itstheamarie

I am sharing this article as food for thought, especially for the slow losers! (The bottom line is to follow the Dr.'s instructions) Many people have found what works for them, but for those of us who feel like we are doing "everything right" and encounter frustrations, a little reading couldn't hurt:
This week, several people have brought a recent case-study to my attention and asked me for comment. In it, a 51 year old female began marathon training along with a (self-reported) low calorie diet and either appears to have gained weight or not lost weight (she also showed a very depressed metabolic rate, nearly 30% below predicted). By raising her calories gradually, her body fat (as measured by BIA) came down and her metabolic rate increased. Now, without more details, it’s hard to really comment on this and the link to the case study is the total amount of information available. But we’ve got an older (either post-menopausal or peri-menopausal) woman, undisclosed anti-depressant medication, self-reported food intake and a method of body fat measurement that is, at best, problematic (read Methods of Body Composition Measurement Part 2 for more details). Odd things happen metabolically around menopause, some medications can cause issues, food reporting is notoriously inaccurate and BIA isn’t ideal to track changes. Then again, the measured metabolic rate change is pretty interesting; something was going on. That said, I’ve mentioned in previous articles that one oddity that I’ve seen (and personally experienced) over the years is one where the combination of very large caloric deficits and very large amounts of activity (especially higher-intensity activity) can cause problems for people either stalling or slowing fat loss. Like my previous article on The LTDFLE, or Long-term Delayed Fat Loss Effect, this is one of those oddities that seems to crop up more often than you’d expect. It’s also one where there’s not a ton of research but I will happily provide a good bit of speculation on what I think may be going on. I’d also note that the combination of big caloric deficits and large amounts of activity clearly isn’t detrimental to everyone. Some folks can get away with it but, for many, it tends to backfire more than anything else. First, Some Background Back in my early 20′s, I remember a very specific client I had. She was a little bit, well, to be honest nuts. She was older, I think she had gone through menopause but I wouldn’t swear to that. In any case, she started working with me, determined to lose weight and immediately jumped into something like 2 hours of cardio per day and cut calories massively. She claimed 600 calories per day and I won’t even try to describe her diet; it was insane (Breakfast was supposedly one-half an egg and to this day I’m not entirely sure how you eat half an egg). Now, I didn’t know much at that point but I had this general idea that too much activity and too few calories was a bad thing. For weeks on end I entreated her to either cut her activity or raise her calories. She adamantly refused; how could that possibly work? I tried to point out that what she was doing wasn’t working either and she could hardly do worse by trying something different but that line of logic went nowhere. In any event, at one point she went on a cruise or a vacation or something. And what do you think she did? Exercised less and ate more like everybody does on vacation. And she came back something like 5 pounds lighter (some of which may very well have been The LTDFLE mind you). “See, see.” I told her, “You ate more and exercised less and good things happened.” And she immediately went back to a massive caloric deficit and over-exercising. But that’s how it goes sometimes. Later in my 20′s, mind you, I’d do the same thing during the now infamous Bodyopus experience (probably the singular experience that taught me what NOT to do during a fat loss diet). Frustrated by stalled fat loss (I had dieted far too long at that point in the first place), I worked even harder, cutting calories further and adding more activity. That coupled with some genuinely awful ‘carb-loads’ took fat loss to a standstill. In addition to those case studies, this is a phenomenon that I’ve seen elsewhere including the support forum, I imagine readers run into it constantly: people (frequently but not always women) who try to combine excessive caloric deficits with massive amounts of activity (often with a lot of that activity being high-intensity activity) and nothing is happening. And if you can get them to reduce activity (or just cut back the intensity to reasonable level) or increase calories, things invariably start to work better. . What’s Going On: Let’s Talk About Cortisol Cortisol is one of those hormones that I imagine everyone reading this has heard about and about which a lot of misinformation exists. Simply cortisol is a stress hormone, released by the body in response to nearly all kinds of stress. In the fitness/bodybuilding world, cortisol has gotten an almost exclusively negative reputation (cortisol is ‘bad’ in the way that testosterone and thyroid are ‘good’) although this is simplistically incorrect. Rather, whether cortisol does good things or bad things in the body depends on how it’s released. Simply (and I’d simply, ha ha, refer folks to Robert Sapolsky’s amazing book Why Zebras Don’t Get Ulcers for a detailed look at this; I also talk about cortisol in The Stubborn Fat Solution), acute pulses of cortisol tend to do good things and be adaptive and chronic elevations in cortisol tend to be bad and be maladaptive. For example, the morning cortisol pulse helps to promote fat mobilization. In contrast, a chronic elevation of cortisol (especially in the face of high insulin levels) tend to promote visceral fat accumulation. As a non-fitness related topic, acute pulses of cortisol tend to be good for memory (why we often remember stressful situations in such detail) while chronic elevations (as often seen in depression) make memory go down the toilet. And there are endless other examples of where acute cortisol pulses are good and chronic elevations are bad; again see Sapolsky’s book for details. In any case, dieting in general is a stress. And of course training is a stress. And the more extreme you do of each, the more of a stress occurs. And I suspect that a lot of what is going on when folks try to combine excessive caloric deficits with massive amounts of activity is that cortisol just goes through the roof (there’s another issue I’ll come back to at the end that relates to this). Simply, you get these massive chronic elevations in cortisol levels. Tangentially, this is also one reason I suspect that various types of cyclical dieting help with some of this issue. For at least brief periods, when calories are raised to maintenance or above, you break the diet/training induced elevations in cortisol. This of course assumes that the person isn’t mentally stressed to the nines by raising calories like that but I’m getting ahead of myself. . So Why is This Bad? As noted above, chronic elevations in cortisol can cause a lot of bad things to happen. One of them is simply Water retention and I’ve mentioned in previous articles that water retention can mask fat loss, sometimes for extremely extended periods. I talked about this in some detail in The LTDFLE and suspect that some of the ‘fat loss’ is actually just water loss when calories are raised and cortisol mediated water retention dissipates. Reducing total training (volume, frequency, intensity or some combination) does the same thing. But that’s probably not all of what’s going on. Another effect of chronically elevated cortisol levels is leptin resistance in the brain. I’m not going to talk about leptin endlessly here again, you can read the Bodyweight Regulation Series for more information. When the normal leptin signal to the brain is blocked, a lot of things can go wrong metabolically and I suspect that this is part of the problem. In this vein, although not necessarily related to cortisol per se, at least one study found that the addition of 6 hours per week of aerobic activity to a very low calorie diet (in this case a Protein sparing modified fast) caused a larger decrement in metabolic rate than the diet alone. The body appears to monitor caloric availability (simplistically caloric intake minus output) and if it gets too low, bad things can happen. This is why I so strongly suggested AGAINST the inclusion of much cardio in The Rapid Fat Loss Handbook; it causes more harm than good. Invariably, the biggest source of failure on that plan is when people ignore my advice and try to do a bunch of cardio. And fat loss stops. In any case, there are several different plausible mechanisms by which the combination of excessive caloric deficits an large amounts of activity can cause problems. Whether it’s simply cortisol related water retention, a drop in metabolic rate due to leptin resistance or something else, something is going on. From a more practical standpoint, for a lot of people, the combination simply doesn’t work. Mind you, some seem to get away with it but not all. . An Additional Variable There is another variable that I have noticed over the years in looking at this issue. As odd as it sounds, it has to do with personality. In discussing this, for example, I’ve often noted that the people who seem to have the biggest issues with the whole lots of cardio/big caloric deficit tend to be a little bit ‘tightly wound’ (to put it politely). A bit less politely they are stress cases. You can almost ‘hear’ the stress in their typing. Every post has lots of exclamation points and there is this undercurrent of “I MUST LOSE FAT NOW!!!!!!” in their posts. When fat loss stalls for a day, they freak out and want to cut calories or go add another hour of cardio. You can almost ‘see’ the tension in them as they sit hammering at the keyboard looking for solutions. And this is an issue because these types of folks already over-secrete cortisol. As a true oddity, there is the issue of amenorrhea (loss of menstrual cycle). Typically it’s been thought to be related to body fat levels or caloric intake and this is a general cause. But there is often a type of amenorrhea seen in women without any of the normal predisposing factors. In this case, it’s all due to mental stress. Basically, there is a subset of folks who are already high-level stress cases. They tend to be drawn to harder is better in the first place, tend to be resistant to change (like my client from my early 20′s) and their already high level of cortisol production is simply amplified by the combination of too much activity and too few calories. And suggestions to raise calories and/or reduce activity are invariably met by resistance (again, like my client from ages ago). What they really need is to just chill the hell out. But invariably the approach that they are intuitively drawn to is the wrong one for them: moderate deficits and moderate activity always work better in those folks. It’s getting them to do it that’s the hard part. Tangentially, I suspect that the classic hardgainer is of a typical type but that’s another topic for another day. . Summing Up So that’s that, a look at one of the oddities of fat loss, the situation where the combination of excessive caloric deficits and excessive amounts of activity seem to hurt rather than help fat loss, along with some gross speculation (and just enough research to make it sound like I know what I’m talking about) on what may be going on. In a practical sense, of course, most of the background isn’t that relevant. The simple facts for the majority of folks is this: you can either cut calories hard OR do large amounts of activity. But you can’t do both. Well you can do both, you just probably shouldn’t under most circumstances. Share and Enjoy: Where am I: Blog > Fat loss > Physiology of Fat Loss > Why Big Caloric Deficits and Lots of Activity Can Hurt Fat Loss
http://www.bodyrecomposition.com/fat-loss/why-big-caloric-deficits-and-lots-of-activity-can-hurt-fat-loss.html
For those of us stressing over numbers but are feeling & looking better & healthier- Should we really chill the hell out?

I was traveling on my pre-op, so I had to find a way around the canned stuff. I went to panera and ordered chicken noodle Soup, but I asked for the broth only. I then strained it, and let me tell you, I was in HEAVEN! You could probably run it through a cheese cloth to get the last bit of particles out post op.

I have been overweight my entire life, but I had accepted that I am a "big girl." I have lost and maintained for a while, then eventually gained over and over. Luckily every time I diet, I pick up a good habit. At this point, I don't drink any sugar and exercise 3-4 times per week. That has been enough to maintain but not really lose. Lately, my knee has been getting the best of me while I jog or do Zumba, to the point where I have to back down.
Then, at Christmas dinner, as my diabetic aunt and grandpa were checking their blood sugar, I took a good look at my aunt, who everyone has always compared me to physically. She is about a size 24/26, and has had numerous surgeries for her obesity related health problems. I asked here what size she was at my age (25)- turns out she was exactly my size (18/20). At that moment, I felt like I was looking into a mirror of my future. I had to decide if wanted to live like that or if I wanted to change my fate.
Scheduled surgery 2/7/2013.

I was traveling on my pre-op, so I had to find a way around the canned stuff. I went to panera and ordered chicken noodle Soup, but I asked for the broth only. I then strained it, and let me tell you, I was in HEAVEN! You could probably run it through a cheese cloth to get the last bit of particles out post op.

Looks like your loss is going well! If it ain't broke, don't fix it :-) My doc's office advised that number of protein= number of carbs, but since I've been stalled for the past 3 weeks, I'm dropping carbs to see if being in ketosis will help move things along. Good luck and please keep us updated!

I bought mine at Walmart near the diabetic supplies.

I have been overweight my entire life, but I had accepted that I am a "big girl." I have lost and maintained for a while, then eventually gained over and over. Luckily every time I diet, I pick up a good habit. At this point, I don't drink any sugar and exercise 3-4 times per week. That has been enough to maintain but not really lose. Lately, my knee has been getting the best of me while I jog or do Zumba, to the point where I have to back down.
Then, at Christmas dinner, as my diabetic aunt and grandpa were checking their blood sugar, I took a good look at my aunt, who everyone has always compared me to physically. She is about a size 24/26, and has had numerous surgeries for her obesity related health problems. I asked here what size she was at my age (25)- turns out she was exactly my size (18/20). At that moment, I felt like I was looking into a mirror of my future. I had to decide if wanted to live like that or if I wanted to change my fate.
Scheduled surgery 2/7/2013.

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I have been overweight my entire life, but I had accepted that I am a "big girl." I have lost and maintained for a while, then eventually gained over and over. Luckily every time I diet, I pick up a good habit. At this point, I don't drink any sugar and exercise 3-4 times per week. That has been enough to maintain but not really lose. Lately, my knee has been getting the best of me while I jog or do Zumba, to the point where I have to back down.
Then, at Christmas dinner, as my diabetic aunt and grandpa were checking their blood sugar, I took a good look at my aunt, who everyone has always compared me to physically. She is about a size 24/26, and has had numerous surgeries for her obesity related health problems. I asked here what size she was at my age (25)- turns out she was exactly my size (18/20). At that moment, I felt like I was looking into a mirror of my future. I had to decide if wanted to live like that or if I wanted to change my fate.
Scheduled surgery 2/7/2013.

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I'm done with diets. I swore off diets.. out of my life for good and I'm officially a member of dieters anonymous. My body has suffered enough abuse over the years. It's eat healthy w/excercise all the way or it just wasn't meant to be.
Lol.. Ok, sorry, carrying on ( I just hate the word diet)

I was unimpressed with the fitbit. I have used a Bodybugg for several years and just upgraded to the newer Bodymedia Link. It is a sensor that is worn on the back of your left arm with an armband. I'm extremely confident in the accuracy of the monitor (except for sleeping. It's way off for sleeping, but I would expect anything would be off for me, because I have a sleeping disorder and I spend a lot of time reading in bed at night waiting to go to sleep.). It is a triple axis accelerometer with skin temperature, galvanic skin response, and heat flux sensors (just sounds sexy and technical, doesn't it?). I love the amount of data that it provides. I could tell you for any 6minute segment of the day how many calories/minute I was burning. I was using the bodybugg (which is basically just the older version) while I was really dedicated to weight loss and triathlon. The data, tracking, and interface helped me to lose 115 pounds. I knew every week what my weight loss was going to be based on my downloaded data and my food log long before I ever stepped on the scale.
I have 2 complaints about the Bodymedia: 1 - it's not invisible, so I sometimes have to explain that thing I'm wearing (but that can be fun sometimes, because people think it's cool) and 2 - it's not waterproof, so I can't use it to measure calories I burn during a swim.
MyFitnessPal interacts with the Bodymedia interface. You can link your accounts and use MFP to log your food if that's what you're comfortable with and it will be transferred to your Bodymedia interface so you can look at all your other data.
I can't say enough good things about the Bodymedia... but I guess I'm a bit of a geek...

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I agree with most of the others who say it depends on if the person has realistic expectations. Although it comes easily for some, most vets will tell you it is the very hard to maintain, because lifetime maintenance is based more on the behavioral changes that occurred during the losing phase. Even though the sleeve is a TOOL, there is a chance that it will not actually work FOR you. It will work WITH you. After a few weeks out, we could all eat around the sleeve by consuming nothing but candy and milkshakes. It's all about compliance and how your body handles the changes- mental and physical. :-) But there are always exceptions to both sides of the story!

I have found that diet Swiss miss hot chocolate will take care of my sweet tooth for 25 cal, 2g Protein, 2 g sugar.

This is another reason why I don't keep track of calories "burned" during exercise. IMO it's all a guesstimate and I don't want to feel like a slave to the number of calories burned. It definitely makes sense that you will burn less calories the more weight you lose and some people will try to workout harder to compensate. I guess in the end it depends on what you want. I turn up my intensity and not time. I can't stand the thought of doing more than 20 mins of cardio and my body seems to be responding to the less is more approach.

I have always disagreed with the super-low-cal approach, I think it makes your metabolism fall through the floor. I also think overexercising can have a negative impact, particularly too much cardio of a certain kind/intensity. Have you read any of the newer research out there about eating more calories (of a healthy kind of course lol) to keep your metabolism up, doing strength training to support your metabolism, and doing only periodic hard cardio in limited amounts? It's all very interesting. It's what I've done, even though I didn't plan it that way, and it's worked out well for me (so far at least, 27 months out...). I do think, for whatever it's worth, that hating on yourself and being SO hard and negative toward yourself, is never going to help. Hating your body and seeing it as the enemy to be conquered...I just can't see that being productive in any way -- perhaps even in a real physical way. Without seeing a therapist (I understand the stigma potential in your situation), maybe try reframing your thoughts and beliefs about yourself in a more positive way. Pretend you are a person you totally love and treat yourself accordingly, especially emotionally and mentally. I'm not talking positive thinking of the affirmation kind, I'm talking retraining your brain to go in different directions than it has done.
Anyhow -- my very best to you, GT. I hope you find your center again soon. <3

After reading all the posts around "eating more to lose more" and speaking to my nutritionist, I tried to increased my calories and Protein last week. I got in around 1100 calories and over 115 grams of protein on average each day. Interesting enough, my doggie had surgery on Friday and I have been stuck home with her and hadn't worked out hard at all..got on the scale yesterday for my weigh in and I am down 3 pounds. I don't know if it is a fluke and it is the first time I haven't had to fight for any kind of loss since surgery.
I am going to maintain the calorie and protein intake this week again and see what happens.

I spent so many years hating how I looked in dresses so I just never wore them. I didn't even like wearing bridesmaid dresses, and I wore pants to prom. For the first time ever I actually love how I look in a dress and I can not WAIT to wear this outfit out this weekend. Everyone here has always been so supportive of me so I wanted to share these photos.
Anyone out there on the fence about this surgery, all I can say is it is the BEST THING I EVER DID for myself.

at 3 weeks I was lucky to get in 500 because mostly liquid and very small amounts. but everyone's sleeve is different in what it can hold. my doctor never gave a calorie goal. however the office wants us to get Protein from real food not shakes as much as possible because solid food is where the restriction works. I was able to get upto 800 calories at 4-5 weeks and upto 1200 at about 8-9 weeks and that's where I'm staying. I eat about 5 times a day. I lose about 2-3 lbs a week with this regimen. I do minimum of 60-70 protein a day and try to keep sugar under 40 and overall carbs under 100. many here are more strict but I need to live this plan forever so that's how I work it.

Yes! And it will help you retain your lean body mass, which will contribute to a sustained metabolism throughout weight loss . You can still burn by focusing on the activity you do when you're NOT working out (NEAT: non exercise activity thermogenesis) such as fidgeting, cleaning, shopping, wrangling kids. Because let's face it, we're NOT working out (23 hrous= 96% of your day) a lot more each day than we ARE working out (1 hour = 4% of your day). All the crazy people who tell us to park far away and take the stairs all these years were on to something. I wear a Bodymedia Fit, which uses sensors to track steps, heat reflux, and etc to calculate daily burn. To my surprise, I have better burns on days when I am out and about all day- more than the days when I have a good workout but am a couch potato the rest of the day. Moral: don't feel tied to a cardio machine to push through your pain and burn calories, do something you can enjoy and sustain! You can avoid looking "skinny-fat" this way, bc lifting weights is what transforms the SHAPE of your body. Focus on compound lifts that engage multiple muscle groups through pushing and pulling (most bang for your buck).

OMG thank you SO much for posting this!!!! I was about to pull my hair out with the misinformation being spread about needing to be on a VLCD (very low calorie diet) forever to lose/maintain. Anyone every question why there are a MILLION threads on here about stalling after eating low cal and working out like crazy? OUR BODIES GO INTO PANICK MODE AND HOLD ON TO WHAT WE HAVE. As my doctor told me regarding losing my menstrual cycle- evolution has taught our body to resist famine. Say what you want about starvation mode, but I am walking proof that our body will shut down natural processes (ovulation since we can't support a child) to resist famine. Many of us experience this before surgery, too (stalling at 1,2000 cal/day). The reason we regain + more wt after these diets is that we gave up and went back to our ways after losing weight (MUSCLE and fat), but have ruined our metabolism (less lean body mass = lower BMR). This happens with the sleeve, too- look at all the threads about regain as we slip into old ways. The good news is, you can reset your metabolism by eating at TDEE. This is something to think about in the long term, not immediately after surgery of course. VST is great for support, but there are other sources out there, too. Myfitnesspal has several groups such as "EatMore2WeighLess" and "Eat.Train.Progress" who can provide you with information for days along with success stories about people who eat at normal levels and maintain weight loss (long term, not week 3 post op). We have to realize that if we are doing things that we can't maintain for life, all the work and stress we're putting our bodies through could be in vain. Your success does not depend on your sleeve. It depends on the choices we make all day every day to be healthy or not. Lastly, be careful who you listen to (myself included)! There are countless books and papers on these subjects who are written by experts. There are trainers and registered dieticians who can help, too. If you are having success, keep up the hard work! If not, keep looking for what works for you, because everyone is going to give you a different answer.

I agree with SleeveOfSteel, in that it's perfectly safe to consume more in order to feed your daily functions. Everyone has a different energy expenditure, so the round numbers don't work the same for everyone. Do a 350 lb man and a 190 lb woman need the same number of cals? That's why we see so many people comparing themselves to other's losses. If you take the more balanced approach, it's likely that you will be able to establish habits that will last long term. However, you will need to accept the fact that you MAY lose slower. But if you're truly doing it for health, then it won't matter! Stay focused on your goal, and continue to seek support. Moving up to 1200 so soon may have you thinking a month from now, oh, I need 1500, then 2000 and it will continue to go up and up as the swelling goes down and you can consume a larger quantity. The easiest way for us to wreck the process is focusing on things that "go down easy." Nearly anyone can get cals sky high if we turn to sliders (especially long term as we lose the newbie motivation to make healthy choices). If we follow the "rules" of Protein first, we will continue to feel restriction/fullness even if you eat small quantities throughout the day. At this point, going that method would still land your cals pretty low. It will be a journey, but you will constantly have to ask yourself if you're making changes that you can maintain for life? If you are, then you'll be fine! Keep up the great work, and congrats on your losses so far!