Sunday, May 25, 2014

If you're fat and lose weight, you're probably gonna get fat again



So I came across this article this morning, and I found it quite interesting.

http://www.cracked.com/quick-fixes/fat-officially-incurable-according-to-science/

If you don't feel like reading it, here is the high level overview....

Basically multiple studies showed that only about 2 out of a 1000 people who lost enough weight to get down to what was considered a "healthy weight" (I'm taking some liberties here), actually kept it off.

At first, my bullshit meter wants to go off, and say there is no way that's correct. But then I sat and thought about it for a while. And I realized, that's probably more accurate than I wanted to initially admit.

Now, I'm sure there will be lots of people chime in to say "I was X amount, and now I'm Y amount and have been for so many years." That's fine. What the article is starting is that through studies they found that is exceptionally rare. That the GREAT MAJORITY of people who were obese, then lost weight, became obese or at least "got fat" again later.

With more thought, I came to the conclusion that well, that's probably correct.

Virtually all of the people that I know that lost a significant amount of weight, gained most of it back later. Not always all of it, but a good degree of it.

The initial parallel that entered my mind was the relapse rate of drug addicts.  So, I went and researched what that rate was.  

According this this........

The NIDA estimates that 40 to 60 percent of recovering addicts will backslide, meaning that relapse is not only possible but likely.

Wow.

So if you're addicted to crack, you're more likely to stay clean than a fatty turned thin person is to stay thin.

Well, that's the initial thought.  However that's taking all of these studies at face value without applying real world context to the situation.  

So let's expound a bit, and get back to that later.

First off, there's sort of a willing level of ignorance by many of us that doesn't get applied to the physiological portion of why this epidemic exists.  And I don't use the word epidemic here haphazardly.  

According to the CDC roughly 35% of American's are currently obese.  That's more than one-third of the population.  

The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.

To put it in terms that might make this jump out at you more, if obesity were replaced with a zombie virus, that would mean every third person living on your block or street would be infected.  

So about, 106 million zombies nationwide.  Give or take a bite.  Pun works all sorts of ways here.  

The reason why I say there's a certain amount of being willfully ignorant by many of us (at times, myself included) is because we narrow down the cause of obesity to nothing more than a lack of discipline.  And at the heart of it, that indeed is how someone generally becomes obese.  But what keeps them obese, or causes them to become obese again after losing weight, is probably a little more than that.  

I don't think I'm reaching here when I write that food can most certainly be a drug.  At least for many it most certainly looks like a drug, insofar as how the body ends up reacting to it.  However food addiction is still a controversial topic in the dieting and health industry.  

What we do know is, certain foods like cheese, chocolate, shitty cuts of meat, etc tends to release dopamine, the feel good chemical in the body, in massive amounts.  This is what's known as the "reward system".  You eat shitty food, and the body releases massive amounts of dopamine to let you know "hey, I like this shit.  Feels good, man.  Eat more of it."  

Over time, just like any addiction, the body ends up lowering the amount of dopamine released by eating these foods, and the dopamine receptors down regulate to basically keep the body in balance.  So now, in order to get that same "feel good" reward system that you got before, you have to eat more junk food to make that happen.  

Now ol fatty-in-the-making has to eat more of what he or she craved before, in order to "feel better" than they once had to.  So instead of eating a small slice of cheese cake, now one needs two slices, or some ice cream to go with it as well.  And that's after a meal that's already laden with fat and sugar.  

And the cycle begins.  Just like with drug addiction.  

Over time, the brain actually becomes rewired to seek out these foods.  From this study.....

Dopamine (DA) regulates emotional and motivational behavior through the mesolimbic dopaminergic pathway. Changes in DA signaling in mesolimbic neurotransmission are widely believed to modify reward-related behaviors and are therefore closely associated with drug addiction. Recent evidence now suggests that as with drug addiction, obesity with compulsive eating behaviors involves reward circuitry of the brain, particularly the circuitry involving dopaminergic neural substrates. Increasing amounts of data from human imaging studies, together with genetic analysis, have demonstrated that obese people and drug addicts tend to show altered expression of DA D2 receptors in specific brain areas, and that similar brain areas are activated by food-related and drug-related cues.


There are lots of these studies that back this basic physiological response, yet we're still at a point where food addiction is still "controversial."  Mainly because, in my opinion, it wouldn't be very financially sound for the fast food industry, which is roughly a 200 billion dollar a year industry, to agree with such claims.

And we as American's, or people in general, would probably have trouble buying in anyway despite all the facts.  Once again, we just fall back on ol fatty not being disciplined enough without understanding it may indeed more complicated than that.

Since drug addicts relapse at a rate of about 40-60 percent, it might be hard for us to reconcile that it's more than a lack of discipline.  But upon further examination, the person suffering from crack addiction isn't being bombarded with commercials and advertisements to go smoke crack on a daily basis.  They don't have to drive by "legal crack houses" on every street corner.  They don't walk into a store, and see crack readily available on the shelves.  They don't have to go to a casual gathering at a house warming and watch everyone else "light up" and enjoy the festivities.  

My guess is, and it's just my guess, that if you replaced all the fast food chains with crack stores, and put crack in every Quick Trip and every grocery store, that the relapse rate would probably be much higher. 

On top of that, some people appear to be more wired for addiction than others.  I personally can start a diet, and eliminate junk, and never crave junk after a couple of weeks of "eating clean".  I quit smoking back in 2000 cold turkey, and never once did I ever crave a cig again.  While some people go through all sorts of measures to quit smoking and just can't ever seem to kick the habit.  On top of that, because of genetic factors and different body types, some people are more inclined to be on the plump side.     

Now I don't want to let fatties off the hook here either.  I don't want to start piling up "excuses" for them.  

You became obese more than likely, because of a lack of discipline and self awareness.  The 130 pound high school chick that is now 30 and pushing 300 pounds had to cross 150, 170, 190, 200, 225, 250, etc.  There were a lot of bad decisions made on the way to 3-hundo.  A 20 pound weight gain shouldn't have gone unnoticed, and have been met with "shit, I've gained 20 pounds in the last year, I need to get my shit together."  

But then it didn't happen, and another 20 got packed on.  Women often lie to themselves because "I can still fit into my size 8."  Well, that doesn't mean a whole lot.  Lots of women can gain 15-20 pounds and still essentially be in the same clothes they were before, but that doesn't mean you didn't get fatter.  

Men do the same shit.  

"I'm not much fatter." and then GROSSLY underestimate their bodyfat, without ever actually getting it taken.

Fact is, 15% doesn't look a ton different than 18% bodyfat, however once you cross over that 15% threshold you tend to acclimate fat gain at a far faster rate than before.  And then guys are on some forever bulk cycle and still think they looked like they did back at 15% when everyone else can see they resemble the Michelin Man more than they resemble the "muscular man" they were before.

People are awful at enabling their shitty habits.  Especially when said habits are ones that make them "feel good".  So they constantly ignore the consequences of said habits until the results from them are such that they can no longer be ignored.  

Then the process to get back down to what was once their "normal weight" is a painful process, and one that is often met with failure, and obviously later on, relapse.  

In my opinion there are a few reasons why that is....

First off, most obese people don't approach their problem like an addiction.  People that are addicted to hard drugs go to clinics, go to support groups, have sponsors that keep them accountable, etc.  Yet severely obese people do things like hire a trainer, or find an online diet, and then try to follow it without taking into account the psychological (extreme cravings) and physiological troubles that will accompany withdrawal.  These issues need to be addressed, and addresses in a similar manner as people with drug addiction.  It's not enough to "find a diet" or "do more exercise."  You have to be honest with yourself, and treat it LIKE an addiction.  

One common issue I see with obese people is that they gravitate towards diets that still allow the shitty foods in their diet that caused these problems in the first place.  Would it make sense for the crack addict to talk about "going clean" then talk about "well, I only smoke one rock once a week now.  Sometimes three times.  It all depends on if that crack fits my macros."  

It has to eliminated, and over time, the brain essentially has to be "rewired." (I know, that's not the best term here but work with me.) 

The second thing I have seen personally and up close, are people that have been obese most of their life get down to a weight they are "proud of" when in all actuality they still have a ways to go.  I've trained several women in the past that eventually became very complacent with the size they got down to, and became very resistant to make the more difficult changes they needed to make in order to get to an ideal size for their structure.  

And in every one of those instances, those women got fat again.  100% of the time.  

People lose weight, and feel proud of their weight loss, but then don't realize they still fit the mold of being obese.  

"Well, I've lost 100 pounds in the last two years."

That's awesome.  But you're still 200 pounds at 5'5".  You still have work to do.  

These people become content, don't make all the changes needed in order to continue making progress, keep allowing themselves to eat the food that got them obese, and eventually they are back on that downward spiral.  

The other issue I see now, is that we've become a society of fat enabling.  I can't tell you how many memes I've seen that talk about loving your fat body, or "real women have curves." and such shit as that.  

Love handles and muffin tops are not "curves".  Ok?  

There is an overwhelming push by the media and society now to make big beautiful.  Nevermind that being obese carries both a heavy financial burden on the healthcare system, and is associated with just about every major health issue we see today.  Yet here we are as a society, propping up being obese as something that shouldn't be frowned upon or looked down at.  

I'm sorry, but that's just idiotic.  

I'm not saying we should "fat shame", but for the love of God, we shouldn't be propping up obesity as something that is beautiful or to be considered natural.  It's neither.  It's the physical manifestation of unhealthy eating habits.  There's nothing beautiful about that.  The reason why muscular ripped bodies APPEAL to the great majority of people as being sexy is because of our evolutionary hard wiring that it represents a healthy mate.  

If you are an obese person, it behooves you to take measures to address every facet of the problem properly.  If you've been obese for the last 10 years, simply "finding a diet" is not wholly addressing the problem.  And thus why people with eating disorders or food addiction often fail in their efforts to "get clean."  Because the underlying issue is not being resolved.  And the cycle happens again and again and again.  This is why so many people do a fad diet, lose weight, then gain it all back.  Then they look for the next fad diet.  And it starts all over.  The root of the problem is never being addressed, and cementing proper lifestyle changes that will remain in place, aren't being laid down.

If you're obese, and have been for quite some time, you're going to need to do more than "eat less, and move more."  You're going to need to approach your issue from one that looks very much like drug addiction.  That means getting help in all the facets that will allow you to carve out a new lifestyle.  It may also mean that you have this battle throughout most of your life.  If you fit into the spectrum of people who have more highly addictive personalities and also are more inclined genetically to be fat, then you have to find a bigger approach than hiring a "diet coach." or "personal trainer."  Those can be important parts of what you need to do, but it's not the whole picture.  And you're not going to see the big picture until you rid yourself of denial about your issue, stop resting on your laurels, and decide to approach this with a complete change in lifestyle and mindset.  

As with any addiction, the first step is admitting you have one.  Until then, you'll just keep passing bigger numbers on the scale. 

8 comments:

  1. I lost 110 pounds and kicked an opiate addiction. At the same time. I agree with your premise wholeheartedly. The weight quite frankly is a lifelong war. The drugs? Becoming fit and active has given me a purpose and direction that have replaced the drugs. Not saying it aint tough but it's on the back burner. I became a distance runner (chasing that dopamine - literally) But the food thing is a bastard. Still. And admittedly the "cleaner" I eat the easier it is. Not saying a treat is bad. Just try eating 1,000 calories of chicken breast. Or apples. Now try eating 1,000 calories of pizza or ice cream. Ya, exactly. Great article man.

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  2. I had to laugh at the crack "fitting my macros" part. Hilarious.

    However, I will offer some testimony to whole "rewiring" theory. In my experience, it is true. Once you spend enough time (years) away from sweets, sodas, baked goods, etc. you actually begin to have a kind of repulsion. You realize how those foods were packed with unnatural amounts of sugar and sweetener and the idea of eating anything more than a sampling becomes physically sickening. That's just my experience, though. I would honestly rather eat a plate of steamed broccoli.

    Some people might think that is a bit extreme, but I think it is basic human nature - adaptation and evolution. Your brain tends to prune away the dopamine pathways it no longer uses.


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    1. Indeed. There was an article about a family that cut sweets out for a year and tried to reintroduce them back in and they all became physically ill.

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  3. Great article. I haven't lost the weight yet, but I get up every day and try again. I've accomplished several difficult tasks in my lIfe, but kicking sugar has got to be the hardest thing I've ever tried to do. The stupid internal dialogues I catch myself in, the Starbucks rut, temptation at every turn. Sometimes I wish there was a resident rehab to break bad food habits, it really feels like addiction.

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  4. Very impressive article. I think that the world is glorifying obesity to an extent, especially for women. I have always been a larger lady (10-20kg overweight usually) & enjoyed food, but in the past 2 years since embracing weightlifting, and over the past 6 months powerlifting, I have seen my weight drop by 1-2 kilos, but my body composition change dramatically. I can eat more calories to maintain my weight of 80kg.. and I regularly deadlift 120kg to keep it off :)
    People today market the hell out of the easy fix. Eating isn't the only thing that can change your weight. Lifting heavy can too :)

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  5. You're the first person in the fitness community that I've seen actually to talk about Food Addiction. It is a real problem and having you shed light on it means a lot to me.

    Question though, if someone close to me (specifically my mother) has been obese for 10+ years, but used to be thin, how do I tell her she needs more help than the Jillian Michael's 30 Day Shred?

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    1. I don't know. It's the first time I've really looked at it from this angle and did the research. Obviously it's something that needs to be addressed by a professional but I don't think that it's something being wholly accepted right now for the reasons I described.

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  6. Mr Carter, this is a wonderful article. More people need to read it. May I copy paste your post on my blog after acknowledging your authorship, obviously. Thanks.

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