Why you can keep the weight off

If you want to be discouraged about losing fat and keeping it off, by all means read “The Fat Trap,” published in The New York Times Magazine on Dec. 28. If you’re curious, here’s the link.

The article—very well-written, by the way—summarizes the thinking of a number of scientists who believe the evidence indicates that almost no one who loses fat can keep it off. I haven’t had my head in the sand for the past several decades, so I am well aware of these research threads as well as the empirical evidence that most people who lose fat eventually regain most or all of it.

But I am not discouraged about your chances or my chances of getting lean or staying lean for life, and I’m going to tell you why.

First, let’s look at one of the key studies and experts cited in the NYT article.

Joseph Proietto of the University of Melbourne, Australia, says that his patients, despite being highly motivated, “inevitably, gradually . . . regain the weight.”

What sort of food plan was used to help these patients lose fat? Ten weeks on a VLCD, or “very low calorie diet,” of about 500 to 550 calories a day.

In other words, medically supervised near-starvation. I’ve written about Dr. Proietto’s research before, and I have several unanswered questions about the study’s conclusions. (Here’s the article I published on Oct. 29, 2011, on the topic.)

My primary burning question: would a much more moderate caloric-restriction plan (involving cutting something like 250 to 500 calories a day) have achieved a different result?

And although no such studies are cited, another expert quoted by the NYT says “the pace of weight loss is unlikely to make a difference because the body’s warning system is based solely on how much fat a person loses, not how quickly he or she loses it.”

Well, based on what research? No supporting facts are given.

Apparently Dr. Proietto is currently looking at the effects of slower fat-loss methods. That sounds promising, and I will be eager to learn what he discovers.

Question 2: How much muscle mass did the study participants lose during their 10-week diet? (Probably quite a lot, given their VLCD.) How much muscle would they have lost on a moderately restrictive diet? (Loss of muscle mass = reduced metabolic rate. Read my two-part series on increasing your metabolism here and here.)

Question 3: When the participants stopped dieting after 10 weeks, how did their eating habits change? Did they begin to eat at maintenance level? Or did they return to their old habits immediately or eventually (meaning, did they start consuming more calories than they needed, which is how they gained weight in the first place)? Was anyone monitoring them?

Question 4: Were they taught how to maintain their weight with a calorie-controlled food plan and exercise?

Question 5: Would the results have been different (I suspect yes) if they had been engaged in resistance training in order to build muscle, which would have increased their metabolic rate and thus helped them keep the fat off?

Everyone agrees that the best way to lose fat is with a combination of caloric restriction (“dieting”) and exercise. And the best—really, the only—way to maintain that fat loss is to continue to exercise and to eat at maintenance level (consuming just as many calories as the body burns daily).

Where are the studies that examine whether people who do these things regain or not? There’s one very intriguing project that does track these people, and it’s the National Weight Control Registry.

If you are a successful “loser” who has lost at least 30 pounds and maintained the loss for at least one year, you are a candidate to join the registry. Here’s a blurb from the website:

The National Weight Control Registry (NWCR), established in 1994 by Rena Wing, Ph.D., from Brown Medical School, and James O. Hill, Ph.D., from the University of Colorado, is the largest prospective investigation of long-term successful weight loss maintenance. Given the prevailing belief that few individuals succeed at long-term weight loss, the NWCR was developed to identify and investigate the characteristics of individuals who have succeeded at long-term weight loss. The NWCR is tracking over 10,000 individuals who have lost significant amounts of weight and kept it off for long periods of time. Detailed questionnaires and annual follow-up surveys are used to examine the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintaining their weight losses.

How do they do it? Visit the website for details, but these successful maintainers eat breakfast, control food portions, and exercise daily, among other things. That’s what maintenance takes: permanent lifestyle change.

It’s not impossible lifestyle change, and as one of the women quoted in the NYT piece says, it requires constant vigilance.

You have to decide whether a life of health and high energy is worth vigilance. It is to me.

It’s worth the effort to recovering alcoholics or drug addicts or former smokers. They too have to be vigilant. But I don’t see a lot of NYT articles discussing how stopping drinking, drugging, or smoking is nearly impossible.

Yes, we live in an obesigenic culture, and there are about a million reasons why it’s easier now to get fat than ever before in history. Yes, it’s very difficult to lose fat and keep it off. I will never sugar-coat the work involved.

But I hate like hell when the media use science to discourage the very people who desperately need to believe they can achieve their fat-loss goals.

I know you can. And I believe in you because I believe human beings were meant for challenge, struggle, and mastery.

Fat loss and maintenance are very hard work indeed. And absolutely worth the effort.

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