Landmark Study on Maintenance – What Do You Think?

[Alex Brecher 10,484]

It’s been in the news all week, so let’s talk about it…there’s a new study in the journal Obesity that answers some questions many of us have been wondering about for years. In case you missed it or need a brief refresher, here’s a very brief summary.

Researchers followed 14 of the 16 Biggest Loser contestants from Season 8 (2009). They found:

-13 of them regained weight since the finale.

-Four were heavier than their Season 8 starting weights.

-Resting metabolism slowed…a lot. Contestants burned about 500 fewer calories per day than same-weight study participants who had never lost a lot of weight.

-Hunger hormones worked against contestants, with leptin (a satisfying hormone) dropping, and ghrelin (a hunger hormone) rising.

-Contestants thought about food…a lot.

I don’t think the weight regain was a surprise to those of us who are not too confident in the show’s weight loss methods that depend on grueling exercise for hours a day. These methods just don’t seem sustainable, either mentally (is it really fun to exercise 6 hours a day for life?) or practically (some of us have jobs and families…).

But there is also a lot of buzz around the physiological factors, including slowing metabolism, thinking about food, and increased hunger. Does that mean we’re all doomed to be obese forever?

Clearly not. Many of us are successful maintainers. So here’s what I take home from this study.

-I can’t compare myself to anyone else. John Doe may weigh the same as I do, but that doesn’t mean I can eat like him. So why would I even look at what John Doe is eating?

-Take your weight loss journey as a chance to develop healthy habits that you can love forever. You’ll only be losing weight for a year or two after surgery…then it’s time to maintain. Consider that first year or two when your sleeve, band, or pouch is doing the most for you a time to figure out what works for you. If you make a mistake, it’ll be easier to get back on track when your surgery is recent and you’re still motivated by the prospect of weight loss.

-Fix your head. If you’re going to be battling hunger more than most people, you’ll be a lot more successful if you’re not battling emotional eating, too.

What did you think about the study and its results? Did you learn anything you can apply to yourself?

[VSGAnn2014 12,992]

Alex, thanks for raising this topic. The study has been much discussed -- there are already two long threads on this article:

http://www.bariatricpal.com/topic/366761-study-of-season-8-biggest-loser-contestants-re-weight-regain-causes/?hl=%20biggest%20%20loser

http://www.bariatricpal.com/topic/366768-ny-times-article-on-weight-loss-metabolism-and-hunger-hormones/?hl=%2Bbiggest+%2Bloser

But even more revelatory to me was learning about (thanks to @@Sylvia13 ) another study (done by the same researchers who did last week's Obesity-published research) that compared the metabolic rate changes between 13 of The Biggest Loser contestants vs. 13 RnY WLS patients. The WLS patients' metabolic rates dipped about half as low as TBL folks. And best of all, a year after surgery their metabolic rates came back to where they were pre-op.

Here's the link to this second study: http://www.ncbi.nlm....es/PMC4236233/

[Djmohr 6,965]

It is disheartening to know that our bodies work so hard against us but it does make sense given how many times in my life I dropped 50 to 100 pounds through diet and exercise but those pounds always came back and brought some buddies with them too.

When I was young it was almost a game for me, I got good at losing the weight. What I did not see coming was how age plays into your ability to lose. I actually got to a point where I could lose tops 5lbs only to have it return and frustrate me. When I realized that i was doing more damage than good I finally threw in the towel when it came to diet and exercise completely. By then though a lot of damage to my bones and organs were in full swing. Ugh.

I have learned that there is no such thing as a diet for me. A healthy balanced meal that consists of good Proteins, vegetables and fruits in my diet is critical to my being able to maintain my loss. As I have just entered the maintenance phase in the last couple months I am still learning how many calories I can eat per day to maintain. For me, it is lower than most because I am also not physically capable of doing the exercise i would like to. Hopefully soon we will figure things out so I can get back to cardio daily which will allow me to add some additional calories.

I am sad for those folks who are obese and don't understand how this works. I am thrilled for the young folks who recognize they need to do something more permanent.

The only cure for obesity long term is WLS. I believe that to be completely true. I would argue those folks that go through WLS and dont take the time to learn good nutritional habits still won't be successful long term and they will continue to blame it on the surgery.

Obesity is an epidemic and it is quite scary. I seriously notice people more now that I understand the disease and I feel like our PCPs are not educated enough about obesity and the cure. When you are in a crowd of people just stop and take notice of those around you. There are very few normal sized people. Most are overweight, on their way to being obese or obese already. It's frightening.

[katanne 215]

I've read the article about this in the New York Times - the only contestant who has gotten down to below his end-of-show weight was a guy who'd regained it then had gastric sleeve surgery and is now maintaining. WLS is just a tool, but it can be a powerful one.

[Alex Brecher 10,484]

@@VSGAnn2014,

Thanks for the link to the other discussions and also to the second study showing that WLS patients had their metabolisms return to normal or as expected after a year (although I can’t access the link you posted).

@@Djmohr,

That is a really insightful observation that you kept losing the weight as a sort of game when you were younger, only to eventually get to the point where you couldn’t lose weight anymore. I think for anyone who is successful at long-term maintenance, as is true for you, there is no such thing as a “diet” other than eating well.

I do disagree that WLS is the “only” solution to obesity. It may be the only solution for some of us – and maybe for all of us who have gone that route! But I do know people who have lost serious weight (50 to 100 or more lbs – enough so that they could have been WLS candidates) and kept it off for decades. They work really hard at it, just as hard as we (WLS patients) do. But obviously for myself, I felt that WLS was the only way to go!