Study of Season 8 "Biggest Loser" Contestants re Weight Regain Causes

[VSGAnn2014 12,992]

Check out this feature story in today's NYTimes. It reports on a very good research study with albeit a small sample -- 14 of Season 8's 16 "Biggest Loser" contestants.

(FYI, TBL's Season 8 was in 2009.)

Summary: Dramatic weight loss lowered their basal metabolic rate, and it never came back up.

But we already knew that, after decades of yo-yo dieting, right?

BTW, one of the contestants (Rudy Pauls) had weight loss surgery since being on TBL and is doing pretty well weight-wise.

I predict this is going to be a huge news story for some time.

http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?emc=edit_th_20160502&nl=todaysheadlines&nlid=40256033&_r=0

[2goldengirl 2,076]

Fascinating article.

Now I'm more interested in ever in going up to UC Davis and having my RMR tested here near the beginning of my sleeved life. I'll go back and have it done again a year from now. Their School of Sports Medicine will do the testing.

I know that all the years of yo-yo-ing have done a number on my metabolism.

[VSGAnn2014 12,992]

Also loved this throwaway paragraph in the story:

"On the day of weigh-in on the show's finale, Mr. Cahill and the others dressed carefully to hide the rolls of loose skin that remained, to their surprise and horror, after they had lost weight. They wore compression garments to hold it in."

So let us please not assume that it's only weight lost through WLS that produces loose skin.

[VSGAnn2014 12,992]

It's worth remembering that TBL contestants have lost weight faster and in one of the most extreme ways possible. I certainly didn't lose weight nearly as fast as those poor folks did. My calorie deficit also wasn't even remotely as huge as theirs. I do wonder how extrapolatable these study's findings are (other than "directional") for others who've lost weight by diet / exercise. And mostly, I wish like hell someone would do this kind of study on on WLS patients!

In fact, the ASMBS seriously needs to pony up resources to do this kind of research. I'm getting pretty tired of the lame-ass "long-term studies" reported by hospitals with horrific non-response bias thanks to the majority of patients who fade into the woodwork over 1, 2, 3, 5 years post-op.

IMHO.

[Inner Surfer Girl 12,015]

Excellent article. (As an aside, I am surprised Biggest Loser would allow such a research study,)

[JamieLogical 8,684]

So glad you posted this. It's fascinating and pretty depressing at the same time. I have long suspected that losing weight TOO quickly or by creating too large a calorie deficit would wreck your metabolism. I see it here on these forums all the time. People post that they are gaining weight by eating 1100 calories a day and everyone assumes they are just lying or at the very least, inaccurately tracking their food. I suspect those people have genuinely, permanently altered their BMR.

I feel very lucky that my BMR still seems to be "normal" form someone my size. Not sure how true that would hold if I began to regain weight, but I don't intend to find out!

[VSGAnn2014 12,992]

The research I've read (conducted by some of the same NIH researchers who are reporting their TBL study today) suggests that the greater your caloric deficit while you're losing weight (the difference between your caloric output and your caloric input), the more you lower your basal metabolic rate.

However, let's remember that the TBL study doesn't investigate a population of WLS patients.

Once again, I would love to see the bariatric surgery industry take responsibility for conducting valid research using samples from a much more diverse WLS population than those who are still checking in with their surgeons several years later.

The way you do such research is to figure out ways to compensate patients for participating in the study -- WHETHER THEY'VE LOST WEIGHT OR NOT.

And FTR weight loss and weight loss maintenance are FAR from the only outcome variables we are all interested in learning about.

Anybody out there listening?

[LisaLouBop 181]

@@VSGAnn2014

Thank you so very much for posting this. A real eye opener.

Wiping the tears from my eyes, heading to the gym!!!!!!

[Miss Mac 6,261]

Which only goes to prove that WLS is not an easy way out. I also think that a lot of us were already well schooled in nutrition long before we had to meet with a professional nutritionist. We know this stuff, but our screwed up metabolisms fight us every inch of the way.

I have been on a diet since gaining 70 pounds with my pregnancy with my second child in 1978. Since 2006, I have been on a Mediterranean diet with a Mediterranean chef in the house (my gentleman friend is from Malta). He cooks - I clean - it works out better that way. And I gained another 50 pounds while maintaining an aggressive exercise program.

My kitchen skill is baking all of those tasty things that I really have to be cautious about eating, only now I have to incorporate bariatric-friendly ingredients. Can you believe that with all of the issues that flourish with obesity, the 2015 USDA food Pyramid still says that we need 6-11 servings of grain such as bread, Cereal, rice, Pasta, per day?????

I am so thankful for my sleeve because I could not maintain a weight loss any other way. My bariatric program follows patients up to five years, so I plan to keep all of my appointments. My third year follow-up will be in December.

[Daisee68 2,493]

A little depressing indeed. I realize we did not lose as fast as they did, but at 110 pounds down in 10 months, that is still kind of fast, so scares me a little. The part where the Dr says they would need to exercise 9 hours per week to keep the weight off tells me that he already knew some of what the outcome would be. 9 hours a week is above what a normal recommendation would be. I will tell you if I am expected to do 9 hours of formal exercise a week, I am certainly doomed....

I am not saying this is making me give up but it is certainly eye opening. Once again, I am very grateful I am still seeing a therapist too because the article talks about the cravings in addition to the ability to eat / burn less.

[IncredibleShrinkingMan 437]

You said it, @VSGAnn2014. There is hardly anything in this article that is news, the least of which is that Biggest Loser is an awful show by awful people.

Leptin was proven to be an ineffective therapy, though. I am surprised they are still talking about it.

[VSGAnn2014 12,992]

@ ... actually, I was impressed by the consistency in almost all participants' responses in terms of changes in their metabolic rate -- and was honestly shocked at how huge the decreases in their metabolism. It's the first quantitative *proof* I've seen that metabolic rates do decrease and by a lot.

I keep thinking I know about so much about obesity. But there's so much more to learn.

I'm thinking that this study and the coverage it's likely to get in popular culture because of who the participants were and how popular that show is (ugh, I know) is going to accelerate interest in bariatric surgery.

[Healthy_life2 8,319]

Thanks for the article. I still have so many questions about obesity and surgery.

I would like to think surgery studies would be different from the biggest looser weight loss program.

I don't see many surgery patients 6+ years out. I think for many reasons. Life turn to normal..You don't Identify with weight loss mode and some experience weight gain.

Patients in my area don't keep follow up appointments for 5 years. The studies at my surgeons office are not correct due to the lack of continued participation.

This Leave me with more questions than answers.

I still depend on all the senior surgery patients. I follow what keeps them successful. I wish I met more people long term out.

[CowgirlJane 14,259]

My RMR was tested in December, and I was kinda surprised how high it is. Wonder how high it was before WLS? Or maybe my active lifestyle has kept it up? I mean, I still need to eat under 2000 calories a day, but it isn't the super low that other women report.

Anyway, I do think this was a useful article because people need to realize that going to a "fat farm" and living in a totally fake environment with crazy workouts and very restricted diets will work out here in the real world. It is useful for people who have had WLS that the honeymoon of "I am full after just a bite" doesn't last forever either....

[lifeofblair 308]

When I was younger I wanted to do a biggest loser type diet, little did I know how much they work out and how little they eat. I'm glad that I never did anything like that. I am also curious what my metabolic rate is.