Tuesday, May 10, 2016

The Problem with the Biggest Losers

Three years ago a group of us at work did our own version of "The Biggest Loser," the popular TV reality show that gets highly obese people to lose a lot of weight. None of us were at the level of obesity seen on TV. Some of us even had a relatively healthy habit of exercise when we started the competition. We did all need to lose weight, though.

Over the next several months we did our weigh-ins and kept doing whatever we each wanted to do to lose the weight. I cut back my sugar consumption, added a boost to my exercise, and counted calories. I was successful. I placed second in the group. I had started at 211 and, over the two months I lost around 25 pounds. I continued on my regimen. By November 2013 I was at 176 pounds.

Two things happened then.

1- I semi-retired and got out of what had been an almost daily six-year habit of exercise because I was no longer working every day.
2- I had a minor surgery that slowed me down a little.
The results:
  • By March 2014 I was consistently above 185: +10 pounds in 4 months.
  • I went over 190 for the first time in mid-year 2014.
  • By May 2015 it was 203.
  • My cholesterol and blood sugar crept back up to borderline levels by Fall 2015
  • I peaked in March 2016 at 214. Back up 38 pounds. 
With all this in mind I saw the news articles last week on a study of "Biggest Loser" TV participants:
"Biggest Loser" study: Why keeping weight off is so hard
Here's a little bit as reported by CBS News:
It's well known among obesity experts that when people lose weight, their resting metabolic rate slows, meaning they burn fewer calories while at rest. Their rate is often slower than it would be compared to other people of the same size who hadn't lost a lot of weight.

"The phenomenon is called 'metabolic adaptation' or 'adaptive thermogenesis,' and it acts to counter weight loss and is thought to contribute to weight regain," wrote the authors, researchers from the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health (NIH), in Bethesda, Maryland.

To learn more, using blood, urine and other tests, they calculated the resting metabolic rate and body composition changes in Season 8 contestants six years after the end of the weight loss competition.
The results are both shocking and not surprising with even the small, personal anecdotal evidence in my own situation:
...only one of the 14 contestants succeeded in maintaining their slimmer weight. The rest regained a significant amount of the weight lost during the competition, and their resting metabolic rates (RMR) remained unusually low.

And obesity experts said it supports previous research and what they've seen in their patient populations -- that it's really hard for people who've been obese and then lose a lot of weight to maintain their lower weight, or to lose weight again after they've buoyed back up to a higher weight.

I know I have faced the problem talked about above. Along with the medical findings I have seen two other factors involved:
  • Judgement of others who wonder why you can't exercise will-power. This breeds our own self-esteem issues as we buy into it. We wonder why we are so weak and powerless.Then the second factor kicks in:
  • Instant gratification. We want to lose the weight quickly. We can't be patient and let it be a slow, daily process. That is partly because slow daily progress only shows up in the long-term, the big picture that few of us are able to sustain.
In the end we become losers at being The Loser.

It may very well be that we have been pursuing the wrong goals or missing some important points. Back to the news articles:
Dr. William Yancy, director of the Duke Diet and Fitness Center, said "The Biggest Loser" perpetuates the idea that the recipe for weight loss is simple: diet and exercise and you can drop the weight. But he said the study helps show how much more complicated an equation it is to keep the weight off for the long term.

"There's that constant mentality that if you diet and exercise to lose weight it can be fixed. But it's a lifelong challenge and we've struggled really hard to make it be seen like diabetes, that it [obesity] needs to be treated like a chronic illness," said Yancy.

He said that he's seen people manage to keep the weight off when they've approached obesity with the attitude that it's a chronic illness.
Yes, I realize the danger in making everything into a "disease" or "illness." That can easily become a cop-out, a reason to give up and just keep on eating and gaining. It is the issue that I have faced every day for the last 27+ years with addiction and alcoholism, both personally in recovery and professionally as a counselor. It can lead to a denial of responsibility and a fatalism that can be truly fatal.

What if our ability to lose weight and keep it off IS an illness? Well, I don't know the details of how that works, per se, but I do know how it works with addiction. As a result I also know that there is a key element that we need to bear in mind.

Responsibility. I am not a victim of my disease.

As a recovering person I have the responsibility (!) of daily managing my disease of addiction. I have to:
  • take responsibility for the actions I take each day 
  • live in a way that allows for daily management of my symptoms and
  • be willing to change my lifestyle to deal with the symptoms and the consequences of my disease.
This could be a description of the disease of not being able to keep the weight off, a disease that could be called pre-obesity or food-ism. I have to give it a name that is meaningful to me and describes my situation. Borderline obesity and borderline diabetes could be my description of it in my situation. It is not a disease of will-power. It is, as indicated above in the studies of the Biggest Loser participants, a disease of metabolism. Just losing the weight doesn't change the metabolic system very quickly, if at all.

I am not sure at this point where all this takes me. I can, however, begin to apply what I know about addiction and see if it works. Things like "turning it over" and daily prayer and meditation. It could be things like awareness of triggers and urges- cravings- and the many ways I have discovered and used over 27 years to deal with chemical cravings. It may be as basic (though not simple) as "easy does it" and "one day at a time."
  • For today I will practice a different lifestyle.
  • For today I will be aware of the urges to eat in unhealthy ways
  • For today I will ask for help and support to deal with stressors
  • For today I will be grateful for the healthy opportunities ahead of me
  • For today I will be good to myself, not allowing my impatience to overcome my daily movement toward health.
There are probably more that I could add. But that's a start.

Link to CBS News article referenced above.

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