Is Long-Term Weight Loss Possible?

Headlines appeared in the health section last week, which had the result of discouraging millions of people. The news?

“Obesity research confirms long-term weight loss almost impossible”

Only about five per cent of people who try to lose weight ultimately succeed, according to the research. Many people will take the weight off, but only about 5% of those keep it off for more than 5 years.Caucasian woman's feet jumping on scale

The latest research is also showing us that our bodies are hard-wired to gain weight and are strongly resistant to losing weight. We have evolved into these effective fat-making machines in order to survive in times of hardship and scarcity.  However, scarcity of cheap and easy calories is a relic from the past for the vast majority of North Americans.

Our appetite and metabolism are finely regulated through a complex relationship of various hormones including leptin, ghrelin, cortisol, insulin, obestatin, peptide YY among others.

The relatively recent discovery of leptin was greeted with excitement and anticipation in the scientific world. Leptin is made in the fat cells and signals to the brain to “stop eating”. It is our “I’m full hormone”. The flip side of leptin is ghrelin, which is synthesized in our stomach cells and tells the brain when we are hungry (“start eating” hormone). Overweight or obese people tend to have high circulating levels of leptin. As they lose weight, leptin levels drop and ghrelin levels rise. One study out of Australia showed that after one year of maintaining a 10% weight loss, the subjects still had low levels of leptin and higher levels of ghrelin. Many concluded that it was as if the body was trying to put weight back on.

So are the overweight doomed to be forever overweight?Large woman checking her weight on a scale. She seems disappointed.

Not so fast. Before we come to hard and fast conclusions on these results; there are some who see a more positive spin on these studies.

Much uncertainty still exists as to the precise mechanisms of action of our hormones and metabolism. One other school of thought is that obese people have high levels of leptin because they are leptin resistant, that is, the fat cells are sending out the signal to stop eating but the brain is not receiving it. As overweight or obese people lose weight, leptin levels are reduced. This may be partially due to the fact that there is less body fat, which is the original source of leptin. However, it may also be due to the fact that our cells are becoming more responsive and sensitive to leptin. Lower levels could reflect a positive sign that the brain is finally getting the message to “stop eating”.

Stack the Cards in Your Favour

No one said weight loss and maintenance were easy (or if they did, they were lying); however, I do not believe it is all doom and gloom and near impossible to make lifelong changes to our body composition.

The causes of obesity are a complex combination of psychosocial, environmental, metabolic and genetic factors. We tend to solely focus on reducing calorie consumption and increasing energy expenditure to lose weight. While important, this singular approach targets only one element of weight gain: eating too much and moving too little.

It is important to stack the cards in your favour and look at all aspects of why people gain weight in the first place in order to devise an effective plan to take that weight off and keep it off.

Psychological Factors:

strawberry flavored doughnut isolated on white

Are you an emotional eater? Many people eat for reasons aside from hunger. It may be due to stress, loneliness, boredom, even happiness where a “calories be damned” attitude takes hold. Getting to the root of this problem is essential before one should move forward with any weight loss plan. Practicing stress relief, writing in a journal, taking up yoga or meditation may be enough for some. Others may need longer term counseling to address emotional eating.

Metabolic Factors:

Sleep, Stress & Mental Health

We like to think it doesn’t matter, but inadequate sleep, chronic stress and depression can all sabotage a weight loss or maintenance plan.Tired woman in bed refusing to wake up

After even one night of bad sleep, our ghrelin levels (“I’m hungry” hormone) rise. Both lack of sleep and stress also elevate our stress hormone (cortisol), which can lead to increased appetite, high blood sugar, and eventually abdominal fat accumulation.

Depression and obesity are intrinsically linked; however, it is a chicken & egg conundrum. We are not sure what came first: the depression that led to weight gain or the weight gain that led to depression. Depression can lead to emotional eating as some foods, especially those high in sugar and fat, do cause a brief release of endorphins and dopamine leading to a “feel good factor”. This in turn can lead to further cravings and bingeing which inevitably result in feelings of regret and shamefulness exacerbating one’s depression.

It is critical that factors such as stress, depression and fatigue are addressed either prior to or while undergoing any weight loss program in order to increase the chances of success.

The Key to Revving up the Metabolism – for life!

Time and time again, we hear of one single factor that can help get the weight off and keep it off. It is not forgoing all carbohydrates, it is not a “cleanse”, it is not a magical supplement from the jungles of the Amazon. It’s exercise people.
E. X. E. R. C. I. S. E.

Exercise has been studied again and again to assess its benefits against multiple health factors. So far, it has been shown to:Woman running on treadmill. Image shot 2011. Exact date unknown.

• build muscle and increase metabolic rate (help with weight loss/maintenance)
• improve our sensitivity to insulin which can help control/ prevent diabetes and help maintain healthy weight
• be our first life of defence against heart disease as it:

  •  lowers blood pressure
  •  increases HDL (good cholesterol)
  •  reduces body fat / helps maintain a healthy weight
  •  reduces stress & anxiety and improves sleep

• improve mood and reduces symptoms of depression
• reduce risk of dementia
• reduce risk of developing certain cancers and help prevent cancer recurrence
• reduce risk and slow the progression of osteoporosis
• improve health outcomes in individuals with chronic kidney disease
• And much much more.

New discoveries are constantly shedding light on how and why exercise benefits our health in multiple ways. A relatively new and exciting line of research involves brown fat. We have both white and brown fat in our bodies. Brown fat’s main function is to generate body heat. 50 grams of white fat can STORE about 300 calories worth of energy. Whereas, 50 grams of brown fat can BURN 300 calories of energy through heat.

It has been shown that those with higher levels of brown fat tend to be leaner than those with lower levels.

So how do we get more of this brown fat?

One way is to keep cool and shiver, but that is not really a lot of fun. The second way is through exercise. Exercise enhances the activity of a newly discovered hormone called irisin. Irisin activates brown fat to make heat from stored energy (thermogenesis) and it has also been shown to convert white fat into brown fat thereby increasing the body’s overall levels of brown fat.

Exercise is the closest thing we have to the “magic bullet” for weight loss. Its benefits extend well beyond calorie burning. Exercise stimulates biochemical reactions in our bodies that induce changes in our metabolism setting ourselves up for weight loss and long term weight maintenance. It must be given the highest priority in those wishing to reach or maintain a healthy weight.

Bottom Line:

The problem with last week’s shocking headlines is that it can lead to a feeling of despondency among those currently trying to lose weight and keep it off. Why choose an apple over a doughnut if our bodies are hard-wired to put the weight back on anyway? In rebuttal to those headlines, I believe there is plenty of hope and plenty of evidence that long-term weight loss can become a reality for anyone.

It most certainly will require a multifaceted approach with due care and attention given to each individual element that factors into why some people gain weight and others don’t. Exercise, mental health, lifestyle choices, emotional eating, social support, sleep, and stress all must be addressed in order to stack the cards in your favour.

Don’t let the headlines get you down. Show them they were wrong.

 

References:

Anastasilakis AD1, et al. Circulating irisin in healthy, young individuals: Day-night rhythm, effects of food intake and exercise, and associations with gender, physical activity, diet and body composition. J Clin Endocrinol Metab. 2014 Jun 10:jc20141367.

Crujeiras AB1, Zulet MA2, Lopez-Legarrea P2, de la Iglesia R2, Pardo M3, Carreira MC3, Martínez JA2, Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients. Metabolism. 2014 Apr;63(4):520-31. doi: 10.1016/j.metabol.2013.12.007. Epub 2013 Dec 18.

Lidell ME, Betz MJ, Enerbäck S.Adipocyte. Two types of brown adipose tissue in humans. 2014 Jan 1;3(1):63-6. doi: 10.4161/adip.26896. Epub 2013 Oct 28.

Myers MG1, Cowley MA, Münzberg H.Mechanisms of leptin action and leptin resistance. Annu Rev Physiol. 2008;70:537-56.

María Pardo, Ana B. Crujeiras, […], and Felipe F. Casanueva. Association of Irisin with Fat Mass, Resting Energy Expenditure, and Daily Activity in Conditions of Extreme Body Mass Index. Int J Endocrnolgy 2014: 857270

Sumithran P1, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J.Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011 Oct 27;365(17):1597-604. doi: 10.1056/NEJMoa1105816.

Tsuchiya Y, Ando D, Goto K, Kiuchi M, Yamakita M, Koyama K. High-Intensity Exercise Causes Greater Irisin Response Compared with Low-Intensity Exercise under Similar Energy Consumption. Tohoku J Exp Med. 2014;233(2):135-40.

 

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