Hunger After Weight-Loss

- POSTED ON: Oct 29, 2011

                         
About six years ago, I reached my goal weight,
and now for all of that six years, I’ve been working
to maintain my body at that normal weight.

Here in the DietHobby Archives you can find many articles
that talk about how I do this, my own experiences and viewpoint.
The recent LA Times article quoted below
confirms that my own individual experiences are generally true.
I can personally testify that this hunger persists…even after 6 years.

"Dieters face a long battle with hunger.
Study finds weight loss triggers hormones that tell you to eat,
making it clear why it is so difficult to keep those lost pounds off.

As if people needed a reminder that losing weight is hard
and maintaining weight loss is even harder,
a study has found that for at least a year,
subjects who shed weight on a low-calorie diet
were hungrier than when they started and had
higher levels of hormones that tell the body to eat more,
conserve energy and store away fuel as fat.

The report, published Wednesday in the
New England Journal of Medicine, helps explain
why roughly 80 percent of dieters regain lost pounds
within a year or two of losing them -- and, sometimes, regain more.

After weight loss, "multiple compensatory mechanisms" spring to life,
the study shows, and work together to ensure that weight loss

is reversed quickly and efficiently.

The researchers, led by Joseph Proietto of the University of Melbourne's
Department of Medicine, write that
more than one solution to obesity will likely be necessary:
"a combination of medications" that will have to be safe for long-term use.

Two-thirds of Americans and a growing proportion of the developing world's population
are overweight or obese, and though obesity rates in the United States have begun
to stabilize, there's been no significant decline.

The Australian study paints a "very comprehensive" and "really discouraging" picture
of the breadth of the body's response to weight loss, said Dr. Daniel Bessesen,
an endocrinologist and obesity researcher at University of Colorado's
Denver Health Medical Center.
It captures just how many resources the body musters to ensure that weight is restored
-- a long list of hormones that regulate appetite, feelings of fullness after eating
and how calories are used.

The study enrolled 50 obese men and women without major health problems
and put them on a strict low-calorie diet for eight weeks. Within two weeks
after that diet, and again a year later, researchers measured subjects' blood levels
of nine distinct hormones that affect appetite and metabolism, and asked subjects
about feelings of hunger after meals, between meals and as mealtimes approached.

The challenges quickly became evident.
Thirty-four of 50 enrolled subjects made it to the one-year mark.
Four withdrew during the eight-week period of dieting
-- a rigorous 550-calorie per day regimen.
Seven failed to lose 10 percent of their body mass,
which had been set as a condition of continued participation.
And five withdrew during the yearlong "weight maintenance" phase,
when subjects got regular counseling on a diet-and-exercise plan
to stay at the new weight.

Of those who remained,
the average weight loss at 10 weeks,
when hormone levels were first measured, was just short of 30 pounds.


One year out, those subjects had gained back
an average of just more than 12 pounds.
But after and between meals, their appetites

-- and the hormones that influence hunger -- rebounded even more robustly.

The hormones -- including leptin, ghrelin, amylin, cholescystokinin and insulin --
vary widely. Some are secreted from the gut,
others by the pancreas or fat cells themselves.
Some increase appetite, some tell the brain that enough food has been eaten
and others help regulate how calories are used.

And for the dieters,
those hormones were sending a single message a year later:
 ".Eat more".
The subjects said they were just as hungry
as they had been upon completion of their crash diets
and significantly hungrier than they had been before their diets had begun.

"The high rate of relapse after dieting is not surprising," the authors concluded"
.

Article by: MELISSA HEALY, Los Angeles Times October 26, 2011


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Existing Comments:

On Oct 29, 2011 wrote:
I saw this as well. I could not help but wonder what the results would have been if the subjects had had education and support to step down their calorie consumption rather than plunging it to 550 a day. I think they needed a comparison group and the hormone levels measured at, say, 6 months, if they had reached a 10% loss by then. Maybe you know of research that shows that the hormone levels change when the fat is lost no matter what the rate of fat loss. Isn't it possible the body could be "fooled" into keeping the balance of the hormones more stable by not attacking the homeostasis response so viciously? I'm not claiming that these people would become thin, but I'd bet they could get to and maintain a 10% loss without all the drama of disrupting not only hormones but social habits. Unfortunately in our society, such people would probably still think of themselves as failures because they wouldn't be thin. Of course, I never have a leg to stand on in these debates because my obesity was short-lived, though I have been overweight by BMI standards for 40 years. So the fact that for the most part I don't feel more "hungry" or even as hungry as I did 25 lbs. ago is rather moot . (I used the quotation marks because I was hardly ever actually hungry when I was at my highest weight. I wonder what hormones were at play when I felt urges to eat despite the fact that I wasn't really hungry, as I get now waiting for my meals. I don't feel that nagging sense all the time now, and less so the more I do honor not snacking.) I do suspect that many formerly obese people just accept either consciously or unconsciously that they will have to eat what might be thought of as semi-starvation calorie intakes to stay as low as they want to be. In fact, I know I've said in the past that it seems akin to becoming a competitive athlete or professional musician in that it takes a mind set as well as behavior to permanently change weight. And I'm amazed that there are formerly obese who can even get to the low weights that some do, as you have. I can't even get there! but I do believe I will get into my normal weight BMI within the next year and will likely stay there. But I do think many could lose significant weight and keep it off without undue misery.


On Oct 29, 2011 Dr. Collins wrote:
             I believe that there is no easy way. For people who have an ongoing lifetime weight problem losing and maintaining weight loss comes at a high cost. The more successful one is at weight-loss the higher the cost. I've no real answer about someone who only has a small amount of weight to lose. For many years I worked hard to try and maintain only a 10% weight loss (That is, I was trying to lose more, but my efforts were only enough to cause me to maintain.) My own experience is that for many, many years even a weight loss from 220 to 190 took a lot of ongoing work to maintain. The weight-loss I am currently maintaining occurred at about a 1 lb weight loss per week, with me eating an average of around 1200-1250 calories day, which -- t the time -- gave me an average calorie Deficit of around 500 calories Of course, as a larger, younger person my body burned more calories. Now as a small, older person I gain weight if I eat a 1200 calorie daily average. And for several years, I've had to eat around 1050 calorie daily average to maintain at normal weight...and even while doing that, my weight has crept up by by about 5 lbs. Personally, I find being at a "normal" weight motivates me to keep up the effort, far more than being obese and having to work hard to keep from becoming even more obese does.


On Oct 29, 2011 kimberchick wrote:
Hi Phyllis :-) I found this article very interesting yet also somewhat discouraging...kind of like wgt loss itself I guess. I'm not good @ handling hunger :-( I am very committed to losing at least 73 lbs tho and this article has given me a lot of good information - plus I find it easier to deal w/the unpleasant parts of life when I know that 1)they're normal experiences and 2)I'm not alone w/my struggles. In that way this article is very helpful to me and I thank you for sharing...as I rarely (as in never) read the LA Times lol Wishing you an awesome day w/little or no excess hunger :-)


On Oct 29, 2011 Dr. Collins wrote:
             Hi Kimberly, my viewpoint is that "the truth is the truth" even when it is less than pleasant. I find that I am better prepared to deal with reality, when I have an accurate concept of what it is. We are constantly exposed to untruths and outright lies by marketing interests. So many of these falsehoods raise false expectations and lead to personal heartache. Personally, I don't find wishful thinking to be helpful. I prefer to see the unvarnished truth and deal with the emotions that accompany it, so that I can ultimately achieve Acceptance of what is, so I can work out what steps I need to take to accomplish my personal goals.


On Oct 29, 2011 TexArk wrote:
I have found that following suggestions for resetting leptin has really helped the hunger problem. This includes eating a protein breakfast, not eating in between meals, moderate carbohydrates, and not eating 3-5 hours before bedtime. Leptin is considered the master hormone and if we are obese we are definitely not leptin sensitive. I am speaking as someone who has fought this for 45 years and for the first time I am maintaining a weight loss without hunger. The total calorie count is low for someone 5'7" (about 1300 calories) but finally no cravings and no hunger except pleasant hunger at mealtime. I have also given up wheat and sugar and I think that has also helped satiety.


On Oct 30, 2011 Dr. Collins wrote:
             Hi TexArk, You give some good behavior suggestions. I'm not so convinced that any one hormone is the "master" one. There are quite a few, including insulin and leptin, that seem to be very inter-related, and people seem to think that there are many still undiscovered. Personally, I've found that keeping my carb level moderate does help relieve hunger symptoms, and that the more carbs I eat, the more food I want ... and, for me, this actually seems to be a carb EFFECT on my body, and not simply that carbs TASTE more delicious.


On Oct 30, 2011 kimberchick wrote:
I am totally on-baord w/facing the truth even when it's unpleasant :-) I'm intrigued by TexArk's comment regarding leptin...I truly am a carb addict and I wonder if reducing my carb intake would help w/hunger issues. I think I shall gradually work on that - hoping that if I start now by the time I reach the point in my wgt loss/maintenance where I need to reduce my daily calorie intake below 1500 (which seems to be the lowest I can reduce my calorie intake to w/out suffering hunger) the lower carb intake will prevent or at least help w/hunger issues :-) I'm already well-trained @ not eating between meals but I'll have to reinvent my breakfast (currently cereal & toast) and work on not eating too close to bedtime. All doable for me...I think ;-)


On Oct 30, 2011 Dr. Collins wrote:
             Hi Kimber, I've found my mock pancake recipe to be a good substitute for a cereal or bread based breakfast, and I know you've tried it and like it. For those who don't know, it is located here at diethobby in the RECIPE section.


On Nov 03, 2011 jjo wrote:
I found this article because I was curious why, after finishing a one month healthy eating/exercise regime and losing 11 lbs, I am constantly famished. I will eat a huge meal, and within 20 minutes my stomach aches like I haven't eaten in 24 hours, I salivate and I can't even concentrate because I am so hungry. Cue another large meal or snack, and once again within 20 minutes I am starving again. I have never experienced constant hugger like this in my life. Good to know that there is a chemical reason for it, but wow is this going to be hard!


On Nov 04, 2011 Dr. Collins wrote:
             Hi jjo, Yes, there is a chemical reason, and yes it will be hard, but you can learn helpful ways to deal with it. Maintenance of weight-loss takes work ... as much, or more, work than weight-loss. This is such an obvious fact, that one would think it would be plastered everywhere. Personally, I think the reason that it isn't is because that Truth doesn't help sell dieting products.


On Nov 05, 2011 kimberchick wrote:
I did love the faux french toast...a lot :-) I'm currently getting most of my protein from Fage (10 for $10 the last couple of weeks!) and chicken or tuna fish. I found these packaged tuna steaks that are awesome and versatile and @ $3.49 per svg a much better deal than fresh tuna steaks which are currently $12.99/lb here :-( I'll be doing my grocery list a bit later and will be sure I have the ingredients on hand to make a few batches of faux french toast next week! Thank you for posting the recipe...so convenient for refreshing my memory...I have lots and lots of recipes written down on yellow notebook paper and it can take me quite some time to find the right one :-O


On Nov 05, 2011 kimberchick wrote:
Hmmm, just checked the math and it's actually cheaper to buy the tuna steak @ $12.99/lb :-O $12.99/lb sounds so expensive (even my favorite steak is less that $10/lb) I couldn't imagine it being cheaper than the packages I was buying for $3.49! The tuna steaks I buy are cooked and I don't know how much wgt tuna loses in cooking but I'm at least inspired to find out :-)


On Nov 06, 2011 Dr. Collins wrote:
             Hi, Kimber, Thanks for your comments.

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