet industry agrees that weight loss is rarely sustained. A report for members of the industry stated: “In 2002, 231 million Europeans attempted some form of diet. Of these only 1 percent will achieve permanent weight loss.”

The specific “Biggest Loser” diet plan is probably not to blame. A previous study found similar metabolic suppression in people who had lost weight and kept it off for up to six years. Whether weight is lost slowly or quickly has no effect on later regain. Likewise — despite endless debate about the relative value of different approaches — in head-to-head comparisons, diet plans that provide the same calories through different types of food lead to similar weight loss and regain.

As a neuroscientist, I’ve read hundreds of studies on the brain’s ability to fight weight loss. I also know about it from experience. For three decades, starting at age 13, I lost and regained the same 10 or 15 pounds almost every year. On my most serious diet, in my late 20s, I got down to 125 pounds, 30 pounds below my normal weight. I wanted (unwisely) to lose more, but I got stuck. After several months of eating fewer than 800 calories a day and spending an hour at the gym every morning, I hadn’t lost another ounce. When I gave up on losing and switched my goal to maintaining that weight, I started gaining instead.

I was lucky to end up back at my starting weight instead of above it. After about five years, 41 percent of dieters gain back more weight than they lost. Long-term studies show dieters are more likely than non-dieters to become obese over the next one to 15 years.

That’s true in men and women, across ethnic groups, from childhood through middle age. The effect is strongest in those who started in the normal weight range, a group that includes almost half of the female dieters in the United States.

Some experts argue that instead of dieting leading to long-term weight gain, the relationship goes in the other direction: People who are genetically prone to gain weight are more likely to diet.

To test this idea, in a 2012 study, researchers followed over 4,000 twins aged 16 to 25. Dieters were more likely to gain weight than their non-dieting identical twins, suggesting that dieting does indeed increase weight gain even after accounting for genetic background. The difference in weight gain was even larger between fraternal twins, so dieters may also have a higher genetic tendency to gain. The study found that a single diet increased the odds of becoming overweight by a factor of two in men and three in women. Women who had gone on two or more diets during the study were five times as likely to become overweight.

The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Boxers and wrestlers who diet to qualify for their weight classes presumably have no particular genetic predisposition toward obesity. Yet a 2006 study found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports.

To test this idea rigorously, researchers could randomly assign people to worry about their weight, but that is hard to do. One program took the opposite approach, though, helping teenage girls who were unhappy with their bodies to become less concerned about their weight. In a randomized trial, the eBody Project, an online program to fight eating disorders by reducing girls’ desire to be thin, led to less dieting and also prevented future weight gain. Girls who participated in the program saw their weight remain stable over the next two years, while their peers without the intervention gained a few pounds.

WHY would dieting lead to weight gain? First, dieting is stressful. Calorie restriction produces stress hormones, which act on fat cells to increase the amount of abdominal fat. Such fat is associated with medical problems like diabetes and heart disease, regardless of overall weight.

Second, weight anxiety and dieting predict later binge eating, as well as weight gain. Girls who labeled themselves as dieters in early adolescence were three times more likely to become overweight over the next four years. Another study found that adolescent girls who dieted frequently were 12 times more likely than non-dieters to binge two years later.

My repeated dieting eventually caught up with me, as this research would predict. When I was in graduate school and under a lot of stress, I started binge eating. I would finish a carton of ice cream or a box of saltines with butter, usually at 3 a.m. The urge to keep eating was intense, even after I had made myself sick. Fortunately, when the stress eased, I was able to stop. At the time, I felt terrible about being out of control, but now I know that binge eating is a common mammalian response to starvation.

Much of what we understand about weight regulation comes from studies of rodents, whose eating habits resemble ours. Mice and rats enjoy the same wide range of foods that we do. When tasty food is plentiful, individual rodents gain different amounts of weight, and the genes that influence weight in people have similar effects in mice. Under stress, rodents eat more sweet and fatty foods. Like us, both laboratory and wild rodents have become fatter over the past few decades.

In the laboratory, rodents learn to binge when deprivation alternates with tasty food — a situation familiar to many dieters. Rats develop binge eating after several weeks consisting of five days of food restriction followed by two days of free access to Oreos. Four days later, a brief stressor leads them to eat almost twice as many Oreos as animals that received the stressor but did not have their diets restricted. A small taste of Oreos can induce deprived animals to binge on regular chow, if nothing else is available. Repeated food deprivation changes dopamine and other neurotransmitters in the brain that govern how animals respond to rewards, which increases their motivation to seek out and eat food. This may explain why the animals binge, especially as these brain changes can last long after the diet is over.

In people, dieting also reduces the influence of the brain’s weight-regulation system by teaching us to rely on rules rather than hunger to control eating. People who eat this way become more vulnerable to external cues telling them what to eat. In the modern environment, many of those cues were invented by marketers to make us eat more, like advertising, supersizing and the all-you-can-eat buffet. Studies show that long-term dieters are more likely to eat for emotional reasons or simply because food is available. When dieters who have long ignored their hunger finally exhaust their willpower, they tend to overeat for all these reasons, leading to weight gain.

Even people who understand the difficulty of long-term weight loss often turn to dieting because they are worried about health problems associated with obesity like heart disease and diabetes. But our culture’s view of obesity as uniquely deadly is mistaken. Low fitness, smoking, high blood pressure, low income and loneliness are all better predictors of early death than obesity. Exercise is especially important: Data from a 2009 study showed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out. Exercise reduces abdominal fat and improves health, even without weight loss. This suggests that overweight people should focus more on exercising than on calorie restriction.

In addition, the evidence that dieting improves people’s health is surprisingly poor. Part of the problem is that no one knows how to get more than a small fraction of people to sustain weight loss for years. The few studies that overcame that hurdle are not encouraging. In a 2013 study of obese and overweight people with diabetes, on average the dieters maintained a 6 percent weight loss for over nine years, but the dieters had a similar number of heart attacks, strokes and deaths from heart disease during that time as the control group. Earlier this year, researchers found that intentional weight loss had no effect on mortality in overweight diabetics followed for 19 years.

Diets often do improve cholesterol, blood sugar and other health markers in the short term, but these gains may result from changes in behavior like exercising and eating more vegetables. Obese people who exercise, eat enough vegetables and don’t smoke are no more likely to die young than normal-weight people with the same habits. A 2013 meta-analysis (which combines the results of multiple studies) found that health improvements in dieters have no relationship to the amount of weight they lose.

If dieting doesn’t work, what should we do instead? I recommend mindful eating — paying attention to signals of hunger and fullness, without judgment, to relearn how to eat only as much as the brain’s weight-regulation system commands.

Relative to chronic dieters, people who eat when they’re hungry and stop when they’re full are less likely to become overweight, maintain more stable weights over time and spend less time thinking about food. Mindful eating also helps people with eating disorders like binge eating learn to eat normally. Depending on the individual’s set point, mindful eating may reduce weight or it may not. Either way, it’s a powerful tool to maintain weight stability, without deprivation.

I finally gave up dieting six years ago, and I’m much happier. I redirected the energy I used to spend on dieting to establishing daily habits of exercise and meditation. I also enjoy food more while worrying about it less, now that it no longer comes with a side order of shame.

I listed Dr. Aamodt’s book in DietHobby’s RESOURCES Books & Tools section with the following comment:

"Why Diets Make Us Fat: The Unintended Consequences of Our Obsession With Weight Loss by Sandra Aamodt PhD (2016).

The author, a neuroscientist and proponent of mindful eating, discusses scientific research on weight and health.  Her central argument is that our body weight tends to settle at "set points" — that 10- to 15-pound range the brain maintains despite repeated efforts to lower it.

Once people see how the set-point theory reflects their dieting experience, they realize that although they don't have the final say on their weight (their brain does), they do have real influence — through exercise and other health-affirming activities — over their health and well-being."

Dr. Aamodt’s information is extremely valuable, and I recommend her book for people working to maintain weight-loss. 

Dr.Sandra Aamodt thinks that you can’t - and shouldn’t - fight back against your Set Point. Her solution is the Behavior of eating mindfully, while following the body’s hunger signals, and to accept whatever weight the body chooses to give you as a Result of that Behavior.

I agree with her opinion that we are stuck with our biological and historical Set Point. However, although the “solution” to the dieting and maintenance struggle that she proposes could be effective for some people, it is not one …. for various reasons … that I find personally acceptable or one that I’m willing to adopt. 

Sandra Aamodt’s personal experience is that of a person who has struggled with being overweight or slightly obese, and not of a person who deals with the struggles caused by a history of extreme, morbid, or severe obesity.  Dr. Aamodt’s personal Set Point might keep her from meeting our culture’s high standards for “thinness”, but her choice not to struggle against it won’t cause her body to become Fat Enough enough to make her a TRUE VICTIM of our fat biased culture. The majority of offensive comments and other behaviors showing open disgust, ridicule, and abuse are primarily reserved for those who are extremely fat. 

The Set Point of someone who has struggled with 10 to 50 excess pounds is very different from the Set Point of someone who has struggled with 100+ excess pounds. Also, someone who has carried 50+ excess pounds for only a year or so is going to have a lower Set Point than someone who has carried that same weight for several years and longer. 

This is the ongoing dilemma for those who are Fat.  It is a situation in which day-after-day, year-after-year, a difficult choice has to be made between two or more alternatives, all of them equally undesirable. 

Each of us must make the eating and behavior choices that will work for us personally in our own individual lives.  Everyone doesn’t value the same things the same way. Food vs. Body Size vs. Desire and everything else that is involved in those categories.  Everyone’s choice is equally valid, despite the fact that those - often difficult - choices can result in making us Thin, Overweight, or Extremely Fat.

My own personal choice is to treat Dieting as a Hobby.  For many, many years I have continually dieted; have been vigilant about what I eat; and have diligently worked against my own body’s Set Point in order to maintain my “reduced fat” body inside the BMI weight range that is labeled “normal”. 

Leave me a comment.

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Existing Comments:

On Feb 21, 2017 TexArk wrote:
So glad to see you are still at it. I just read a post where someone is again saying that we are all lying about our low calorie intake if we are not losing, etc. So I found your update again as validation: Since that time, for more than 11 years, I have maintained at, or near, my goal weight. This past 9 years I've needed to work hard to maintain my weight within my weight-maintenance range by eating a daily average of less than 1050 daily calories, and even while consistently doing this, I've experienced a twenty pound creep. I am consistently working to reduce and eliminate this gain by dropping my calorie averages below that number, and engaging in as much moderate exercise as is appropriate within my chosen lifestyle. The only thing different this time, from all my other prior dieting attempts, was the continual, consistent logging of ALL my food into this computer food journal.

On Feb 21, 2017 TexArk wrote:
This is exactly where I am at 70 years of age. I will gain weight if I eat as much as a 1200 calorie a day average for a week. I know that because I have weighed and recorded my food for years at a time! So I have to be happier at a weight out of my normal range or eat 1000 a day. For now I am just weighing more.

On Feb 21, 2017 Dr. Collins wrote:
             TexArk, it's great to hear from you again. I can't even count the number of times that people -- including medical professionals - tell me I'm lying. However, none of them have ever taken me up on my offer to show them my detailed records. They are convinced of the "Truth" of what they've been told, and are uninterested in seeing proof that their "Truth" is not correct for every person. Even after many years it is still very annoying to be considered either stupid, careless, or a liar. This past year, a diet medical doctor who has had online contact with me for the past 8 years, and has spent several hours speaking personally with me on diet issues, told me he didn't want to see my records, and nothing would ever convince him that I wasn't eating more food than I claimed, UNLESS he had some way to LOCK ME IN A CAGE for a couple of months with total control over every bite of food that I had access to. I KNOW what I've experienced personally, and what I've seen of others over these many years, so I totally believe that this is your personal experience. Like I said in one of my recent posts, the weight issue involves COST vs. BENEFIT... and the COST to some people is higher than it is to others, and the BENEFIT is Less for some people than it is to others. It's a matter of VALUES, and what is personally important to us at the time. .. AGAIN, it is so GREAT to hear from you, I'd like to know more about it it is going for you.

On Feb 22, 2017 Kae wrote:
although I cannot deny that I found this post depressing I am glad that I took the time to read it. If for no other reason than it is always helpful to deal with reality whether it's the reality we want or not. I don't know honestly what my response will be if (when) my weight starts to creep back up even when I'm eating the same number of calories that got me to my goal weight but I suspect that my solution will be a combination of eating fewer calories and living with a bit more weight. Again .. I find it so helpful when you share these kinds of articles as they say forewarned is forearmed :) as for mindful eating .. I cannot trust my body to accurately tell me when I'm hungry or full :( if I'm stressed or depressed I'm hungry .. at least my body thinks I am :/ so that doesn't seem like a good solution for me personally; my plan is to continue to weigh measure and count calories .. at least until being at a healthy weight no longer matters to me ;)

On Feb 22, 2017 TexArk wrote:
I think we need to keep in mind that even if we have to carry a little more weight than we want, that doesn't mean we throw it to the wind (the WTH attitude). One more anecdotal evidence: My stepmom was just over 5 ft. tall and always very slim (size 6 petite). My dad was always about 40 to 50 lbs. overweight. I stayed with them after my dad had a stroke before they moved into assisted living. I watched what my stepmom ate and was amazed...half an apple or less and then saved for later meal, half of a small Michelina frozen dinner, a spoon of peanut butter, maybe a cheese stick...that would be the total for the day. I started counting her calories unbeknownst to her...she averaged 800 or 900 calories a day. When they moved into assisted living with controlled 3 meals a day with one dessert...no snacks available, she gained lots of weight and my dad lost all of his excess weight as well as his belly! She went up to a size 10 or 12 and had lots of belly fat. Go figure.

On Feb 22, 2017 Dr. Collins wrote:
             Thanks Kimber and TexArk for your thoughtful comments. TexArk, your experience with your stepmom sounds very reasonable. I am also 5 ft tall, and ALSO have to deal with the issue of being one of the "Reduced Obese", and it sounds to me as though your stepmom's way of eating is very similar to the way I am eating at present. RIght now I'm experimenting with a different plan which allows "random eating events" involving small amounts of food with a 900 daily calorie limit. I'm calling it "Freedom in Maintenance". Part of this experiment is to allow frequent tiny "meals" or limited larger meals without attempting to set any specific "Habit" pattern. I am an at-home elderly person who finds food to be one of my greatest pleasures. No matter WHAT meal pattern I've tried to adopt as a habit hasn't been sustainable for me, so I'm trying out... no particular pattern, just recording my food, restricting my calories, and living in the moment. Unless my weight starts to skyrocket, my plan is to do this long enough to see what natural patterns emerge, and to see if it is sustainable.

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