More On Genetics And Obesity
Posted by Lori on March 11, 2008
“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’ve been reading Gina Kolata’s book Rethinking Thin. Ms. Kolata is the head science writer for the New York Times, and she explores the many diets and the research around weight loss and weight loss maintenence. She makes clear in this book that we have known definitively since the 1950s that it takes far more than diet and exercise to keep weight off.
The New York Times published an outstanding excerpt from her book that really contains the most essential information as it relates to those of us who are trying to understand how we got in this situation and moderate from there. This particular section talks about the initial obesity studies and how, by the early sixties, science had documented that after a dieter successfully loses weight, their metabolism drops to put it right back on. It’s infuriating to think we’ve know this this long, and it hasn’t been made part of the cultural discussion.
It was 1959. Jules Hirsch, a research physician at Rockefeller University, had gotten curious about weight loss in the obese. He was about to start a simple experiment that would change forever the way scientists think about fat.
Fred R. Conrad/The New York Times
Jules Hirsch, a research physician at Rockefeller University, conducted a simple but groundbreaking experiment on obesity nearly 50 years ago, changing the way scientists think about fat. Obese people, he knew, had huge fat cells, stuffed with glistening yellow fat. What happened to those cells when people lost weight, he wondered. Did they shrink or did they go away? He decided to find out.
It seemed straightforward. Dr. Hirsch found eight people who had been fat since childhood or adolescence and who agreed to live at the Rockefeller University Hospital for eight months while scientists would control their diets, make them lose weight and then examine their fat cells.
The study was rigorous and demanding. It began with an agonizing four weeks of a maintenance diet that assessed the subjects’ metabolism and caloric needs. Then the diet began. The only food permitted was a liquid formula providing 600 calories a day, a regimen that guaranteed they would lose weight. Finally, the subjects spent another four weeks on a diet that maintained them at their new weights, 100 pounds lower than their initial weights, on average.
Dr. Hirsch answered his original question — the subjects’ fat cells had shrunk and were now normal in size. And everyone, including Dr. Hirsch, assumed that the subjects would leave the hospital permanently thinner.
For those of you who can’t bear to read entire paragraphs, in the 1950s, Dr. Jules Hirsch put 8 people who had been obese since childhood in the Rockefeller Hospital for eight months and fed them 600 liquid calories a day – a diet that guaranteed they lost weight. They lost on average 100 pounds and then spent four weeks on a maintenence diet before they were sent home. What happened when they went home? They gained the weight back.
So, Dr. Hirsch and is partner, Dr. Rudolf Leibel, repeated the experiment again and again. Each time, the end result was the same.
“The weight, so painstakingly lost, came right back.”
Then something else was noticed.
But since this was a research study, the investigators were also measuring metabolic changes, psychiatric conditions, body temperature and pulse. And that led them to a surprising conclusion: fat people who lost large amounts of weight might look like someone who was never fat, but they were very different. In fact, by every metabolic measurement, they seemed like people who were starving.
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.
So, when you lose weight, your body ceases to function normally. Wow. So, here you are all trim and happy – and your body thinks you’re dying of starvation. Wow. Wow. Wow.
This explains a lot, doesn’t it?
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 semi-starvation neurosis is real. You’ve experienced it, no doubt. But it’s not you being undisciplined or gluttonous – it’s how our ancient bodies have evolved to protect us.
And here is one of the money quotes in the article:
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.”
Next, Dr. Ethan Sims decided to find out what happened when thin people got fat. Did they stay that way? Because the popular belief is that fat people get that way be eating badly – so if the belief is true, these guys should put the weight on and get stuck with it. Just like you and I did, right? Wrong.
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.
So, when you lose weight beyond your set point, your metabolism drops by up to 24% per square inch. When you gain weight beyond your set point, your metabolism speeds up by 50%.
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.
So, that’s what you’re up against. It’s not, as a commenter below suggested, simply enough that you eat appropriately. Eating appropriately won’t keep weight off and it likely won’t prevent you from gaining it either. Your body is going to rebound to it’s set point after you lose weight.
UPDATE: I found a study which I wrote about in another post that I’m going to add in here. A study in Canada put women on a supervised 500 calorie per day liquid with exercise diet. They lost weight, of course. Then they scooted their calories up to 800 per day and all of the women gained weight. Got that? These women gained weight consuming 800 calories per day. So that’s why your diets fail as well – it’s not about eating appropriately. It’s about the fact that whenever you diet and reduce the amount of colories you consume, your body reduces your metabolism accordingly. So when you go back to a calorie level that you can actually live on, you gain weight. It doesn’t matter how balanced, or low fat, or high fat, or how many veggies you eat with that new calorie intake – it only matters that it was higher than the calorie intake you were consuming while dieting.
You have to decide what you want to do. You have three choices that I know of:
1. Accept yourself as you are and quit fretting about your weight.
2. Spend the rest of your life on an aggressive diet with an aggressive work out plan and hope for the best.
3. Get weight loss surgery and be able to lead what most bandees regard as a normal life.
If you take anything away anything from this blog, I hope it’s the awareness that guilt is not earned on your part. What I hope you will do is look in the mirror everyday and see a wonderful person who is loved and needed. Whether you’re fat or not doesn’t change who you are in your loved one’s hearts. Just put that burden down. Guilt is not yours to carry on this subject. Even if your weight is impacting your marriage. Even if you have children who need you.
I’m a big believer in the whole fat acceptance movement because no one should be beating themselves up over something this far beyond human control. I spent years of my life monitoring every single bite I put in my mouth, kept my calorie intake way under 1500 per day, worked out daily and gained weight steadily the whole time. I’ve had relationships go south because of weight. We live life with the genetics we have, not the genetics we want.
If you need to lose weight, then take a read what I’ve written above and take a good look at weight loss surgery. It’s a tool – really, the first tool we’ve ever had – that will allow you to get back to a moderate weight and stay there without complication. Studies say you’ll live longer and you’ll be happier. You’ll probably earn more money too.