I don't have to personally agree with every word that another person says
to appreciate and enjoy their viewpoint. 
And, every so often, I run across an article in someone else's blog that is so amusing and clever,
that despite any minor points with which I might personally disagree,  I wish I'd written it myself.
Here's an example that I find worth memorializing at DietHobby:

........QUOTE.......
  "The weight loss conundrum

Disclaimer: this post expresses my personal opinions. Fancy that. On my personal blog too. And guess what, this opinion may even be different to yours. You can let me know if you agree or disagree with the views expressed here. You might even go as far as to tell me that I am wrong. I may or may not care about that. Enjoy reading.

Phew. Now that we got that out of the way let’s talk weight loss. Everyone on the internet knows that the best way to get traffic is to tag your pearls of wisdom “weight loss tips” and “Jessica Biel’s diet secrets”. I have neither. Sorry. But this post was mostly brought on by the frustration that the topic of losing body mass is still a priority not just in conventional women’s magazines but in the ancestral health community.

You know the one: “Yes, I’ve given up grains because Robb Wolf told me to, I don’t eat refined carbs after reading Gary Taubes, I stopped sugar after watching that Lustig’s video and I force down a tablespoon of fermented cod liver oil since attending Weston A.Price conference. I feel great but… How do I lose another 10kgs?”
And of course there is no shortage of available experts on the interwebz:

- eat less carbs
- eat more safe starches
- introduce interval training
- stop HIIT to salvage your burned out adrenals
- eat sauerkraut for healthy gut
- calories don’t matter
- calories matter
- start IF
- use FitDay to track your daily intake
et cetera.

It’s all very sad.

In the meantime the average long term success of most weight loss strategies is around 1%. Yeah, sure, most people do it wrong. They choose the wrong diet (Lemon Detox, anyone?), they choose the worst possible exercise (if you are a female with a cup size C and above, for god’s sake stop running). And they just don’t have the willpower that the new dieter has (sarcasm font). Because the new dieter knows that he/she will be different. I will be in that 1% who does it right and stays skinny ever after. The End.

There are numerous reasons why weight loss strategies fail. And there are numerous reasons why they succeed. Temporarily. You can lose weight in literally thousands of different ways: Paleo, low fat, low carb, low calorie, ketogenic, vegetarian, aerobic exercise, HIIT, IF, bariatric surgery, liposuction…

That’s why the to and fro arguments on which approach is better for weight loss is kinda pointless. YES! YOU CAN LOSE WEIGHT EATING MARS BARS AND DRINKING COKE! (feel free to leave this page at this point and celebrate).

We have this love and hate relationship with a number that determines our body mass. Lily Allen famously said: “And everything’s cool as long as I’m getting thinner”. There is another number that we have become very preoccupied with in the last few decades: serum cholesterol. Chasing that number (down) is the name of the game, mostly by pharmacological means. Of course, you could tilt this snow globe upside down and decide that the number per se is not very meaningful and in fact represents some other pathological process in the body. Ideally you would choose an intervention that both addresses the cause of the problem and pushes that number in the direction you want. A nutrient-rich diet free of processed junk and pro-inflammatory toxins accompanied by reasonable physical activity is likely to address the chronic inflammatory state that leads to dyslipidaemia and therefore drop the dreaded cholesterol numbers down and please your conscientious doctor.

But sometimes it doesn’t get you to the magic 5.5 mmols that your doctor wants to see. Just like your 6 month foray into the Paleo diet fails to get you to that elusive number that determines your weight, size and consequently happiness. Time to go on PaleoHacks and shout for help.

I am not having a go at the desire to be slimmer. Sure, I wouldn’t mind losing a few kgs. I also wouldn’t mind losing my freckles or having bigger hands (it sucks trying to find surgical gloves that fit). Neither affects my sense of self worth.

So for what it’s worth, these are my ideas in relation to weight loss (note, doesn’t say FOR weight loss):

I am overweight? Oh thank you, kind sir, I wish I knew this earlier!
Let me just switch to a healthy diet and start running.

1. If your primary focus is weight loss you are already behind the eighth ball. If being skinny was a powerful motivator we wouldn’t have 2/3rds of the Western world overweight or obese. Wanting to lose weight tends to screw with people’s heads even with the best foundation: they start stressing (excess cortisol=bad), they start reducing/counting/starving/hating their bland food/exercising at 5am and generally stop listening to their bodies.

Things are quite different when you eat to nourish every cell in your body. Shift your focus to wellness and flip the switch.

1a Unless you have congestive heart failure or chronic kidney disease, chuck your scales. Like now. Get up and throw them in the bin.

2. Start with having a nutrient-rich diet and get rid of junk. Use whatever framework takes your fancy: Paleo, primal, perfect health diet, whole30, Mediterranean, vegetarian (gasp! ). Minimize the “healthy” versions of unhealthy food, you don’t want any food holding you emotionally hostage.

Until you have that down pat, forget the words “Do you have these pants in a smaller size?”

3. Find a regular consistent physical activity you enjoy. I know exercise is supposed to be about torture. That’s ok if you enjoy torture, no judgement here. Do something you can see yourself doing regularly in a year. Or five.

3a. Do not ramp up the volume/intensity of the said activity to accelerate weight loss beyond the level you see yourself comfortably doing long term. Did I hear you say “bootcamp”? Pfft.

4. You cannot fix self esteem issues with weight loss. The two have very little to do with each other.

4a. In the same vein, having weight loss as a dangling carrot in the future can derail your enjoyment of today. Don’t put off activities, clothes or happiness until you get thinner. See point 1.

5. It seems that the thoughts of weight loss frequently return when people are still longing for a six pack in spite of measurable improvements in their physical and mental health. This is where we hit a little snag.

Let’s say you start off in the obese category. Up to a certain point weight loss and health gains go together. Then you reach a state where your body is happy, healthy and well-nourished. To lose more subcutaneous fat from this point will not gain any further health benefit. In fact, you may dip down into negative territory. If you are body builder, dancer, gymnast or any athlete dependent on low body mass this is the risk you have to take. If you are a suburban mother of 2, disappointed she doesn’t look like her graduation photo any longer, you may be playing a dangerous game. If you still choose to continue down this path that’s cool. Your choice. It’s way harder to shift the happy-healthy weight so you may have to pull out all stops. Some of those deviate even further from the path to long term health and wellness. Obviously if you are naturally lean and small you have to flip this scenario 180 degrees. Getting massive past the point of diminishing returns may not be optimal for your body either.

When I see an obese patient I do not have an overwhelming desire to help them lose fat. To me their weight is nothing more but an external manifestation of serious internal issues. I worry about their risk of heart disease, diabetes, Alzheimer’s and autoimmune conditions. I feel the same level of concerns for the skinny-fat: normal BMI with little muscle and obvious visceral adiposity.

Incredibly sexist and quite offensive to naturally thin women.
However we don’t think twice when the ads are turned the other way around.

For a health-conscious and somewhat rebellious community we are still remarkably superficial and eager to conform to the current body image stereotype."
               by Anastasia on Primalmeded.com

   All good points that are certainly worth consideration.

A strange and all too common phenomenon is the way a person, who is has never been very far beyond the borderline of the obesity range, loses around 20 to 30 lbs and suddenly becomes an expert on dieting and obesity.

These people take their personal experience with minor weight loss.. (which of course, might be MAJOR to them personally)… and decide that whatever worked for them ought to work for everyone, and that clearly the solution to the weight issue is easy, because “hey, if they can do it, so can anyone”.

This is like someone who has just finished their first piano lesson telling others about how to become a concert pianist.  It’s like asking someone without cancer how they prevented cancer in their own body, and then using those lessons to treat cancer patients.

I say to such a person:

"Congratulations on your weight loss. I'm sure it's significant to you. But you do not have the same issues that a person with 100 or 200 pounds to lose frequently has."

It’s almost amusing how everyone feels they have an “expert” opinion to share with someone who is trying to lose weight. Even people who have never had a weight problem tend to assume that they are doing something that fat people aren't doing, and therefore they also know the solution to obesity.

There are many naturally slim people (some of them who are even doctors or nutritionists) who truly think obese people are just ignorant, greedy, and lazy. After all, they, themselves, have slim bodies which stay slim by "occasionally taking walks and not eating entire gallons of ice cream in one sitting."  Especially, those who have mediocre processed food diets, and are borderline sedentary, are very quick to assume that obese people must have VERY bad habits.

Anyone who truly believes that people who continually struggle with weight issues are simply missing the information, personal desire, and sense of personal responsibility it takes to succeed, is showing that they don't have a grasp on what it really is, to struggle with a great deal of excess weight, nor an understanding of obesity’s difficult issues. The "eat-less-move-more formula," for a morbidly obese person, is frequently far more complex than even the majority of medical professionals make it out to be.

The habits as outlined in the National Weight Registry Control research – which appear necessary for the majority who succeed at weight-loss maintenance, …. such as daily weighing, calorie counting, lots of exercise etc….. are the same behaviors that are castigated by those medical professionals who involve themselves with treatment of “Eating Disorders”. And yet there is an immense amount of proof that if a reduced obese person stops self-monitoring and making immediate corrections, the weight comes back on without fail.

Many people find it easy to lose a bit of weight, but the body fights back, so very few are able to do what it takes to keep it off.  Invariably when I read "inspiring" weight loss stories in the popular media, 99% of those profiled haven't even made it to the 5-year maintenance mark. When .. and if ... they get there, I’d like to hear about it. Also, please tell me what society you can live in where normal sized people don't feel compelled to shame fat people. I'd like to move there.

Sometimes doing what it take for weight-loss maintenance feels like a dreary way to live. My own position is: “Being Fat is Hard. Losing Weight is Hard. Maintaining Weight is Hard. Choose Your Hard.”

Weight loss is difficult and often complex, no matter how determined you are.
As a reduced obese person who is now maintaining a large weight-loss, I am well aware that obese people sometimes make excuses and wallow in self-pity instead of doing things that they “know” will be effective in decreasing weight. Many people spend decades looking for the magic of an easy way, while in basic denial of the simple truth that eating less calories than you burn will …in most cases…. lead to weight loss.  Truthfully, it is very hard to believe how few calories an obese person actually burns, because for many, the Scientific Theory that 3500 calories equals 1 fat lb just doesn't always hold true for everyone at every weight.

More precisely, it's not that we fat people need to hear this from others - after all, what fat person hasn't already heard it a thousand times?. Rather, it's something that many of us need to take to heart once and for all, instead of continually ignoring/denying the Reality of the difficulty of the consistent, ongoing, lifetime effort it is really going to take.

Eat less calories than we burn.  However, how do we individually DO that?
And then, … how do we do it consistently, FOREVER?
Obesity can't be treated with a one-size-fits-all solution. We are not cookie cutter people and what works for one person won't necessarily work for another. How great it would be if everyone could truely take to heart the message within the video below.

                                            
I am certain that there is NO One-Right-Way to lose weight.
However there are plenty of wrong ways,
and what's right for one person is almost certainly wrong for another.

My body doesn’t provide me with the ability to eat intuitively. I put every bit of food that goes into my mouth into my computer food journal. I also use my food journal to help guide me in my decisions of what to eat. I see looking at the calories ..and other nutrients…when I eat as like looking at price tags when I shop. Just like price isn't the only consideration when shopping, neither are calories the only consideration when eating. Food is also in my life to celebrate and comfort, and therefore knowing the amount of calories doesn't always lead to low-calorie choices.

Brian Wansink is a brilliant researcher based out of Cornell whose life's work revolves around mindless eating. His recent research study determined that consuming crackers from 100 calorie packs vs. large bags, cut consumed calories by 25%.

I’ve noted that tracking in a computer food journal protects me against mindless eating by allowing for the use of calories in decision making. There are people who feel that you don't need to count calories to eat mindfully, and that there are other ways of journaling, and that one is better served by paying attention to how one’s body feels, and/or to one’s psychological state.

So who's right? Should one eat intuitively, or should one count calories? And looking at an even larger picture, should one do low-carb, slow-carb or low-fat? Should one include cheat days or no-cheat days? Should there be forbidden foods, or should everything be allowable? These questions could go on and on.

I’m a member of The National Weight Control Registry … which is the world's largest prospective study of people who have been successful with long-term weight management. It tracks how people have lost weight before they register within the program. The average registrant has lost about 65 pounds and kept it off for more than five years. The Registry’s records indicate that while there are some behaviours which are shared by a large majority of registrants, …such as eating breakfast and exercising, … there is an enormous variety in the way each of these registrants' manage their own weight.

As of today, Amazon.com has more than 71,000 titles with the word, "diet" in them. And truthfully, each of these diets probably all 'work' for someone. However, many of these diets will probably provide a temporary result only, because one needs to actually like the way one lives in order to keep living ..or weighing .. that way.

I agree with Dr. Yoni Freedhoff, MD when he says :

“It's about living the healthiest life that you can enjoy, not the healthiest life that you can tolerate, because if your life is simply tolerable, you're not likely to keep living that way. To take an extreme example, while becoming a teetotaling, vegan, shut-in, marathon runner might well help you to manage your weight, is that a life you'd be willing, or even able, to live with forever?”

One’s bodyweight involves many different variables. Some of these are within our control, and some are not. There are some things in our lives that we can change to help manage our weight, but there are also some things in our lives, which affect our weight, that we either won't be able, … or won't be willing,…to change.

We can use our scale numbers … weight, body mass index, body-fat percentage…. to see where we are in life, and to decide whether or not to Diet. But it can be a mistake to set detailed and arbitrary goals based on those specific numbers, because the ultimate goal that we actually need is to live the healthiest life that we can enjoy.

There is no point in trying to live a life that we can't sustain. The personal cost of reaching and maintaining some table's definition of “ideal” might be too high for some of us. We are rightfully proud and satisfied with our personal best in every other area of our lives, and our personal best is also good enough weight wise.

So if you want to lose-weight, or maintain weight-loss, which diet should you choose?
Whatever works for you. Whatever you can honestly see yourself doing for the rest of your life. If there were only One right way, we'd all be doing it.

Here at DietHobby, I share my own experiences and opinions as I work to maintain a very large weight-loss. I am now in the 7th year of maintaining at normal weight after spending much of my lifetime in morbid obesity.  Those who are interested can see more details in the ABOUT ME section under RESOURCES.  Recently I posted detailed records of my average food intake together with a summary of my weights during those periods. See Records: My Past 8 years. 

One of the things I've personally discovered from my own experience is that weight maintenance is very difficult, and it takes an enormous amount of ongoing, consistent effort.   When I first reached my goal weight, I had some vague idea from things I'd read, that the first 5 years of maintenance were the most difficult, and if and when I could achieve that point, it would become much easier. 

In my own case, I have discovered this not to be true.  Even though the first couple of maintenance years were difficult, the subsequent years became MORE difficult.  Maintenance did not become easier after 5 years, and I can honestly say that here in my 7th year, maintenance is more difficult than it has ever been. 

My detailed records confirm my subjective experience that .... not only do I need to eat fewer calories than the BMR or RMR charts indicate to maintain the same weight, ..... but, when I raise my daily average calorie intake ... even slightly for a brief time, or for a lengthy time period... I gain weight.  However, for the time period of the past 3 to 5 years, I've discovered that decreasing that average calorie intake to the same extent, does not cause a corresponding weight-loss. 

As an example.... if we use conventional wisdom, and assume that an excess or deficit of 3500 calories = a 1 lb fat loss....my detailed daily food-intake and weight records indicate that during the past 3 to 5 years,  if I eat an excess of 3500 calories I will definitely gain 1 lb fat, however, when I eat a deficit of 3500 calories I will NOT lose 1 fat lb.  In actuality, the 3500 calorie calculation appears to no longer be applicable to my body.  Water weight aside, and referring to fat weight only, it appears that it takes far less excess calories for me to gain 1 fat lb, and that it takes a far greater calorie deficit for me to lose 1 fat lb.  During the past 5 years, I've run many personal experiments testing this particular issue (even using different micronutrients), and each time, my results have confirmed this to be true for my own individual body.
Not only is this a frustrating condition, it is one that almost no medical professional addresses.   Probably, this is reasonable, because there is no actual scientific research on formerly obese people who have lost large amounts of weight, and have maintained it for long time periods.  I personally, am a member of the National Weight Loss Registry, and I have discovered how little data exists about this matter.

There's not much information available on this issue, so I was pleased to discover the following article by Dr. Arya Sharma, M.D.

Why Diet and Exercise is Not a Treatment for Obesity

If going on a diet or starting an exercise program resulted in persistent weight loss, we would not have an obesity epidemic.

Unfortunately, as anyone who has tried this knows, maintaining a significant degree of weight loss requires daily dedication, motivation and a limitless supply of will power - nothing short of developing a compulsive obsession.

As readers will recall, the biology of the post-weight loss state is nothing like the biology of someone who has never lost weight. There are countless ways in which the psychoneurobiology, energy physiology and metabolism in anyone who has lost weight are remarkably different from someone ‘naturally’ of that weight.

Simply stated, someone who was 150 lbs and has lost 20 lbs cannot hope to maintain that weight loss by simply eating the same amount of food or doing the same amount of exercise as someone who is ‘naturally’ a 130 lbs.

The 150 lbs person who has lost 20 lbs, to maintain their new 130 lbs, has to actually now live like someone who is ‘naturally’ a 110 lbs; just eating like someone who is 130 lbs but has never lost weight, will simply result in rapid weight regain.

This is why just cutting out a few ‘extra’ calories or walking a few ‘extra’ steps is not an effective or sustainable strategy for maintaining weight loss - for any clinically meaningful weight loss (when indicated) - we are looking at cutting hundreds of calories from the diet and adding hours of serious exercise per week - forever!

A comprehensive and fascinating overview of the fundamental changes that occur with weight loss to ultimately make sustaining this new weight an ongoing challenge, is discussed by Paul Maclean and colleagues from the University of Denver Colorado, in a paper just published in the American Journal of Physiology.

The authors provide a detailed synthesis of data from a wide range of weight loss studies that include studies in clinically overweight and obese adults, in diet-induced, polygenic animal models of obesity, and with dietary (non-surgical) interventions involving an energy restricted low fat diet.

The consistent finding from all such studies is that all individuals or animals in a post-weight-loss state face considerable ‘homeostatic pressure’ that aims to drive their weight back to initial levels.

The paper extensively discusses how changes in biological signals of fat stores (e.g. leptin) elicit profound metabolic and behavioral adaptations.

The key findings of increased hunger and appetite, reduced satiety and substantially increased ‘fuel efficiency’ have very real underlying biological drivers - drivers powerful enough to ultimately wear down even the most persistent dieter.

As the authors point out - persistent dieting is so difficult because it requires maintaining a remarkably large ‘energy gap’:

“Because both sides of the energy balance equation are affected after weight loss, the biological pressure to gain weight is a consequence of both increased appetite and suppressed energy expenditure.

During weight maintenance after weight loss, this energy gap reflects the magnitude of the daily burden that thwarts cognitive efforts to maintain the reduced weight.

Regardless of which side of the energy balance equation is most affected, the energy gap imparts a substantial pressure to eat in excess of the energy requirements.

The magnitude of the energy gap is greatest at the nadir weight after weight loss. Likewise, this energy gap does not dissipate with time in weight maintenance. Rather, studies in DIO (diet induced obesity) models indicate that the magnitude of the energy gap gradually increases the longer they maintain their reduced weight with an energy restricted diet .

The implications from these observations are that the biological pressures may strengthen with time and the amount of lost weight, gradually increasing their perceived influence.”

The paper also extensively discusses some of the lesser known metabolic adaptations to weight loss including profound changes in gut biology that enhance caloric extraction from food as well as alterations in liver function, skeletal muscle and fat tissue that promote weight regain.

While all of this may seem hopeless to readers, the authors actually end on the rather positive note that:

“… only by acknowledging that these homeostatic pressures emerge, we can proactively develop and implement regain prevention strategies to counter their influence. To ensure success, the regain prevention strategies will likely need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter.”

Obviously, it is also important to note, that no ‘weight-loss strategy” actually addresses the many complex reasons why people may gain weight in the first place.

Whoever said that treating obesity was simply a matter of ‘eating less and moving more’ (ELMM) probably also believes that they can live forever by simply breathing less.

AMS
Burlington, Ontario
Maclean PS, Bergouignan A, Cornier MA, & Jackman MR (2011). Biology’s Response to Dieting: the Impetus for Weight Regain. American journal of physiology. Regulatory, integrative and comparative physiology PMID: 21677272

Dr. Sharma’s Obesity Notes
Dr Arya Sharma, M.D.  -   www.drsharma.ca

 I, personally, have proven that it is possible to achieve a large weight-loss and to maintain the majority of that loss for at least  7 years.  However,  it is true that ... for me... this has required  "daily dedication, motivation and a limitless supply of will power - nothing short of developing a compulsive obsession".  I've also found it true that in order to achieve the maintenance of normal weight, my "regain prevention strategies" have had to be very "comprehensive, persistent, and redundant".

I have found weight-loss to be difficult, and maintenance of that weight-loss to be even more difficult.  Nevertheless, for me personally, I find this to be worthwhile, and I intend to continue on with my maintenance efforts.  And, I'm going to do my best to make my continued and consistent efforts as enjoyable as possible.

Losing weight needs time, patience, and consistency in eating less food than one's body uses. Maintaining weight-loss also requires time, patience, and consistency in eating ONLY the amount of food that one's body uses. The sad fact is that most people give up before they've even barely begun. There are always lots of people starting and giving up diets, and many more coming up behind them to do the same thing.

We are now so used to the instant gratification that comes in so many areas of our modern life, that a part of us can't help but expect it to also apply to the size of our bodies, so we become disenchanted when the first few days of a diet doesn't bring much by the way of a result on the appearance or size of our bodies. It has been such hard work, why hasn't it made any difference?

Dieting needs Time, Patience, and Consistent Effort, three things that are in short supply nowadays. Regrettably many people are just not inclined to participate in the long run, they want results, and they want them NOW. That's just not going to happen.

We can be successful at losing weight, and at maintaining weight-loss
…but only with Time, Patience, and Consistent Effort.