Genes Take Charge, and Diets Fall by the Wayside

[Aeon]

Another questionable piece from the New York Times.

Genes Take Charge, and Diets Fall by the Wayside (http://www.nytimes.com/2007/05/08/health/08fat.html) May 8, 2007

Excerpt:

The Rockefeller subjects also had a psychiatric syndrome, called semi-starvation neurosis, which had been noticed before in people of normal weight who had been starved. They dreamed of food, they fantasized about food or about breaking their diet. They were anxious and depressed; some had thoughts of suicide. They secreted food in their rooms. And they binged.

The Rockefeller researchers explained their observations in one of their papers: “It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.”

Eventually, more than 50 people lived at the hospital and lost weight, and every one had physical and psychological signs of starvation. There were a very few who did not get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and, always, counting calories and maintaining themselves in a permanent state of starvation.

LOL


Is body weight inherited, or is obesity more of an inadvertent, almost unconscious response to a society where food is cheap, abundant and tempting? An extra 100 calories a day will pile on 10 pounds in a year, public health messages often say. In five years, that is 50 pounds.

The assumption was that environment determined weight, but Dr. Albert Stunkard of the University of Pennsylvania wondered if that was true and, if so, to what extent. It was the early 1980s, long before obesity became what one social scientist called a moral panic, but a time when those questions of nature versus nurture were very much on Dr. Stunkard’s mind.

He found the perfect tool for investigating the nature-nurture question — a Danish registry of adoptees developed to understand whether schizophrenia was inherited. It included meticulous medical records of every Danish adoption between 1927 and 1947, including the names of the adoptees’ biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.

Dr. Stunkard ended up with 540 adults whose average age was 40. They had been adopted when they were very young — 55 percent had been adopted in the first month of life and 90 percent were adopted in the first year of life. His conclusions, published in The New England Journal of Medicine in 1986, were unequivocal. The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.

The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”

In other words, being fat was an inherited condition.

(...)

The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.

He published it in the journal Science in 2000 and still cites it:

“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”

[ValerieL]

The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.

He published it in the journal Science in 2000 and still cites it:

“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”

I absolutely, 100%, believe this. We think controlling our weight is about character, willpower and self-worth. It's not. It's about finding a way to live in harmony with our genetics and bodies so that we don't have to control our weight.

[Nancy LC]

This could be me. :(
Before the diet began, the fat subjects’ metabolism was normal — the number of calories burned per square meter of body surface was no different from that of people who had never been fat. But when they lost weight, they were burning as much as 24 percent fewer calories per square meter of their surface area than the calories consumed by those who were naturally thin.

Interesting:
One way to interpret Dr. Hirsch and Dr. Leibel’s studies would be to propose that once a person got fat, the body would adjust, making it hopeless to lose weight and keep it off. The issue was important, because if getting fat was the problem, there might be a solution to the obesity epidemic: convince people that any weight gain was a step toward an irreversible condition that they most definitely did not want to have.

But another group of studies showed that that hypothesis, too, was wrong.

It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.

His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.

Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.

When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.

The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.

Pretty grim except that in some regards it is relieving to hear that the reason we're fat isn't because we're weak-willed. I think the article is good. It helps set realistic expectations about how your body may react to weight loss and why it'll be a life-long battle for many of us.

[ValerieL]

I guess I don't feel it's that grim, it's more like a clue. It reminds me why low-carb worked for me (I wasn't hungry anymore so losing the weight was relatively easy). It reminds me why I get into trouble when I stray too far from my low-carb maintenance. It reinforces my belief that my exercise helps me maintain my weight loss because it lets me eat more than I might be able to otherwise.

And it doesn't say anything about long term metabolism changes, maybe after long enough of staying at a lower weight, the metabolism returns to more normal rates? We all know the statistics that 95% of dieters regain their weight within 5 years. I'd love to see the statistics of what happens to the 5% that made it the 5 years. How many of them regain the weight later? If the number is really low, maybe metabolism does reset?

My husband occasionally expresses the viewpoint that I expend a lot of energy and attention on my weight maintenance. I exercise a ton, I'm on the forums constantly, sometimes he feels I'm obsessed with it. But maybe that's what it takes in the face of the genetics. It's a fair trade off to me right now in my life, but I can see how it wouldn't always be or might not always be possible.

These ideas just reinforce for me my previous belief, like my signature says, that this *isn't* about our character, how strong we are, if we are good people. Even on these boards, when people lose their weight they often feel it's because they proved themselves stronger than the weight, the obesity. Are we? Are we really? Or did we find the particular diet that works with our bodies to quiet the incessant hunger that used to drive us to eat?

[seyont]

I may inherit a train set from my father, but I did not inherit obesity. Nor can I inherit a cold or the sniffles.

What I did inherit- I, alone, according to the author - are 3 million years of human and 120 million years (?) of mammalian adaptations to a world in which there was NEVER a loaf of bread or french fries. Meat and perhaps a salad has always been on the menu.

[Nancy LC]

Well I've been maintaining my (not goal) weight for a number of years. I have to be constantly vigilant about my natural inclinations to eat carbs, to overeat even low-carb food and to battle my lack of desire to exercise. Not to mention the fact if I want to lose more weight (still have another 20 pounds I should get rid of) I have to also adopt a rather low calorie diet as well. Battling those inclinations is like trying to control your beathing when you're walking up many flights of stairs. You can do it for a bit but when the body wants something, it has ways of getting what it wants. In my case, it really wants me to be this weight, or heavier.

Even though low carb does make it easier than high carb, it doesn't make it easy. At least not for me.

If low carb made it easy we'd hardly need a support group. It just makes it somewhat more possible.

[ValerieL]

Ditto to what Nancy said. I'm in exactly the same place. And if it *is* about the genetics, it's easy to see how there would be varying degrees of genetic predisposition to gaining weight, someone might have only been 15 lbs overweight and the shift to ideal weight is far easier to do than someone whose genetics is programmed to be far heavier.

It explains why so many come here at high weights similiar to mine now and just by doing low-carb lose right down to low normal BMIs and why I can't budge past a low-overweight BMI even living on induction levels carbs.

[Rachel1]

Ditto to Nancy and Valerie. It took me a year on Induction to lose 20 pounds. It's taken me five years since then to lose another 15. I have a 'nutritional holiday' maybe 10 times a year, and the rest of the time I'm between 20-50 carbs per day. I have to drastically increase exercise and reduce calories - to the point of discomfort - to lose. I haven't hit my goal yet, which is VERY frustrating.

I KNOW it's genetics, because, with the exception of my brother (who also battles a tendency to weight gain), I'm the thinnest person in my whole family.

Oh, well. I keep telling myself I'm healthy, and I guess that's more important than vanity. Still ...

Rachel

[LC FP]

It took me a year on Induction to lose 20 pounds. It's taken me five years since then to lose another 15. I have a 'nutritional holiday' maybe 10 times a year, and the rest of the time I'm between 20-50 carbs per day
If carbs were only available seasonally as you grew up, you probably would never have weighed 162 lbs.

Being "born to be fat" doesn't make sense in a carb-restricted world. You're just part of a very cruel experiment in human diet manipulation.

[ValerieL]

An awful lot of men on this thread not believing the genetic component to obesity and weight management. Hmmm... couldn't be your *genetics* that make it easier for you and thus you don't have the same experience with weight that we women do, could it?

[Nancy LC]

Maybe something on the Y chromosone? :p

[Rachel1]

Being "born to be fat" doesn't make sense in a carb-restricted world.

I don't see why not. Gaining weight easily on seasonal carbs would give some people an evolutionary advantage. An extra few pounds of fat gained on berries and starchy tubers would come in awfully handy at the start of a long, cold winter. It's also possible to gain weight on low carb, provided one eats enough calories. Quite a few people on this board can attest to that.

I'm not saying that genetics is ALL there is to it. I'm just saying that we shouldn't discount genetics as one of a number of interrelated factors.

Rachel

[LC FP]

My point is that when your "genetics" were being laid down, your ancestors lived in a carb-restricted world. Overabundance of high-carb food wasn't part of the equation. Carbs are a new evolutionary pressure. It has nothing to do with gender.

DNA is the most stable organic molecule in the universe. Your DNA is ~99% homolous with a chimpanzee. Your cells make the same enzymes that dandelion cells make. 10000 years of agriculture can't change your metabolism.

[ValerieL]

No argument on when genetics were laid down. But it doesn't change the fact that the ability to handle carbs could be genetic. Just because there wasn't the opportunity for that genetic feature to present itself in a carb-restricted world doesn't mean that that the genetic feature of handling carbs poorly (leading to obesity) or handling them well didn't exist back then and now.

[MizKitty]

I must admit, this type of research strikes fear into my heart. I hope you all suggesting today's modern high carb diet is equally a part of the inevitability of being obese, as is genes, are correct.
I've done this twice before - taken off 150 pounds. In 92-93, and in 96-97. Neither time LC, but the standard low fat low calorie diet. Since I couldn't keep it off, I had given up on trying it again. I knew I could lose it, but what was the point of all that work if I couldn't keep it off?

I've joined in threads about it before, and have actually had people get mad at me... I understand that, know no one who is working so hard to lose wants to be told they won't be able to keep it off, that 95 out of 100 will put it all back on. They want/need to believe they will be one of the 5 who don't.
But my experience told me I wasn't one of those 5.

I was considering the surgery. Say what you want about it's downsides, and the inevitable stories everyone will tell about someone they knew who had it and put the weight back on, it has a much higher long term success rate, I think nearing 80%.
Something different happens with the surgery. Some physiological change. Do you know that Type II diabetics are often cured by the surgery? I don't mean by the weight loss. I mean most are off all their diabetes medicine before they even leave the hospital, before they even lose a pound.

But I'm afraid of the surgery, so decided to give this another try, this time through LC, which is the diet that is best for a diabetic anyway, and similar to what surgery patients are told they must eat for the rest of their lives.
Maybe that's part of the surgery's success not being credited?

I do feel different this time, doing LC. I'm accepting that this is how I will eat for life now, I'm not on a diet that will come to an end. I accept now that when I look like a normal person, I will never be able to eat like a normal person, whatever that means.
I wasn't there the first 2 times I lost the weight.
Wasn't diabetic either, that makes a huge difference, when this is just as much about restoring my health as it is my waistline...
Thanks to diabetes, I can never go back to 'eating like a normal person'.

But to read of research that "proves" you can't defeat your genes is very upsetting.
V, I'd like to see that research into the 5% too. I hope we can reset out metabolisms.

[Nancy LC]

DNA does change all the time. It changes by random mutation (which are sometimes passed down to offspring), by environmental sources (sunlight, radiation, chemicals), by viruses and bacteria. Things like plagues can make an uncommon DNA become common if it wipes out enough of a population.

Sorry, I just finished a book on DNA. :D

[waywardsis]

I accept now that when I look like a normal person, I will never be able to eat like a normal person, whatever that means...Thanks to diabetes, I can never go back to 'eating like a normal person'.

But to read of research that "proves" you can't defeat your genes is very upsetting.


Shouldn't it be "thanks to eating like a normal person, I have diabetes"?

It's pretty bad, isn't it, when processed convenience foods and foods that generally don't mesh well with our genetics (grains, etc) are considered what "normal people" eat. I am so thankful for my celiac/gluten intolerance for keeping me from eating like a "normal person" and finding a new normal, one that makes more sense for our species in general and for me in particular.

I don't believe you can't overcome a genetic tendency to obesity or work with your genetic tendencies. I wonder if the tendency isn't actually to obesity...if obesity is merely a symptom of something else you're genetically prone to. Gaining weight for me, anyway, turned out to be partly due to eating gluten etc. Anyway, we're all peculiar!

[LC FP]

DNA does change all the time. It changes by random mutation (which are sometimes passed down to offspring),
The only DNA you own that counts, for evolution, is in your eggs or the cells that produce your sperm. If you have an egg that gets a mutation in DNA that codes for a critical metabolic enzyme, and it gets fertilized, you will miscarry. If you get a mutation in one of your 500 billion liver cells that screws up your citric acid cycle in that cell only, that cell will die and you will replace it.

Your metabolism is such a complicated system any change in the critical enzymes usually results in the death of that cell. Evolution of metabolism almost never occurs, that's why we can use rats and mice (and fruitflies) to simulate our metabolism in all these wonderful studies we discuss and discuss, especially about CR.

[LC FP]

But to read of research that "proves" you can't defeat your genes is very upsetting
Miz, your genes will only make you overweight if they find themselves in an environment they're not supposed to reside in. It appears you've moved to the right zip code, so you should do OK as long as you stay here.

[Nancy LC]

The only DNA you own that counts, for evolution, is in your eggs or the cells that produce your sperm. If you have an egg that gets a mutation in DNA that codes for a critical metabolic enzyme, and it gets fertilized, you will miscarry. If you get a mutation in one of your 500 billion liver cells that screws up your citric acid cycle in that cell only, that cell will die and you will replace it.

Spontaneous DNA changes can be heritable. There are germ cell mutations all the time like achondroplasia, a type of dwarfism, Marfan and progeteria are also. Google heritable mutations. There's a chapter in my DNA book about mutations and inherited diseases. I think random mutations are probably the reason we're not one celled creatures any longer, if we didn't have heritable mutations then we'd still be chimps or something much less evolved.

Then again, a zygote could have a mutation too and that mutation could potentially involve the soon to be sex cells.

There's a famous case of heritable mutation in the English royalty: http://en.wikipedia.org/wiki/Haemophilia_in_European_royalty

Maybe we're talking about two different things though. Were you limiting your statement of mutations to just metabolic enzymes? I thought you were talking about all mutations.

[LC FP]

I guess I was talking about metabolic enzymes. I think we have 2 metabolisms, one we inherited from australpithecus like Lucy that allows us to burn carbs, and one from Homo habilis or erectus (starred in first Viagra commercial) who evolved to eat meat. Since then metabolism hasn't changed much.