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October 31, 2016

GAINZday Thread: Why Eat Less, Move More Doesn't Work

In last week's GAINZDay thread, zombie asked a fair question: If your new diet is taking so long to work, doesn't that suggest the standard dietary advice of eat less, exercise more is just as good, if not better?

I responded in the comments, but not fully, and not with anything but my own assertions.

Let me address the question more fully here.

First of all, you have to understand why I was in a stall, and why my weight loss has been much slower lately.

I didn't begin this thread when I began the diet. I've gained and lost weight a bunch of times over the years. I've dropped 40 pounds on some regimens (after I put on a huge amount of weight and decided: I can't stay like this. I look monstrous).

Having lost weight before, I know what amount of weight is easy for me to lose: about 20-25 pounds.

A lot of weight programs will promise you'll lose 10 pounds in the first 30 days, or you get your money back.

Here's the thing: That's an extraordinarily easy promise to make. 90% of the time people will lose that amount of weight in 30 days no matter what regime they're on. Ten pounds is easy-peasy. Ten pounds is the somewhat-temporary overweight you gain when you're eating poorly above and beyond your normal level of overweight.

It comes off fast. The heavier you are, the easier that first ten pounds is to lose. And the more recent your last ten pounds of added weight was gained, the quicker it will come off.

Everyone's body has a set point of where it wants to be, weight-wise, based on the hypothalamus and insulin sensitivity and so on. Sometimes people who are already fat get into a bad habit of overeating even more, and throw on more weight.

Let's call that weight excess-excess. It's excess weight on top of your normally-carried excess weight.

Excess-excess weight comes off pretty easily, no matter what diet you're on. Tim Ferriss, in fact, suggests that the No Diet Diet might work to take of the excess-excess weight. If all you do is keep a record of what you eat, a detailed journal, then without attempting any particular regime, most people will lose weight, simply because they're being mindful of what they eat.

Without any particular diet goal -- just keeping diet in mind for a month -- you'll probably drop 5 pounds. Who knows -- add some vigorous walking and you'll drop that ten pounds.

Anyway, the point is, I didn't start this thread when I began my diet. I started this thread when I lost the first 25 pounds of excess-excess weight, which I know from past experience are the easy, gimme pounds I can lose in a couple of months by going low-carb.

I started this thread because I know -- from having lost significant amounts of weight before -- that once I get down to 180, which is my normal weight, without any excess-excess fat baggage strapped on top of it -- just the fat I've been carrying pretty much uninterrupted since I was 15 -- that not only does each additional pound get harder to shed, but it's around this point in time that I get bored and stop the regime.

So I didn't start this thread to lose the easily shed pounds.

I started the thread as an accountability thread to lose the hard-to-shed pounds that I previously had never really lost. Even when I was an active athlete (or let's say "athlete" -- I was never any good at anything) in high school.

My stall and my current rate of weight loss (somewhere under a pound a week) are bothersome, and frustrating, but you have to keep in mind: I lost the first 25 pounds of the gimme stuff before I ever posted at all.

I wouldn't brag about that or put up a thread about it because I've always known the first 25 pounds (for me) are a walk in the park. There's not really any question to me that I can drop that in 60 days.

The question I'm trying to figure out is: Can I drop the next 15 pounds of body fat? The tough stuff? The fat I've had stored in fat cells since before I lost my virginity?

My goal here is not to get back to my normal level of overweight. I already did that before starting the thread.

My goal here is to get where I've frankly never been in my life: to normal weight, to 18-20% bodyfat or so. And who knows, maybe lower.

Anyway, I'm not sure if zombie understood that. I lost 25 pounds before the first posting -- didn't mention it, didn't seem important. The thread is about the final 15 pounds of weight. I got rid of the excess-excess fat. Now I want to get rid of the excess fat, not the excess excess, just the normal excess.

Now, as to whether Eat Less Move More works:

Yes it does. A long time ago I lost 40 pounds on that type of diet. However, I was in school, and could afford to blow off classes for almost all of a semester in order to run, swim, and weight-train six days a week with multiple sessions (usually two, but a fair number of triple workouts) per day.

Unfortunately, very few people can spend three hours on exercise a day for six days a week.

And as far as diet: I felt it. I never stopped thinking about food. I dreamed about food. I would be a party, talking to a hot girl, and my mind would be focused singluarly on the canape in her hand, and not in her body.

Just the delicious food she was shoving into her body. I didn't want to be the party weinie her mouth; I wanted to be her mouth.

So, low sex drive. High food drive. Food was far more tempting and erotic.

It was pretty grueling, and it was entirely unsustainable. I suppose I could have maintained this weight level (somewhere around 170 -- svelte and lean for me, normal weight for others) if I did the occasional "triple" (run five miles/swim a mile/weight train) and otherwise kept up the 2-3 hours of exercise per day for six days a week regime.

But who can? No one except professional athletes whose work day consists of such training could.

Yes, Eat Less Move More will in fact work -- for a while. But you simply cannot exert yourself that much forever -- not when you have a job -- and you really cannot live with the gnawing, stressful feeling of always being hungry every single hour of every single day.

The effectiveness of a regime depends greatly on adherence to the regime. If you can't adhere to it, it simply won't work -- even if the math of calories in calories out looks good on paper.

Thorazine is very effective at keeping schizophrenics mentally normal -- except the fact that it zeroes them out and makes them feel like zombies and they stop taking thorazine the moment the doctor isn't looking.

For that matter, an actual starvation "diet" -- not the semi-starvation diet recommended by doctors, but a genuine starvation diet -- will also cause you to lose a lot of weight. As it must, of course.

Like this guy. He did not eat for over a year, except for potassium supplements and multivitamins.

Did it work? Of course. It must. He wasn't eating. He had to burn fat or die.

In 1965, an extremely obese 27-year-old male, weighing in at 456 pounds fasted for 382 days (one year and 17 days) and lost 275.5 pounds.

Doctors from the University of Dundee monitored his condition throughout his fast. During his fast, he obese man recorded low glucose levels for 100 days and defecated every 40 to 50 days. He was given potassium tablets to keep his heart healthy and multi-vitamins every day.

However, while that undeniably worked (and would work, for anyone else who tries it) -- who can realistically adhere to that diet of simply not eating?

Yeah he lost 275 pounds -- because he did not eat any food for 382 days.

The semi-starvation diet promoted by doctors is kind of the same thing. You're going to be hungry all the time. You're going to have low energy. You're going to be mentally fuzzy -- not just because you're distracted by the discomfort of craving food, but because your brain is in an energy-restricted state.

And there are other problems, too -- because the body fights to keep weight on, even when you're eating a low number of calories, by reducing the amount of energy you expend during the day and night.

One of the Biggest Loser contestants was asked why there are no Biggest Losers Reunion Shows. They'd be good for ratings, right? People love reality tv show reunions.

The reason there are no reunion shows, this contestant said, is because all of the returning contestants are fat again, and this would be bad for the show's ratings overall.

Jason Fung looked at the data and saw that, in fact, almost every Biggest Loser contestant -- who lost a lot of weight on a somewhat extreme Eat Less Move More plan -- had gained almost all of their weight back.

Why? Because when the body doesn't have a lot of calories coming in, it begins instituting cutbacks in the energy expended.

So why did all those Biggest Loser contestants gain all their weight back after 6 months? Why do all the Eat Less Move More patients gain all their weight back after 6 months? This is essentially the same question. The simple answer is that metabolic adaptations cause that regain. Specifically, metabolism slows down in response to Caloric Reduction. You start to burn less energy. Your metabolism shuts down.

Letís see what happened to the Biggest Losers. Virtually all of the contestants slowed down their Resting Metabolic Rates (RMR). The energy they use over 24 hours doing no exercise drops significantly. This is energy that is needed to keep the heart pumping, the lungs breathing, your brain thinking, your kidneys detoxing etc. Ė your basic metabolism. It drops. Like a piano out of a 20 storey building.

To give you a sense of the magnitude of the drop, from start to week 30, the RMR dropped by 789 calories on average. Now thatís not quite accurate, because as your body weight drops, the RMR is also expected to drop. That is, carrying around all that extra fat still takes some energy. If you correct for this weight loss related drop in RMR, though, there is still an excess of 504 calories drop. That is, their metabolism is burning 500 calories less per day than expected correcting for their new, lower weight.BiggestLoser4

But canít you make up for this decreased in RMR by increasing exercise? Well, no. Despite a massive increase in the amount of exercise performed by contestants, it was simply not enough to overcome the drastic slowdown in metabolism.

Once you stop having Jillian Michaels screaming in your ear about how she doesnít care if you die on the treadmill, the amount of exercise gradually decreases which further exacerbates the weight regain. From week 6 to week 30, physical exertion goes down. But resting energy expenditure (your metabolism) continues its slide downhill. A double whammy.

As you start burning less energy at rest and burn less energy doing exercise, you get the very familiar weight plateau. The weight loss simply stops because your body has shut down to match the lowered caloric intake. Once expenditure drops below intake, you start the even more familiar weight regain. Ba Bam! Weight regain. Goodbye reunion show."

You can read more about the Biggest Loser contestants' re-gain here. The New York Times article about the contestants' re-gains is here.

It's not just that you wind up moving less -- as zombie pointed out, someone with a truly heroic level of willpower could force himself, despite every instinct in his body, to keep exercising despite a reduced caloric intake.

The trouble is, the body doesn't just spend its energy budget on purposeful movement. It spends it on almost-involuntary movement.

Ever notice that thin people are often fidgety? They're expending calories during the day just by tapping their fingers and pumping their knees up and down at their desk.

I've tried to do that -- on a voluntary basis. I've tried to will myself to be fidgety like a thin person.

Doesn't work. You can't make yourself do something that is essentially an involuntary motor response.

And when the body metabolism slows, it also cuts the budget of a very, very big part of the energy expenditure business -- maintaining core body temperature. A huge amount of anyone's incoming calories are burned simply to maintain their body temperature -- people lose weight in cold climates, for example. (If they're actually exposed to the elements and must work outside. If they're just sitting inside in a warm room, they won't lose weight.)

And there's no amount of willpower a person can use to force his hypothalamus to not cut his core body temperature from, say, an average of 98.6 down to 98.2 as it attempts to economize on the stingy number of calories it has to spend on basic metabolic functions.

You'll live at 98.2 with no problem -- but you might feel cold. And you will also, without quite knowing why, find that cutting your calories by 500 per day is no longer causing weight loss.

Like Jason Fung says -- if you have to take a drastic pay cut, from $100,000 to $50,000, do you think you'll keep spending money as if you were making $100,000? For a little while -- and that's where you'll actually get your weight loss, when you're taking in $50,000 in calories but still spending at the $100,000 rate.

But little by little, you'll adapt to this new change in budget. Your body will tighten its calorie budget belt, and the effect in the real world will be that you're no longer tightening your actual belt around your pants. Your body will have found a new equilibrium at minus 500 calories, and that will be your new just-maintaining weight.

Point is, Fung's recommendation of Low Carb High Fat combined with short duration starvation (the intermittent fast) is designed to keep your metabolism up at the $100,000 rate, while actually on the $50,000 budget.

And if you stay on that long enough -- even while only losing a half a pound of fat per week -- you will reach your goal weight, in time.

And that's the trick -- time.

This plan seems easier to maintain, so I have hopes I can stay on it.

But we'll have to see. I'm experimenting with this. I don't have the data collected yet.

They say that war comes down to three things: Willpower, firepower, and staying power.

Eat Less is willpower, Move More is firepower.

But it's hard to maintain staying power on this regime, and any serious weight loss that really sticks is going to take at least a year's worth of staying power.

Staying power is everything, I think. You can't just lose weight and then go back to your old patterns of overeating and under-moving and expect you'll maintain at your lower weight. You won't. You'll regain.

To actually do the trick, you have to stick with it for a year or two or, ideally, the rest of your life.

I think Fung's regime is sustainable forever. Oh I slip up here and there, and I get lazy and I get indulgent, but I've kept at this now for, I don't know, six months or so, and it's not getting harder. It's not particularly hard at all. It's a bit hard, but not Oh God I Need to Eat Now hard.

But as long as one stays motivated and accountable -- which is the whole point of this thread for me, to sort of embarrass myself into staying strict -- I think it can be maintained.

Will it work? Eh, I know the Low Carb High Fat thing works. I know Intermittent Fasting certainly seems to make it work more.

But can I sustain it until I'm actually at my goal weight at around 165 or so?

I don't know. I do know the pure Eat Less Move More plan will not work past 60 or 90 says, because it's just too hard to maintain.

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posted by Ace at 05:37 PM

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