Set Point

- POSTED ON: Jan 20, 2017

We do not understand how the body resists weight change and why, after weight loss, so many people regain it. The concept of a set point for weight is widely accepted.

The set point is like the thermostat in our central heating system. It is switched on when the temperature falls below a critical (set point) temperature and is switched off when that is exceeded.

Using the word “rachet” might help one conceptualize the set point concept.

To rachet is to cause to increase or decrease by increments. A rachet is a mechanical device consisting of a toothed wheel or rack engaged with a pawl that permits it to move in only one direction.

A person has an existing set point. That person gains weight, and then gains and sustains even more weight gain. This causes the set point to be racheted up, and once it passes each rachet, there is no going back. The rachet is the biological set point and it can be easily driven upwards, but is very difficult to drive back down.

Using the fat cell theory is helpful to further explain how this works.

For an example, let’s assume an average fat cell contains 0.4 micrograms of fat each. A person gaining weight might see that fat cell load expand to 0.6 micrograms. This is an acceptable load increase, and when the person loses weight, the fat cell level drops back to 0.4 micrograms.

 This seesaw can go on forever, but when the weight gain loads the fat cell up to 0.8 micrograms, a tipping point is reached, and the fat cell divides. Now we have two fat cells, each containing 0.4 micrograms. Click! That was the ratchet turning irreversibly.

When we want to return to the previous weight, we must lose half the fat we gained. The problem with this is that each fat cell now has the standard fat load of 0.4 micrograms each, and to halve this to just 0.2 micrograms per cell requires us to get the cells to live a life they do not like. If we let our mind tell us what to eat, we can overcome the disgruntled fat cells which are below their fat quota. But all the time the basic animal biology of our body will be waiting to return to 0.4 micrograms per cell.

Then, along comes an event like a vacation, a holiday, or other eating occasion, and we take our eye off the ball .. lose our mental concentration, but the fat cells in our body didn’t rest, and we’ve regained our weight. The body is now back to the new set point it made when we went past the older set point and hit a new rachet.

   In a 2007 research study, a team of Swedish researchers examined fat biopsies from about 680 lean and obese Swedish people. They found obese people can have as much as twice the number of fat cells as do lean people. The researchers also followed 20 gastric bypass patients who lost weight after their operations. Over the course of two years, their fat cells shrunk in size, but the total number stayed constant.

Fat cells can shrink, but once created, they never disappear. The body’s job is to work hard to get all of its cells (including fat cells) to survive and even to thrive. It is easy to continually rachet the biological set point up, but it is almost impossible to rachet it down.

A fat cell is not merely a passive container that stores fat. Leptin is one of the hormones produced by fat cells. Among other things, leptin tells the brain how much fat is in the body, and provides a direct communication link between the brain and fat cells.

Fat cells are the hub of a complex communication system that regulates many metabolic functions, continuously telling the brain how much energy the body has left, signaling muscles when they can burn fat, instructing the liver and other organs when to replenish fat stores, and controlling the flow of energy in and out of cells.

Because fat is so vital to survival, nature has created a complex system of overlapping feedback loops that make it very difficult to override the body's imperative to store energy. People with extra fat cells tend to regain lost weight rapidly.

 This biological truth is the basic problem that exists with all of those “Non-Diet”, “Intuitive Eating” theories. A reduced obese person cannot rely on one’s BODY to make or to keep him/her lean. In fact… it is just the OPPOSITE. A reduced obese person’s BODY has the specific biological imperative of refilling EACH fat cell to its basic quota, which will return that person back to his/her former obesity set point.

The DietHobby ARCHIVES contain many other articles which also discuss this issue.

NOTE: This article was bumped up for new viewers.  Originally posted on 12/9/2012.


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On Dec 09, 2012 wrote:
"A reduced obese person cannot rely on one’s BODY to make or to keep him/her lean. In fact… it is just the OPPOSITE. A reduced obese person’s BODY has the specific biological imperative of refilling EACH fat cell to its basic quota, which will return that person back to his/her former obesity set point". Phyllis, Does this explain why if a person who has been say 185 lbs. most of their lives and then becomes obese for a period of time or even multiple times goes on a weightloss program picks a goal of say 170 lbs. and achieves it. They attempt to remain at the 175 level; but despite their best efforts, their weight creeps back to the 185 set point the body has established.


On Dec 09, 2012 Dr. Collins wrote:
             John. Applying set point theory, in an example where one weighs, and has weighed 185 for most of their life,...starts at 185 and loses down to 170 and then tries working to remain at 170-175. I'd say that a 10-15 lb difference isn't going to make much change in one's fat cells or set point. HOWEVER, if we ADD the factor "BECOMES OBESE" one or more times, and in this example, we assume this means the person gained 100 lbs,...such as from 185 lbs to 285 lbs... the initial gain into obesity would increase that person's fat cells, possibly double them, racheting up that person's set point from 185 to 285. Therefore, when the person loses weight down to 170, that person still has twice as many fat cells, and the person's set point is no longer at 185, but now is at 285. Apparently, just dropping weight is not enough to cause the body to drop the set-point, and just like fat cells shrink but don't disappear, it might be that the set point is an UPWARD one-way-street. If this is true, a reduced obese person will ALWAYS have to be vigilent with ongoing mental efforts to control eating, either consciously or through following newly acquired habits, because they will always be working against their body's ongoing efforts to refill their fat-cells ...which would be to go back to the highest set point.


On Dec 09, 2012 jethro wrote:
Dr. Collins, this fat cell behavior is very depressing. If I had not known about your personal success despite fat cell behavior, I might have given up. It's a fight to the end, mind over matter. By the way, wouldn't liposuction get rid of some of this fat cells?


On Dec 09, 2012 Dr. Collins wrote:
             Yes, Jethro, the truth about fat cells is very depressing. I think that the set point theory as stated in the above-article is probably the best explanation of why a Reduced Obese person has such difficulty with long-term maintenance. Most people believe that once they acheive a "normal" weight, that their body will adjust to "normal", and adjust to naturally defend that size. However, this does not appear to be the case. There is no research data on this. I, personally, am now completing my 7th year of being "normal" weight, and I still have to continually use mental effort to maintain my weight. Any time I rely on my body to tell me what or how much to eat, it results in weight gain. Regarding liposuction ... there are interesting recent studies showing if you suck out the fat with liposuction, even if it's only a few pounds, fat still comes back, but it is redistributed into another area. The redistribution occurs because of damage to the old area. The body controls the number of its fat cells as carefully as it controls its fat. Fat cells die and new ones are born throughout life. Scientists have foud that fat cells live for only about seven years and that every time a fat cell dies, another is formed to take its place. This is another subject that I intend to write about sometime.


On Dec 10, 2012 Dr. Collins wrote:
"If this is true, a reduced obese person will ALWAYS have to be vigilent with ongoing mental efforts to control eating, either consciously or through following newly acquired habits, because they will always be working against their body's ongoing efforts to refill their fat-cells ...which would be to go back to the highest set point". Phyllis, thanks for that explanation, as it really makes it clear now what must be done to remain at a chosen goal. Speaking for myself of course.


On Dec 10, 2012 Dr. Collins wrote:
             John, Over the past 7 years of maintenance, it has been a constant struggle for me to maintain my weight within a 10 lb "normal" range. There are no research findings on LONG-TERM weight maintenance for the Reduced Obese. It appears to me that my body cooperated with maintenance better during the first couple of years after reaching my goal, and that ... instead of adjusting to the "normal" weight range ... my body has stepped up it's efforts to get me to regain. The average person tends to think that to avoid this maintenance struggle, all that is needed is for one to set one's goal 10 lbs or so higher, HOWEVER my own observation is that this is ineffective UNLESS 10 lbs up puts one close to one's HIGHEST weight. What happens is the ongoing struggle to keep one's body from regaining weight continues ... only at a weight 10 lbs higher than "normal" ... Adjusting another 10 lbs up does nothing to alleviate the struggle. The only thing adjusting the weight higher does is allow the body to burn a very few extra daily calories, but it doesn't solve the problem, and doing that adjustment process is sort of like tossing a crust of bread to a starving man. The body still struggles to return to its highest weight ... only then the struggle is just to stay in an "overweight" range, rather than return to obesity. This process appears to continue even with additional weight gain ... until all the fat cells are totally refilled. As I said, there are no official research findings involving this Long-Term maintenance issue, and probably none will ever exist, due to the extreme difficulty, high cost, and lack of potential profit.


On May 23, 2013 mabelherbert wrote:
I find this information both distressing, as it means that I will never be 'normal' when it comes to food, but also affirming. It explains so much about my struggles with weight loss. You are a wonderful example to me of how goal weight can be maintained, with persistence and dedication.


On May 23, 2013 Dr. Collins wrote:
             Mabelherbert, thanks for sharing your feelings about this. Most of us who have spent years struggling with obesity have ALSO spent years struggling with the FANTASY of becoming "Normal". I've found it personally helpful to ACCEPT the REALITY that Obesity is an ongoing problem for me... and it includes the difficulty of maintaining weight-loss. Getting there.. (to a "normal" weight).. is ONLY the beginning. Behaviors to get there must be continued forever, and for many of us, the eating behaviors required to keep us at a "normal" weight never become easy or "normal".

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