Category Archives: Weight Loss

This May Be Why You’re Not Losing That Weight

Old-school preparation for exercise; stretching actually doesn’t do any good for the average person

You’ll see the term “diet resistant” in the scientific abstract below. It refers to folks who are on a reduced-calorie diet who aren’t losing the weight they should, base on total calorie consumption. Long story short, they’re eating much more than the think and exercising less than they think.

BACKGROUND AND METHODS

Some obese subjects repeatedly fail to lose weight even though they report restricting their caloric intake to less than 1200 kcal per day. We studied two explanations for this apparent resistance to diet — low total energy expenditure and underreporting of caloric intake — in 224 consecutive obese subjects presenting for treatment. Group 1 consisted of nine women and one man with a history of diet resistance in whom we evaluated total energy expenditure and its main thermogenic components and actual energy intake for 14 days by indirect calorimetry and analysis of body composition. Group 2, subgroups of which served as controls in the various evaluations, consisted of 67 women and 13 men with no history of diet resistance.

RESULTS

Total energy expenditure and resting metabolic rate in the subjects with diet resistance (group 1) were within 5 percent of the predicted values for body composition, and there was no significant difference between groups 1 and 2 in the thermic effects of food and exercise. Low energy expenditure was thus excluded as a mechanism of self-reported diet resistance. In contrast, the subjects in group 1 underreported their actual food intake by an average (±SD) of 47±16 percent and overreported their physical activity by 51±75 percent. Although the subjects in group 1 had no distinct psychopathologic characteristics, they perceived a genetic cause for their obesity, used thyroid medication at a high frequency, and described their eating behavior as relatively normal (all P<0.05 as compared with group 2).

CONCLUSIONS

The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis. (N Engl J Med 1992; 327:1893–8.)

Source: Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects | NEJM

3 Comments

Filed under Weight Loss

Diet to Lose Weight, Exercise to Keep It Off

Exercise is more helpful for preventing weight gain than for inducing weight loss

From The New York Times:

It is a question that plagues all who struggle with weight: Why do some of us manage to keep off lost pounds, while others regain them?

Now, a study of 14 participants from the “Biggest Loser” television show provides an answer: physical activity — and much more of it than public health guidelines suggest.

On average, those who managed to maintain a significant weight loss had 80 minutes a day of moderate activity, like walking, or 35 minutes a day of vigorous exercise, like running.

My patients taught me this years ago.

1 Comment

Filed under Exercise, Weight Loss, Weight Regain

Is It True That “Diets Don’t Work”?

3 Comments

Filed under Weight Loss

Can I Do the Newcastle Diet On My Own?

Some of these are Newcastle-compliant

Probably. Also probably not a good idea to fly solo, without personal medical attention.

Here’s a link to details of the diet, which has reversed some cases of type 2 diabetes, prepared by Professor Roy Taylor. Overall, his advice looks pretty reasonable to me. However, with such severe calorie restriction (600-800 cals/day), I think a multivitamin supplement might be a good idea.

Note that Taylor says any reasonable diet that leads to loss of enough excess weight may be just as good as the Newcastle diet.

Steve Parker, M.D.

low-carb mediterranean diet

Front cover of book

 

1 Comment

Filed under Weight Loss

Brown Fat: What’s That?

The Joslin diabetes blog has an interesting article on brown fat and its effect on metabolic rate and insulin sensitivity. Brown fat is just a type of body type different from the more plentiful white fat (which is actually more pale yellow). If there are other colors of body fat, I don’t know.

If you can “activate” your brown fat, it helps you burn more calories, which could be helpful if you’re trying to lose weight. It also improves insulin sensitivity: beneficial if you have type 2 diabetes or are prone to it.

From Joslin:

“When brown fat is fully activated, it can burn between 200 and 300 extra calories per day. It is most successfully activated through cold exposure. A recent study of people with type 2 diabetes had volunteers sit in a 50 degree room for a couple of hours a day for 10 days in shorts and short-sleeved shirts.

“When I say cold, it’s not icy cold, it’s not like the winter in Boston,” she says. “It’s more or less like the temperature we have here in autumn. After this mild cold exposure, all ten volunteers with type 2 diabetes, as shown in that study, displayed increased brown fat activity and improved insulin sensitivity. This is very exciting.”

Dr. Tseng is working on understanding exactly what is happening on a cellular level to activate brown fat in the cold to see if she can create a drug that will mimic the effects. “Although cold works, it’s just not pleasant,” she says. “If you had to sit in a cold room for a few hours every day, perhaps not everybody could accept that.”

Source: How Your Body Temperature Can Affect Your Metabolism | Speaking of Diabetes | The Joslin Blog

Another way to activate brown fat is exercise (at least if you’re a man or a mouse).

Steve Parker, M.D.

2 Comments

Filed under Weight Loss

Over Three Years, Gastric Bypass Beats Intensive Medical Therapy in Obese Type 2 Diabetes

…in terms of weight loss, lowering of HgbA1c, and weight-related quality of life. The specific gastric bypass surgery used in the study is the Roux-en-Y version.

bariatric surgery, Steve Parker MD

Band Gastric Bypass Surgery (not the only type of gastric bypass): very successful at “curing” T2 diabetes if you survive the operation

Average initial weight of participants was 104 kg (229 lb). Bypass patients dropped their weight by 25 kg (55 lb)and HgbA1c decreased by 1.8% (absolute decrease), compared to intensive medical management participants who lost 10.3 kg (32 lb) and dropped HgbA1c only by 0.4%.

I doubt that intensive medical therapy included a low-carb Mediterranean or paleo diet.

Source: Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study | Diabetes Care

 

3 Comments

Filed under Weight Loss

Cut the Crap: Are You Serious About Weight Loss in 2018?

To improve your odds of success, read my series on preparing for weight loss.

Failing to plan is planning to fail.

6 Comments

Filed under Weight Loss