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3 Reasons Diets Don’t Cause More Weight Loss in the Obese

It’s been known for years the actual weight losses from low calorie diets are always less than predicted in both lean and overweight individuals.   This is often used by the clueless to argue against calorie based models of weight loss or energy balance.    They’re wrong, mind you.  But it still raises the question of why this happens: why don’t the obese (people with obesity) lose more weight on low-calorie diets.

Weight Loss from Low-Calorie Diets

As I mentioned above, it’s been long observed that the predicted weight loss from low-calorie diets and the actual weight loss are often significantly different.   Quite in fact, they are often one half as much as would be predicted.  The question is why.

To address the issue, I will be examining a 2007 paper titled Why do obese patients not lose more weight when treated with low-calorie diets? A mechanistic perspective.

As of the writing of the paper, there was a surprisingly limited amount of research on the topic in the sense of looking at the reasons why the weight loss is so much lower than predicted.

On average, the studies examined showed an actual weight loss of 25-50% of predicted based on the dietary deficit created.  I’d note that  this included both high and low-carb diet studies so this shouldn’t be taken as a “the calorie theory of weight loss is wrong”t kind of argument that stupid people make.

The study, thankfully mentions that there are three different ways of setting up a deficit, something I’ve discussed variously. The first is by making an absolute reduction in food intake (i.e. 500 calories/day). The second (my preferred method) is to reduce food intake by some percentage (for example 20%) below baseline. The third, and worst in my opinion, is to use an absolute level such as “Women get 1200 calories/day and men get 1700 calories/day”.  I discuss this topic in some detail in my first book The Ketogenic Diet.

The paper then set out to examine three major possibilities (based on a host of assumptions that they discuss in some detail but that I’m going to skip over) for the failure of actual weight loss to reach what is predicted.  Let me note that there are assuredly other possibilities.  These are the three the paper examines.

Reason 1: An Increase in Food Absorption

The first possibility considered is that there is an adaptation towards increased absorption of food in the gut with dieting.  But, overall the research failed to support this as a reason.  Most foods are absorbed extremely well by the gut.  Animal proteins are in the realm of 90-95% absorption, dietary fat is 97% and carbs can vary.

Even if nutrient absorption in the gut went up, it wouldn’t change much in the big picture since efficiency is already so damn high.    The paper also points out that even a 5% increase in food absorption would only amount to about 100 calories per day extra which still wouldn’t be able to explain the observed results.

The conclusion is that this is unlikely to explain why weight loss is so much lower than predicted on low-calorie diets.

Reason 2: A Reduced Metabolic Rate

The second possibility considered was that a reduction in total energy expenditure/metabolic rate is the cause.  In addressing this, the paper did it in what I consider a problematic way.  Primarily they looked at the difference in resting metabolic rate in post-dieted individuals who were at weight maintenance.  And in this situation, the reduction in metabolic rate is usually quite small, maybe 1-5% tops at least in obese individuals.  In leaner individuals it can be much much greater.

In the big picture this may only amount to 75-100 calories per day.  But it’s also only looking at resting metabolic rate.  There are adaptations in other components of energy expenditure as well.  So this may be underestimating the overall picture.

But that’s not the big issue to me.  Because the drop in energy expenditure after the diet is over is not what is important.  Rather it’s the adaptive component of metabolic rate that occurs during the that is reducing weight loss during active dieting.  And this is often much larger than what is seen at weight maintenance.

So if during dieting you see not only a reduction in resting metabolic rate but a decrease in calorie burn during exercise and/or a reduction in NEAT, then you will get a much lower rate of weight/fat loss than predicted.   But it won’t show up in your calculations if you only look at people after the diet is over.

The authors do thankfully note that the work they examined on total energy expenditure in the weight stable state isn’t exactly the same as what happens during active dieting. Numerous (but not all) studies show a drop in energy expenditure (both in terms of basal metabolic rate as well as overall activity, people tend to move less when they diet) during active dieting.  That alone lowers the effective daily deficit which causes actual weight/fat loss to be different than what is predicted based on simple math.

The researchers point out that “..changes occur in EE (energy expenditure) that could reduce the prescribed energy deficit, but these decrements in EE appear to be tied to the energy deficit, the rate of weight loss, or both, and thus they would slow weight loss but not result in a premature plateau because, by definition, that plateau occurs at the point of energy balance.”

Which is a convoluted way of saying that, even if you’re on a 50% daily deficit, and energy expenditure drops by 25%, that’s still insufficient to STOP weight loss. Because you still have a 25% deficit. The drop will simply slow things down.  At some point of course, the body does come back into balance and a plateau will be reached.

Reason 3: Poor Adherence

By the paper’s logic, if food absorption and metabolic rate slowdown can’t explain the low weight loss from low-calorie diets, then adherence is the primary issue.  Let me note again that their conclusion about metabolic rate is based on a slightly flawed data set.  That doesn’t in any way eliminate adherence as an issue but this is clearly a complicated issue.

This same issue with adherence would also explain the tendency for most to start regaining weight at some point, they simply start reverting to old habits.  That said, it’s clear that there are multiple physiological adaptations that occur to promote weight/fat regain after a diet.

Related to this, the review describes a paper in the discussion which used self-reporting of dietary compliance to various diets in terms of results.    Noting the limitations of self-reported anything, it found that people who started with low levels of dietary compliance ended up with even worse levels.  That alone predicts that many will fail in their efforts.

Additionally, the subjects reporting the greatest dietary compliance lost 20kg (45 lbs) whereas the low compliance folks lost negligible weight.  It’s a conclusion that is unbelievably obvious but really bears making explicit. Those people who adhere to their diet lose weight and those that don’t keep it off.  By extension, those who stick to their diet in the long-term maintain that weight loss and those that don’t don’t.

My Comments

So overall, it appears that the major determinant of overall diet success is simply one of adherence.  Changes in food absorption can’t explain the difference between predicted and actual weight loss and, with the caveats mentioned above, it doesn’t appear that metabolic rate can either (a topic not discussed is individual variance in how metabolic rate change which could explain the often large differential between two people’s results on “the same diet”).

The researchers did acknowledge the limitations of their study, the limited amount of data, the short-time frames over which most studies are done (a year or less) and the fact that they didn’t examine exercise/physical activity in terms of how it impacts or changes during dieting.  As I noted above, changes in activity, an especially NEAT are a key component of daily energy expenditure.  Leaving that out of the model may have led to a slightly incorrect conclusion.

This is important for a number of reasons not the least of which is that some people will start to decrease their daily activity (subconsciously) on a diet, reducing their daily activity energy expenditure.  While this wouldn’t show up as an actual measurable drop in resting metabolic rate, it would still serve to reduce the net daily deficit reducing the real world weight loss from the predicted level.

The paper concludes:

A critical need therefore exists for elucidating the basis of poor patient adherence to prescribed energy deficits. This research effort could lead to even greater clinical benefits for the many obese patients with weight related comorbidities.

Basically, the question is no longer one of what type of diet to put someone on, it’s a question of how to actually get people to stick to a diet in the long-term.  This is an idea I’ve thumped on about for years and discussed in some detail  in A Guide to Flexible Dieting.

Simply, after decades of research, we know about pretty much all there is to now about dieting and fat loss in my opinion at this point.  We know how, from a biological standpoint, to get people to lose weight and/or fat.  We change the way they eat, we incorporate exercise (ideally), to create a long-term deficit.  It may not be simple in practice but it’s simply in premise.

The bigger issue is why we can’t get people to keep the weight off in the long-term.  Because while there are clearly biological drivers on weight regain, a major proportion seems to be people’s difficulty at changing their habits in the long-term.  Once we figure out why that is the case, we’ll be a step closer to generating permanent weight and fat loss results.

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31 thoughts on “3 Reasons Diets Don’t Cause More Weight Loss in the Obese

  1. First off, I almost spit coffee on my monitored when Lyle summarised with “Put bluntly, the people who started the diet half-assed, ended up doing the diet all-assed” a sentiment i’m sure the researches wished they could to portray a bit more antagonistically.
    But this was a great review and, once again, we are affirmed that thermodynamics is the major player here and these forces a pretty inflexible in their function. Personally, I would love for Mr. McDonald would write one of his detailed-obsessed articles on why a pound of mass gained or lost doesn’t always work out to around 3600 kcals. Also, (hint, hint) an article on how, in the early stages of a exercise program for training naive subjects how someone is able to gain muscle mass during a caloric deficit. I have a good idea of how this occurs but I’d love Lyle’s commentary on it. but I’m sure Lyle has a litany of subject matter for future articles.

    In any event, the one thing I’m bouncing around in my head after reading this is at what point does the body actually significantly stop losing weight and how does this occur in the face of thermodynamic theory. Alright death is the obvious answer but I’m talking specifically about patients who have had gastric bypass. Some of them are now physically unable to eat above maintenance yet eventually they stop losing mass. Does metabolism drop so close to their dietary intake (to an isocaloric end) that weight loss effectively stops or becomes so slow to not be noticeable or are these people still finding ways to eat above maintenance? I guess you can drink a few thousand calories or milk shakes if you made the effort but given that obese people are subject to less metabolic decline when compared to their fit and trained counterparts I’m left wondering how physiologically this is occurs outside of a compliance and caloric consumption etiology.

  2. The first is easy, only one pound of fat is ‘worth’ about 3500 calories, muscle isn’t anywhere close (a pound of muscle burned for energy is closer to 600 calories or so). And since people usually gain and lose a combination of muscle and fat, the actual cost to gain or lose one pound of bodyMASS won’t be exactly 3500 calories.

    There is also the water issue which clouds this massively since it has no caloric value but can easily mask true fat loss and make it look like a thermodynamic miracle is occurring.

    As far as gastric bypass, I think you’ve nailed it. The stories are out there that they figure out creative ways to get in more calories, by making massive calorie blender shakes. I also thought I had seen something about the stomach stapling slipping but I’ll be honest that this isn’t something I have paid much attention to. And of course, with major mass loss, metabolic rate will slow down. What was the old maintenance becomes the new maintenance eventually.

    How do fat newbies gain muscle while losing fat? Magic. I have some more involved theorizing about it but that’s all it is. Have to wait for another article.

  3. Ugh (bonks head) I didn’t think about the density issues of a pound of fat vs. muscle. Nor the caloric content of a pound of triglycerides vs a pound of amino acids; the calories are going to be vastly different.

    The water thing was apparent to me, in fact I love it when a dieter complains at how slow their weight loss is when it hits .5 to 1.0 pounds per week (26 – 52 pounds a year mind you) when they lost 3-6 pounds per week for the 1st couple of weeks.

    Shit, i thought it was magic, guess I’ll just have to wait. curious though, and this may be a better forum question, as to what the next book project will be.

  4. Lyle,

    Since hypocaloric diets produce metabolic changes and adherance problems. What do you think about setting calories at maintainence and increasing activity greatly.

    I don’t have the study but there was a research review done on people who had lost more that 100 pounds and kept it off for a number of years. Diets were varied (low carb, low fat, zone etc…) However the common denominator was 1 to 1/2 hour a day of exercise.

    Have there been any studies in this are?

  5. The water thing can actually be more insidious than that: some women can swing 5-10 lbs of water across a month and there seems to be a lot of variability in who does and doesn’t hold water.

    But consider a female on a very moderate deficit who may only be losing 0.5 lbs/week fat loss but who is holding even 5 pounds of water. That will mask true fat loss for 10 weeks and it will look like nothing is actually happening. Of course, the usual effect of this among dieters is to work harder which usually makes the problem worse.

    Of course, this also leads the whoosh phenemenon (discussed with some seriousness, believe it or not, in The Stubborn Fat Solution) where folks wake up after weeks of no-change and find that their weight has dropped by 3-5 pounds seemingly overnight. Just a big water drop.

    All of the above, of course, looks like a thermodynamic miracle but is easily explained by weirdness in water balance.

  6. David,

    Increasing activity without changing diet has been examined, and even there can be variance in results because of how people adapt. I had reviewed a study on that very topic for the newsletter (and almost ran it in the place of this piece) and it showed that people showed drastically different results to an exercise based weight loss program, some lost, some (as I recall) gained. A lot of which came down to adjustments in food intake. The folks who lost weight reduced food intake slightly, the ones who didn’t increased food intake.

    The title of the paper is
    “Individual variability following 12 weeks of supervised exercise: identification and characterization of compensation for exercise-induced weight loss.” Int J Obes (Lond). 2007 Sep 11

    If you want to look it up.

    Now, some of this is simply physiological, exercise can have varied impacts on appetite and hunger for people; some people get a blunting, some people get a stimulation. I’ve seen that newbie exercisers often have hunger stimulated, probably because of shifts in blood glucose; after a few weeks this typically goes away (presumably as their bodies improve the ability to use fat for fuel).

    There is also a psychological component. Some people seem to connect exercise and eating better, the underlying logic seems to be “I worked out today, why would I eat junk?” Others are disinhibited and overeat when they train, the underlying logic seems to be “I exercised today, I earned that cheeseburger and milkshake.”

    So even just adding exercise to ‘maintenance’ can work or not work depending on the specifics.

    Practically, if you look around any gym, you can see plenty of people doing a fair amount of exercise who aren’t gaining weight. In my experience, unless absolutely massive amounts of activity are being done, some amount of dietary control (even if it’s to ensure that food intake doesn’t change) has to occur for weight loss to be anything but disappointing. People have been shown to both under-estimate their true food intake and over-estimate their activity expenditure and this adds up to a lot of disappointments in the realm of weight loss.

    And the study (ies) you’re thinking of is the data on the National Weight Control Registry which tracks successful weight losers which tracks habits of folks who have lost weight and kept it off for some time period. There are a lot of common behaviors but among them is regular engagement in exercise. As I’ve mentioned in several of my books, exercise appears to play its major role in weight maintenance more than in enhancing weight loss per se.


  7. Tell you what, try being a short, menopausal woman and you won’t have to ask why diet compliance is so tough. Our maintenance calorie levels are so low Attila the Hun wouldn’t have balls big enough to stick with it. Now that that little hissy is over, aside from the usual reasons, I think most people can’t stick with diets because they do not track their body composition closely enough to know what is going on. Fat loss or gain is generally an invisible trend over time for most people. I gained just shy of a half a pound of fat since the first of the year, and if I hadn’t been tracking both my LBM and fat levels on a daily and weekly basis, I wouldn’t have known. I wouldn’t have seen that low a fat creep in my clothes or in the mirror. After a month of data the trend is clear. Since I also happened to be counting empty calories on a weekly basis, it is also clear how the fat came back on. It didn’t take much, 500-800 empty cals per week on average and I weight train 5 days a week for an hour, but I eat very close to maintenance so it is understandable that I could have gone over maintenance in good food and then sealed the deal with the empty cals. The reverse can also be true, it can take me a month or more to peel off a half pound of fat. If I didn’t know what my trend was I’d get discouraged and quit. If you’re really serious about losing fat and keeping it off you’ve got to have a very low tolerance for fat creep.

    Your comment about exercise stimulating eating is also right on. I get all my cardio in short intervals through weights because I found cardio makes me so hungry I can’t ignore it. Weights give me steady fat loss over long periods of time with only periodic bouts of carb craving, and, I look leaner than I actually am while I’m about it. I look at fat loss in terms of years, not days, weeks or months. I’m not saying this is true for all people, it’s obvious it isn’t. Even if you’re one of the lucky folks or hyper-focused/disciplined people, keeping a tight track of body comp will be a huge help and encouragement.

  8. I read the study Lyle mentioned — it’s pretty interesting, though not really surprising. It’s not that uncommon for novice marathoners to gain a bit of weight while training, probably through those compensatory mechanisms (eating more, plus the “honey, can you get me the remote?” effect– the decline in non-exercise activity).

    Although it’s clear that for most people diet is the key element, my own experience in losing 45 lbs last year — and keeping it off — was that beginning with an exercise programme and gaining fitness and strength motivated me to get serious about the diet element. t is true that only after making major dietary changes did I lost a significant amount of weight.. But if I had had to start it all at once, I might very well have given up, because at least at first there are fewer intrinsic immediate benefits to dietary changes than to increased fitness. Also, like many women I had failed at dieting many times before and wanted a new approach.

    Thanks for another interesting post, Lyle.

  9. There is a misconception here: gastric bypass is different from banding. If a patient has had a bypass, his stomach capacity is around 20 ml. Okay, after a few years, it may increase a bit. You can’t gulp down a few thousand calories of milk shake after a bypass, because a bypass essentially makes a patient intolerant to ingested sugars. In fact this is one of the reasons we would recommend it for compulsive sweet eaters. It is just the reverse in banded patients. Here, unless there is strong compliance on the patient’s part, he or she can cheat the operation by gulping down sweet drinks, cols, shakes and stuff.
    No sensible bariatric surgeon says the procedure is more than a means to successfully attain weight loss. Diet control and exercise remain crucial elements, the only difference being that post-op there is response to these attempts, whereas these patients have never succeeded in fat loss before operation.

  10. Thanks for the clarification, Rambodoc.

  11. Count your calories, burn more calories than you consume is a nonsense
    medical theory and jargon. People who attempt to do not understand
    nutrition then over do themselves with an disproven theory due to
    the fact you can not burn calories, you can lose more fat sitting
    as a couch potato.

    Just eliminate all carbohydrates which are starchy, simple, refined simple,
    incomplete proteins, trans fatty acids, hydrogenated oils plus carrots
    then cleanse and flush your colon out with a colon cleanse / flush system
    and take a potent natural diuretic in the process.
    20 lbs or more of built up waste could be in the colon and 10 lbs or more
    of subcanteneous water could be stored on the body and it is best to do
    this first to see where your at.

    Consume high amounts of saturated fat, monounsaturated fat,
    omega 3 fatty acid, omega 9 fatty acid among limited amounts of
    healthy fats such as omega 3 fatty acid, cla, red acid, sesamin
    with meat and eggs. Hey fat sheds fat plain and simple while protein
    allows us to maintain muscle mass.

    Another big major factor stimulating the endocrine system especially
    the thyroid will melt fat off among increasing the Growth Hormone,
    testosterone then trenbolone.

    Some people such as myself have lost 40lbs plus of fat utilizing the
    described methods above.

    Who says it’s unsafe to lose more than 2lbs or 3lbs per week is
    nonsense because the physicians with the exception of Sports Medicine
    do not understand nutrition and weight loss centers such as
    Jenny Craig, Nutri Systems and Weight Watchers prolong their clients
    results to continue making cash from the clients then say it’s unsafe
    to lose more weight than written above in this paragraph, all is insane
    and they aought to pay the clients.

  12. Low carb diets cause people to spontaneously eat less.

    Congratulations on proving that ‘eating less’ IS what works for losing weight.


  13. I was morbidly obese (well still am BMI-70 at highest, 42.1 at the moment), started trying to lose weight a few years back. I originally didn’t count anything, just changed what I ate, and dropped ~100 lbs. When I started serious exercise (my job kept me on my feet a fair bit to start with) I also went with a fairly low calorie diet. I truly couldn’t hack it. Between exercise at work, additional exercise, I came home with zero energy. I stopped losing, not because I wasn’t being compliant, because I started to modify my ‘at work’ behaviour to not walk around as much (ie. reduced calories burned). After an illness (somewhat related) I did gain some of it back.

    However, this time (I think) I’m approaching it at a better way, and I’ve found something that works for me.

    – more intake, more moving around, more loss

    Eating a little more than I thought I would gives me more energy, so I move around more, and I burn more. If I eat less, I cut out the NEAT movements and I burn less, and lose less. For me, this works.

  14. As a professional female dieter, you are correct to say it a matter of sticking to it. But where I stumble is, what are the reasonable chances that anyone COULD stick to a low calorie diet without physically limiting the stomach with RnY or LapBand?

    At my age (52) and very likely self-induced wrecked metabolism, to lose weight I must walk the finest line – absolutely no transgressions are tolerated in the scale’s view. I’m fine with eating half sandwiches with celery sticks, zero Carl’s Junior or not eating an entire bag of chips in one sitting, but for cry-eye…when eating one damn dessert over the line will stop the progress? I ain’t made of stone here.

  15. Any calorie lowering below maintenance should be accompanied by thyroid hormone to keep metabolism at the maintenance rate.

  16. Who cares about ‘weight’ loss anyway? Isn’t it about getting smaller and losing fat? Eating more of the right nutritious foods and exercising with intensity works. Builds muscle (even without ‘weight lifting’) and burns fat. The scale may not move much especially at first, but your clothes will get looser therefore proving you are getting smaller. And all that extra good food will provide your body with much needed nutrients.

    What more could you ask for?

  17. I still wonder if there is more to the story than these 3 factors. I will never forget a client I worked with who I would describe as picture perfect. She tracked her calories meticulously, ate a whole foods diet that was carbohydrate controlled, optimal protein, high in fiber and essential fat. She even gave up that beloved glass of wine out fear that it was impeding her progress. Her workouts were consistent, in fact, she was a group fitness instructor. According to the math, she was in a negative energy balance. She was about 15 pounds over her ideal weight and no matter what “diet” she tried, the weight wouldn’t budge. If my memory serves me right, she was on a steroid at one point. The thing I most remember was how hard she tried. She said her futile weight loss attempts were akin to arduously studying for an exam only to fail it. Hmmm….

  18. Joanne, that is where I have landed: weight loss is no longer the focus. Eating judicious portions with lean meats, healthy fats & greens at the center of the plate and conscious daily movement is the right thing to do regardless of what the scale says.

    Not all people fit into the cookie-cutter on insurance company designed scales. Studies prove that thin people have the same co-morbidity issues that obese people have. One can be obese and have full mobility with plenty of energy.

  19. Nicole,

    If you truly feel that your client’s reported caloric intake is truthful and accurate, then i would highly encourage that person to get a cmp to see if any overt hormonal issues are at play there. That being said, with the aforementioned “woosh” effect kept in mind, I have yet to find a client who couldn’t lose weight or girth over several months. The use of the Bodybugg seems to work really well and I’ve found that working towards a “calorie burned” goal is significantly more effective than “activity time” goals (i.e. 45 minutes of cardio).
    but like Lyle said, take a client with a modest caloric reduction and H2O weight can seriously obscure the fat loss as assessed by scale weight. But have that client make a modest caloric reduction (say 250 calories) with 300 calories a day extra burned through exercise and now we’re getting a a very attainable loss that will manifest over a couple of months even with a significant amount of H2O retention. The problem is one “cheat” meal can put a huge dent in the equation for people with a very low BMR. My BodyBugg says that I can burn 4500 calories a day with very moderate cardio and weights so i have the luxury of being able to fudge a little here and there. I really feel bad for the girls who have to count every single calorie.
    anyway the point is, I’ve seen plenty of food logs from people who will swear on their mother’s grave that every piece of celery has been logged rather than suffer the embarrassment and humiliation of conceding a late night cheeseburger or a few extra bowls of cereal.

  20. As a average-weighted person, 130 lbs. on a 5’5″ medium-sized frame, until I was 32, and then spiraled into massive weight gain from depression; overeating and not exercising, I am topped out at 44 and was morbidly obese at 360 lbs. I finally through hard work, eating healthy foods and exercising, took off 200 lbs in 3 years. NO surgery.
    I have done:
    Weight Watchers
    Jenny Craig
    Almost ALL diet book diets: Atkins, South Beach, etc.

    With the first 2, I lost 100 pounds EACH!
    I gained all back and more.

    I NEVER got to the heart of WHY I was doing was I was doing to myself by eating the way I was!!

    I am an emotional eater, plain and simple. My mom died, I ate. My dad was abusive, I ate. Had a bad day, I ate and on and on. I am NOT blaming a single person or incident for what I have done to myself. However, I have never, ever, once had a physician sit me down and suggest I have a full physical and blood lab done to see first, if there were any medical factors causing my weight gain. Nor did any of these physicians ever suggest that I ALSO get some psychological intervention to get to the ROOT of WHY I was eating myself to death!!

    The fast food and weight loss industries go hand in hand, believe me. Drive through Burger King and then drive right into Jenny Craig! Do you know who was assigned to be my “consultant” or diet manager, if you will? A 19-year old college student (who was a sweetheart) working a summer job! She had NO professional training in how to handle my issues! She was “trained” in pushing the newest food addition or a vitamin that was on “sale”. This is “Drive-Thru” weight Loss. After I left the program, I gained it all back and more because I NEVER treated what was really wrong in the first place and that was WHY I was overeating.
    Once I did that, (2 years of food therapy), the weight FELL off! That and a full physical and blood lab. Turns out I have MAJOR thyroid issues and hormonal imbalances that are now treated and not blocking my full potential to get the weight off. I also called my local hospital and inquired about any weight loss programs they might have or know of. These are NOT lose-weight-quick, programs. So if you’re looking for that, this is not the way to go. These are supervised by an MD and require you to have a full physical with all that goes with that (blood work, stress test, etc.) and then you and your physician determine which program ( some include Gastric Bypass or the Band) is best for you; mine was a very low-calorie diet in the form of shakes for a 8 weeks and then meeting with a certified nutritionist who teaches you how to eat REAL food in a real manner. You are weighed in each week and also go to behavior modification classes run by MD’s and psychologists specializing in food addiction. Most insurances will cover 80%.
    It was HARD work and very stressful at times, but NOT as stressful as wondering daily if I was going to die from heart disease or in other obesity-related ways.
    This isn’t rocket science people. There is NO one, who can do this for you. NO pill; NO diet guru; NO magic formula. You can do study after study and have symposiums on obesity and the newest way to get the weight off. But NOTHING wil work until YOU take care of YOU and get the help you deserve.
    Just take the reigns and care enough about yourself to find a physician who will out you FIRST and get you started on the path to health!!

  21. Lyle,

    I started my fat loss journey as an obese male, 38 years old, weighing in at 225 lbs at 5′ 5″ height. I lost 70 lbs over a period of 7 months, got down to 10% BF and saw my abs for the first time in my life, by establishing a daily caloric intake that would create a deficit, then tracking everything I ate, and working out 3 times a week for 30 min each time, doing a combination of high-intensity resistance training and cardio.

    I did not do “low fat”, “low carb”, “high protein”, etc. I simply made sure I ate sufficiently less to create that caloric deficit. I did not miss out on any of my favorite foods (even what others call “junk” foods). I just simply made them part of my daily budget. Some days I was over my target, and some days I was below my target. But I made sure that at the end of the week, I averaged my target number.

    For me, prolonged caloric deficit is the answer to fat loss. Period. Full stop. End of story. It is NOT macronutrient exclusion or over-prioritization, nor number of meals per day, nor elimination of processed carbs (I still ate pizza, regular bread, tortillas and the like regularly, although not exclusively). I think that it was this “flexibility” that I had built into my diet plan was what allowed me to stick 100% to my “diet” over the 7 months… simply because I kept an eye on the most important metric of all… caloric deficit.

    I *cringe* when I hear people talk about having to eat celery sticks and yogurt, go on medically supervised VLCDs, etc. because I know the *hell* that accompanies those failed approaches…. and find it totally unnecessary. My journey was painless and struggle-free once I took starvation, deprivation and dogma out of the equation.

  22. How about going on a $5 dollar word diet and speaking with words ordinary people understand. (e.g. , comorbidly).

    I think this is wayyyyyy to complicated analysis.

    A person need not have a Phd. in biology or be scholarly to lose weight.

    Just follow a healthy lifestyle and don’t go all crazy with trying to lose it all at once. Simply cut a few bad things out of your diet and replace them with some sensible activity like walking the dog, cooh hunting, or swimming in the river. Or, if you have some steep slopes around your place, then, walk up those. Another good activity that burns lots of calories is spliting and stacking wood or cleaning out the hogs’ house (a.k.a., scoop’in poop) Replace the drive thru at Burger King with any of these activities and the net deficit for that day will be more than several hundred calories.

  23. In the future, I’ll make sure and run my articles through a ‘dumbass’ filter just for you since apparently big words confuse your little brain.

  24. Personally I think large people are genetically adapted to cold climates. So making a cold climate person into a hot climate person is like trying to turn a polar bear into a sun bear…..doesn’t work.

    Here’s a good article that explains it:

  25. Julie

    Your link is about evolutionary changes that wouldn’t likely manifest in less than a hundred generations, more likely a thousand.

    Mary Enig (A fats researcher. was interviewed a while ago. This interview was posted to YouTube in 2012. (Yes well after your comment. But for those who follow along after this.)
    Part of the time she talked about problems that resulted from eating Trans fats. 5:40 – 7:00
    (A short digression here.)
    Margarine (A Trans Fat product) became big starting in the 40s. Starting with the war and as it was much cheaper than butter at that time, continued to grow in sales through the 50s. Stabilized for 20 years or so then began a gradual decline.
    Shortening (Another Trans fat product) began earlier and I think grew at the same time but I have not seen a specific chart on it. I know we had Crisco in the house but I have no idea how much or often it was used. Both are used by industry in prepacked foods.
    My family always bought margarine for toast, cooking etc. as it was cheaper than butter by a lot.

    Mary Enig said:
    Nursing mothers who eat trans-fatty acids pass the trans fats to the babies and they have vision problems.
    I need/wear thick glasses.

    There was evidence that Trans fats eaten by a pregnant mother-to-be is causing the birth of obese babies. That they are getting messed up satiety signals. (Don’t know when they are full.)
    Personally I was a big baby (second largest in the hospital at the time and noticeably bigger than the rest.)
    My mother weaned me at 3 months as I was constantly hungry and she couldn’t produce enough milk for me. Which seems unlikely; as I was after a few others and my mother had adequate nutrition and she had never had this problem before.
    When the family went to the ocean. The story is; I ate so much sand, that when it came out in my diapers, shits would just fall apart back into sand.
    One final story.
    I was infected by a cat around the age of three. I remember the hospital as a wonderful place where they would feed me all the time. I just listened for the refrigerator door opening and would show up for juice or milk or whatever.

    Basically a life long problem that I was able to keep under control until I left high school. (I was on teams that made me workout daily.)

    3. A study indicated that adults who ate “Trans” (fats) gained more weight than people who got the same number of calories from other sources.

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