I saw this article at the CBC news web site. I wonder what would happen if they studied only low-carb people.


The rest is at
http://www.cbc.ca/news/health/obesi...sible-1.2663585

I'd be interested to see what happens if they study the regain phenomenon on people who do only the low-carb lifestyle. Or maybe there is a study and I'm just not aware of it.

Edited to add: There are a ton of comments below the article.

The fundamental problem is that it's extremely difficult (and expensive) to accurately determine what people eat when they themselves report what they ate. The ongoing reporting by the National Weight Control Registry of Brown University, for example, relies solely on food recall reports to determine what participants ate over the past year. This kind of reporting is notoriously unreliable. Daily food logs produce more accurate recollections, but the effort required to maintain them means they're unsustainable for the majority of people over the long term.

Researchers also face the problem of extrapolating meaningful results from the small population of low-carbers or paleo eaters in this country. Suppose that there are 50,000 people in the U.S. who faithfully follow a lower-carb food plan. With a current U.S. population at 317 million people, according to U.S. Census Bureau estimates, lower-carb eaters represent only 0.016% of the population. It's hard to argue that this sliver of the population can represent the basis for a public policy that most people will follow. The "healthy user" confounding variable also makes it difficult to determine that the health outcomes of this population is due solely to diet, when even its advocates say that diet alone is just one component of achieving and maintaining healthy weight.

So, while weight gain acts as a reliable marker (most of the time) of abandoning a diet, it's impossible to say definitively if people are complying with any particular diet or not, and whether diet alone makes the difference. That's why we need to regard all articles like this one with a few grains of salt.

The National Weight Control Registry...that's it! I was trying to remember the name of that. It tracks people who have kept weight off successfully for 5 years, right?

Nice. Great way to get people to give up and keep eating the overabundance of GMO corn and wheat, all the while making more and more money for the pharmaceutical and medical industry.

I hate how society keeps giving up on ourselves because of crap like this.

Not quite. You must be at least 18 years of age and have maintained at least a 30 pound weight loss for one year or longer to become a participant.

So, eating right, exercise, doing healthy stuff, makes us fat? Pfahaha! That's a psychologist talking. Taubes said it right: You can't fix a physiological problem with a psychological solution.

That's an academic talking. Experimentalists will say things like "we've gotten really fat really quick really recently, which means it must not be due to our genes, but to our environment".

Recently, I wrote a blog post to argue in favor of repeat dieting. The rationale is that the initial intervention works only for so long, but it works every time, therefore repeating this initial intervention at intervals will allow both to lose more weight initially and to maintain weight once we've achieved desired weight. I mean, think about it. Every single weight-loss experiment shows some measure of success. The focus of the article however is on the short duration of this success, rather it's on the "failure" to succeed long-term with the initial intervention.

The premise of the article is flawed. It assumes that weight loss must be a one-time thing and its effect permanent. It doesn't have to be. It can be a repeat thing with a temporary effect. But it can also be a one-time thing with a permanent effect. Take Adipotide for example. It's a one-time thing, its effect is permanent. However, just like with any other intervention, if the cause remains, fattening will happen again.

I think I'm going to make a point here. The entire planet is on a never-ending cycle of seasons (and days, duh), to which all living things are adapted. It just feels wrong to suggest we could fix obesity with a one-time thing and a permanent effect. That's not how the planet works. It works with repetitive interventions and temporary effects. Well, we're part of this planet for a few million years now. Maybe we're also adapted to its never-ending seasonal and daily cycles. So maybe the solution is repetitive interventions with temporary effects, because we're adapted to this, and because the problem is also produced by repetitive interventions with temporary effects, only here it accumulates to give us a permanent problem.

I weighted nearly 360 pounds when I started to eat low-carb in 2003. I weigh 265 (or so) today. I have sustained longer term weight loss than everyone I know who has lost any serious amount of weight. But I'm still morbidly obese.

At one point, I really thought I'd get to 190. I don't know that I ever will, now. Would I count as a long term success? A long term partial success?

After nearly a decade of low carb and repeated attempts to lose weight with mixed results yo-yo-ing up and down some, I'm basically at the same weight I started at but even fatter around the middle. I've found no matter how low carb I go, even testing to make sure I'm regularly in ketosis and all, the weight just won't budge unless I also in addition semi-starve myself, which I can't maintain very long being constantly hungry, and as soon as I eat normal amounts the weight immediately all bounces right back (was maybe just water loss anyway). I read about lots of other people going low carb and the weight just easily coming off, sometimes lots of it, but not happening here. Low carb never lost me much of any weight, but I stick with it regardless because I want the other health benefits. But I am frustrated with lack of weight loss success. Is there really some way I can lose weight that's realistically doable (doesn't involve being hungry a lot of the time)? Because I'm definitely not like people I know who forget to eat and rarely feel hunger. Sigh!

How are your labs — triglycerides, LDL/cholesterol ratio, fasting insulin level, 25-OHD, HbA1c, DEXA bone density scan, coronary calcium score?

Even with low carb; even ketogenic low carb; the % who lose a lot of weight -- which I will arbitrarily define as around 100# -- and keep it off for years is very, very, very tiny. I think this forum is a pretty good example of that actually.

There are some amazing success stories (Judy and Amory for example, though the latter seemed to have the huge crash from VLC after).

The percentage is so small as to fit the ~2-3% that Joy Nash once recited in a youtube video called "Fat Rant" where she suggested that people who got and became thin after being fat were essentially freaks of nature statistically and people should quit doing damaging diets, starving themselves and feeling horrible about being fat and just eat well and exercise and try to be healthy and not sweat the details.

After many years online I posted on my blog maybe a year ago that the reality of everything I have seen is: Women generally can lose up to about 180# but that is it; if more is lost it returns so promptly as to not matter; that appears to be it. So, if you weigh 500# the reality is the chances that person is going to weight much less than 300# if they are a woman -- let alone stay there even if they got there -- is really, really, really, really, really unlikely.

Nobody wants to say it because they don't want to demoralize people make them say F--- it I'll just eat what I want then!

Well, that's the age 12 response (though understandable) and the one I had (sadly, at age 24) when I realized nobody in my family had ever, EVER gotten thinner in the thighs/ass (lipedema, I'd never heard of it then, but that's why) despite 40 years of dieting on some peoples' part. I figured I was doomed so F--- it, and I buried myself in work and refused to address the topic at all because after following nurses advice (drop protein, eat whole grains) for me it was clearly a losing battle.

But it's also horribly damaging to make people believe total lies such as that merely not-eating 3500 calories is supposed to lose them X amount of fat; or that all your fat ("except maybe the last little stubborn bits") can simply be lost if you just do things right somehow.

It's not merely that the % of people who lose "all their weight" are incredibly statistically unlikely, and that the % that keep it off are even more unlikely; it's that most of them have <150# (as women) (and usually <60#)to lose or less. I'm NOT saying that's not a ton of weight! Hell, successfully losing even 20# is a huge, awesome thing.

I'm just saying that there are at this point in our culture tons of people who are way above that amount overweight, and to hear 'the world' talk about it, if they'd just quit eating bonbons they'd all be thin. People who learn LC stuff come to realize calories aren't too good a measure and that lowcarb has many things to recommend it, but they're often still operating on the assumption that if they just don't eat more than 35 carbs a day "until all their weight is lost" they're going to eventually be 200-300# thinner.

More likely they're going to be thyroid-adrenal crashed once they hit about ~160# down (about 100# more than that for men), and that will be it for ketogenic. If they lose less than that and stop, if they are still functioning normally otherwise, then they are a success story.

It is true that this mirrors my own experience however I'm not basing it on me; I've been online a whole lot of years, watching heavy people with special interest due to my own weight, and this is simply what I see.

It is not cheering. But that's the way it seems to be.

You see these 'amazing stories' that seem to contradict this like, some guy who lost 400# really fast and had massive skin surgery (not wise IMO but oh well) but of course, he gains it back and now he's fat AND he's probably got some surgery side effects AND he dared dream about having a life but JUST KIDDING! -- apparently not. The fact that most people can think of some 'amazing success story' who lost that much usually means (a) right, actually proving how incredibly rare it is and (b) so where are they now? Yeah.

Back in the day when people who were 150+# overweight were rare, it probably wasn't such a big deal to consider like now, because the chances of being able to lose and keep off 40# -- which still a huge accomplishment of course -- are vastly higher and more likely than the chances of losing at all, let alone keeping off, 250#. In today's world a ridiculous number of people are ridiculously huge (I speak with experience on this) and I think for anyone who is morbidly obese or higher, a dose of realism is IMPORTANT.

Nutritional density (underline that three times), stabilizing blood sugar, and getting off 'toxic un-foods' are the only things I would obsess on if I were advising someone of any state but especially very fat, now. I wish I'd figured that out ten years ago. The last ten years of my life would have been so different. I have no idea how different my weight might be -- likely quite a bit less (less regain perhaps, but I'm not sure) -- but the important this is my health and energy would have been different I believe. It took a decade of doing everything wrong to gradually start realizing something about doing it right (still figuring it out, of course).

But I'd have been healthier if I hadn't been focused on weight loss instead of health. On this OMG I COULD ALMOST BE NORMAL that in my head once I found lowcarb before the FIRST time in my entire life I found something that seemed to WORK. So I obsessed on it. And it worked awesomely! Er, until it didn't for me, and that point, neither did anything else, since I was so trashed energetically I could barely get energy to walk across the hall and pee, never mind doing the massive exercise I'd been joyfully doing up to then. (I am still probably 100# down from my high weight, which is something. Sadly, the universe ate my scale, so I don't actually know for sure, but I 'think'.)

The problem in part is that fat is such a social crisis, such a hideousness to live with, that people don't just feel like they want to be healthier, they feel like getting rid of the fat so they will be less embarrassingly bad is life or death egoically -- they are "desperate" emotionally often -- and they want to do it FAST and calculate how many calories they can NOT EAT so they could be X# less by date-Y and speed seems SO IMPORTANT. This is the psychology part not the physical part, but it tends to affect how people behave and how they set their expectations.

Expectations set by a combination of industries that make weight loss and "maintenance" seem not such a big deal, and vastly more common than it is, and totally IGNORE every body parameter that Dr. Sharma has so nicely explained over time that basically adjusts to try and bring the body back to its high weight... do not help.

I think it's like the body sees our high weight as 'full grown' and anything less is side-effect of some starvation period it wants to eventually recoup from, so everything -- taste, smell, satiety, absorption, O2 burning in exercise, everything adapts to try and bring people back.

Sorry it's a depressing topic. It really is and probably more for me than most anybody reading!

PJ

It IS incredibly difficult... in US society. Because we are trapped from birth.

We live in a world of soy formula, damaged food chain, constant cheap "carbs on tap," and no help from nutritionists and doctors. How many of us have been given the wrong advice, and the wrong food, for the past several decades?

I started dieting at 14 and did not achieve lasting success of any kind until low carb. And now I have health issues and I'm not even thinking about losing my extra weight (thankfully not that much) until I get those sorted out, but I'm sure they are from decades of poor nutrition.

I do feel it's worth the struggle because saying F--- it makes things even worse!

My disabilities make it 'easier' for me to maintain my weightloss. Because of my anaphylactic allergies (I have Hyper IgE syndrome) I don't eat out/away from home in restaurants/other people's homes. I have Celiac and coupled WITH the above...there's no WAY I'm eating anything with gluten...I'm sick for three days if I inadvertently eat it.

But...I do just prefer to eat this way...my inflammation is so reduced so the pain from my joints (RA) isn't as bad...and my time on my nebulizer from my IgE mediated asthma is much less.

I do suppose if I were able to eat all the things that might put me back at the weight where I started...I might cheat or just 'give up'.

I cook everyday...two times a day mostly...sometimes only one if I made enough for leftovers...I guess I was just meant to eat this way.

As far as whether to lose weight in the first place goes--I think sometimes our options don't include anything perfect. Maybe we lose weight, get thyroid or adrenal issues, maybe low leptin issues, this all drags the sex hormone issues behind it maybe. But if we don't--there's hyperleptin, hyperinsulin. Another set of sex hormone issues to deal with. So while health should be a more important goal than weight--sometimes they're hard to separate out. For a person who's obese but not insulin resistant or diabetic, healthwise the hormonal trade-off from losing weight on a low-carb diet might not be worth it. For a diabetic, it might be, though.

Jimmy Moore gets criticized for weird blood numbers--mostly a high ldl particle count. Maybe it's not ideal. So far, Jimmy knows how to have really low hdl, high triglycerides--the mix that probably killed his brother Kevin--or be where he is now, with high hdl, low triglycerides, and a high particle count. Sometimes if the devil you know is bad enough, it's worth going with the devil you don't know, and hoping he's not as bad as he looks. I wonder if it's possible for anything that is truly effective to have only desirable consequences?

I think weight loss, like anything else, is partly a matter of faith. Believe in a weight-loss strategy, and you're more likely to adhere to it. This can muddy our thinking, for low-carbers it might lead us into discussions where we insist that the Kitivans must be sneaking out back and gorging on coconut instead of sweet potato and taro whenever the researchers aren't looking. But... it being "common knowledge" that most diets are doomed to fail--and this is something inevitable (this second is something, I think, we don't know)--might be an important deciding factor in and off itself.

My labs, even when I was 350+, were always great. I've always had an issue with hypothyroidism, and I have to take calcium. I'm also borderline low testosterone. In particular my cholesterol numbers have always been very good, so I haven't had change there.

True. I'd be dead already if I hadn't lost the weight I did, even with regain of half of it later. And the issues I had most severely to begin with I don't really now or vastly less, so despite still being huge it's obvious that what I lost did really help. I wouldn't want anybody to NOT lose weight if they could and likely it would help them. I guess the problem is knowing when to stop.

And that's a black box, since it's probably more about the body's nutritional status going into any eating plan, as well as their food/supps while on that plan even if their numbers in food choices are good.


Hmmn. Hadn't considered the last point. But I guess once the body reaches the point of serious multi-factorial dysfunction, you cannot change any one thing without another. Even improving one area of process will often deplete the body more severely of some vitamin they didn't have enough of to begin with and cause three other issues.





It is true it is likely to be a self-fulfilling prophecy, which is likely a big part of why even the people who most observe this reality -- which they say plainly at times (I'm referring to doctors and researchers here like Sharma or Friedman for example) -- don't focus on that at all.

And maybe it's not an INEVITABLE reality but merely an 'observational' one for now which hopefully in the future we can improve on.

But in the present, the unlikely-expectations people have about weight loss, and this is moreso every 10# higher I'm sure, can also cause their own damage.

PJ