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Old 07-10-2004, 07:20 PM   #1  
Mel
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Default I'm not quite as outraged as Meg was

I'm bring back an old subject that Meg raised a few weeks ago (see thread below :"I'm Outraged") because I've done some more reading and more thought. Here's Meg's original post:
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I’m outraged! Here I am, drinking my coffee and reading the morning paper and what do I see? An article comparing diet plans (it’s been an on-going series since the beginning of the year) http://www.post-gazette.com/pg/04169/332980.stm. No problem until I get to this paragraph:
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What discourages me, though, is something I read in The New York Times on June 8, quoting noted obesity expert Dr. Jeffrey Friedman, who says that "body weight is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion.

"People can exert a level of control over their weight within a 10-, perhaps a 15-pound range," Dr. Friedman said. But expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens, he said. "Any weight that is lost almost invariably comes right back."

Frankly, I think that “noted obesity expert” Jeffrey Friedman can blow it out his you know what …. What kind of message is that, to tell people they’re doomed before they even start?? It becomes a self-fulfilling prophecy.

I’d like to point out that WE have many “noted obesity experts” here, such as Karen, Julie, Jack, Beverly, StarPrincess, Mel, myself, and many others who can tell you that it’s very possible to lose weight and keep it off permanently. In fact, we’re all doing it. So there, Dr. Friedman!
I've been reading the book "The Hungry Gene: the Science of Fat and the Future of Thin" by Ellen Ruppel Shell, and learning more about the aforementioned Dr. Friedman. He really is a noted researcher at Rockefeller University in NY. The NY Times article was a vastly simplified abstract of his findings, but that is the gist of his and others' conclusions. And here's why:

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Mild obesity usually reflects a plumping up of individual fat cells, while more severe obesity, and obesity arising from childhood, is usually manifested by a substantial increase in the number of fat cells: average weight adults have 25 to 30 billion fat cells, while the obese may have as many as 200 billlion....This explains why dieters in his (Hirsch's) obesity clinic at Rockefeller Hospital so oftern hit the "wall"- shrinking fat cells fought back, sending ever more frantic "eat" signals to their brains. Eventually as Keys's starvation experiment had shown with frightening clarity, these signals all but drown out other messages to the brain- and become almost impossible to ignore. A reduced obese person is not the same as another person of the same weight who has never been obese...their brains are different."
(bold is my addition)

(Keys's starvation experiment refered to above, was done on conscientious objectors after the Second World War. It has become known as the "Minnesota Starvation Study". Healthy young men were fed a concentration camp diet to assess the effects on both their bodies and minds for 6 months, then given access to as much and any kind of food they wanted. Almost all returned quickly to their previous normal weights. Most did not go above their previous weight, and lost interest in gorging themselves once that body fat level had been attained.)

Somewhere in the book, and I wish I could find the exact quote, Friedman says that a normal weight, previously obese person is someone living in a constant mode of starvation. Reading the descriptions of the study participants' food psychosis reminds me of my own state of mind while I was losing weight (which I admittedly did too quickly) and in the first few weeks of maintenance. I also had the same reactions while doing a bodybuilding comp diet, though I had no intentions of competing.

Ok, so where am I going here? The more I read, the more I believe that in most cases there is a pysiological set point for each individual. In cases of morbid obesity, obviously something has gone radically wrong in creating that point. The human genome has been mapped, but still not fully understood. The hypothalmus is still mostly a mystery, although researchers have shown in both mice and men, that a damaged hypothalmus leads to either obesity or self starvation. Yet there are some of us here who have lost 50, 100, 150 plus pounds, and some who have maintained that loss for years. And many who have failed to maintain, and are on the same sysiphean journey. We had a thread about cravings and how we handle them- that's where the free will part comes in. My theory at this point, is that those who can successfully distract our cravings, or "frantic 'eat' signals" are the ones who can maintain a weight loss. MrsJim assures us it gets easier over time. Maybe refusing to give into those eat signals begins to erase the neural memory of overeating, or actually shrinks the fat cells long enough that they can no longer send out such frantic signals. If we maintain long enough at a certain body fat level, are we creating a new set point? I know that for myself, it's now fairly easy to maintain at what was my original goal, but I've been trying to take off 10 more pounds, and it's been near impossible to fight the cravings and the constant food thoughts.

Any further thoughts?
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Old 07-10-2004, 08:14 PM   #2  
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No arguments from me on anything you say, Mel. I read the book too (heck, it’s my book you’re reading! ) and remember what you quoted because it scared the crap out of me. I think it may even have come up here before the Crash — right before the big crash there was a thread about the biochemical basis for cravings when we lose weight — anyone remember? None of us really knew anything about leptin et. al. but I recall we were discussing it.

Anyway, before I go on to talk about the interesting points you bring up, let me clarify. In my original “I’m Outraged” thread, I wasn’t outraged at Dr. Friedman’s research or any research about obesity. What outraged me what this gloom and doom statement:

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... noted obesity expert Dr. Jeffrey Friedman ... "body weight is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion.

"People can exert a level of control over their weight within a 10-, perhaps a 15-pound range," Dr. Friedman said. But expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens, he said. "Any weight that is lost almost invariably comes right back."
My problem with what he says in that quote is the message that it’s virtually impossible to lose and keep off weight. As we well know, it may be hard but it’s certainly possible for many people to lose weight and keep it off -- if they so choose. If I was to read that statement before I lost weight, I probably would have thrown up my hands in resignation and fallen into a bag of Oreos, never to reappear. I still think it's a patently false and extremely irresponsible statement for a scientist to make, so I guess I’m still outraged about it.

OK, so that’s my beef with Dr. Friedman, not his research. So back to the research and the issues you bring up. I agree with what you say about set points — that in some of us, whether for genetic, environmental, or biological reasons, our set points are out of whack. Mine seemed to be comfortable right around 250 pounds. Some people’s are much higher and others can’t gain above a “normal” weight even if they try. Case in point: DH told me tonight at dinner that he’s been around 160 (he’s 6’ tall) for the past six months, regardless of anything he’s done to try to gain a bit. Obviously he and I have very different biological set points.

I’m hoping with all of my heart that my set point will change over time. Like you, I think it may be happening now, two years out from reaching goal. At least I like to tell myself that my body LIKES being where it is — that it’s strong and healthy and fit here and I feel good. Maybe I'm kidding myself and it’s really just dying to go right back to 250 — I don’t know and I don’t intend to find out. It would be an interesting experiment to take someone like you or me (the reduced obese — horrible term! — though you weren’t really obese, I don’t think) and ask that person to eat whenever he was hungry — whatever he wanted — and stop when he was full, using his body’s appetite as a cue. Like for six months with no access to scales or ways to measure oneself. What would happen? Would that person go back to his old high weight? Or would he stay around where he started at — the new set point??

One problem I see with the above is that, for me at least, weight gain and loss are much more than a physical process. So much of it happens it my head, like you alluded to when you talked about fighting food cravings. Some of the cravings may be physically based but some are undoubtedly psychologically based too — the old comfort eating thing. Although I guess there may be a physical basis for that too, since I've read that eating carbs releases the “feel good” hormones in the brain, so in a sense we’re self-medicating when we eat because of stress and depression.

Hmmm …. no answers for you at all, but those are a few of my thoughts on a very interesting topic. I’m curious what others think??
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Old 07-10-2004, 08:56 PM   #3  
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I totally agree with you on the irresponsibility of the statement, and how it would have affected me, too. And I KNOW what would happen if I ate whenever I felt like eating . Unfortunately, it usually has little to do with actual hunger; as we've all said, it's mostly the head issues. I can feel "hungry" just after I've eaten a huge pile of food that must have filled my stomach; OR I can go nearly insane with cravings without the slightest hint of hunger I don't think I'll volunteer to see if my body has adapted to this level, either

I was clinically obese according to ACE and insurance company charts. For women, that's anything over 31% body fat. But I agree that I wasn't in the sense that it really didn't affect my ability to do what I wanted to do, or go where I wanted. I just couldn't buy the clothes I wanted, and was in danger of future health problems.
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Old 07-11-2004, 01:18 AM   #4  
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For me, it's just the "doom and gloom" presentation of the research that's discouraging. In the past few weeks I've gained somewhere in the neighborhood of 10 pounds (will know exactly tomorrow), much more quickly than I lost them. It does make me somewhat think that regain is inevitable and that I'd better just give up and buy some size 22 clothes for the future.

Except I look at the length of time since I've weighed 247 pounds and at the long periods in my life of stable weight with cycles of regain but not regain to the highest point. During these periods I still had major issues with food but I don't see myself as a "previously obese normal weight" lab rat existing in starvation mode.

I believe I've read somewhere (haven't researched this and can't cite studies so this is just a thought) that the number of fat cells diminishes in a previously obese person who maintains a lower weight for a long period of time. If that is true, it'd seem that maintaining as long as possible, coupled with slight but inevitable regains and then relosses, would be the optimal way to go and it seems a previously obese person could go on doing that forever and that it'd indeed get easier over time.

I know for me, it has gotten easier, it doesn't matter how many times I have to go through this cycle. It doesn't matter to me what the Dr. Friedmans of the world say.

I totally agree that the previously obese person has to be a "CRE" ... chronic restrained eater. If I eat whenever I am hungry (such as during the past three stressful weeks), I gain weight. When I do the opposite, I lose it.

That's life!
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Old 07-12-2004, 06:28 AM   #5  
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As someone who hasn't successfully maintained I have this to offer.

I guess I just cling to the belief that my binge eating problem which packed on the extra 15-20lbs or so is psychological rather than my body screaming for me to eat more. Maybe I am deluding myself, but I do believe I will overcome this. This belief if what got me down to my desired weight.

I guess I just don't believe my initial weight problem was 100% due to genetics. I believe it was environment, and a sense of needing instant gratification when I was feeling down, happy or whatever. I don't believe the huge portions, fast food or what not were a natural way to eat at all and the fact I felt kind of gross afterwards perhaps indicates to me it wasn't the way I was meant to eat.

The thing is, obviously the scientists who do these studies are showing what the reality is, but I sometimes think the science forgets that we're such amazing creatures and through time and training and dedication we can achieve so much (I look at you successful maintainers and I think it's proof)! We have free will and the feats that humans have done though the millenia is absolutely huge!! Yes, I consider binge eating a curve in my journey I didn't want, but I am confronting my problem and working hard.

Do I think I have a set point? yes, but I believe I do, but I believe I can work to be below it. Yet when I was losing weight I examined the eating habits of my naturally thin friends. They ate what they wanted, but only when hungry. When they had a small bag of chips it was usually a meal. If they ate a big lunch, they had a small dinner. They split dessert. Tehy often left food on their plates. For them this was natural (I am sure there are a few people, but in the vast minority who can literally eat what they want and never gain a pound, most thin people I know just have a very natural instinct when it comes to eating). I on the other hand, take forever to tell when I am full, so I have to use portion sizes to tell me "this is how much I should be eating". I also had to relearn what full felt like "not hungry" basically is the only way I can describe it, my old definition of full is really stuffed. I also learned that my body takes more than 20 minutes to feel full. I am still learning to distinguish hunger from head hunger and from cravings

Just my 3 cents Canadian

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Old 07-12-2004, 08:22 AM   #6  
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My thoughts on this subject are relatively simple:

1) The prevalent trend over the last 10-20 years of "low calorie" diets should shoulder some blame for obesity! Of course those losing weight are going to feel like they are starving - because they are! Studies have shown that if you are "starving" (and this doesn't just apply to anorexics!) your body will become much more efficient at hoarding fat.

2) So how do we prevent our selves from starving? Simple. Eat six meals a day, don't restrict your calories to any less than about 1200 a day (unless recommended to do so by your doctor) and finally ... learn to control those cravings. Eating regularly (don't skip brekkie either) will help, but ultimately, taking control over your mind and habits is a battle, and if you win that one, you win the war.

Personally, I think that the direction that his research is heading is a load of bull. 50 years ago, we had the same genes and where were the fat people?
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Old 07-12-2004, 09:05 AM   #7  
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Good points, Apple! You're right -- our genes haven't changed but our environment and lifestyles sure have. I think that obesity is much too complex of an issue to be reduced to something simple like: genes OR environment OR biochemistry OR one's childhood OR whatever. There's a huge interplay between many factors -- plus throw in free will and a little personal responsibilty and there just aren't any easy answers.

I'm a big believer in the kind of diet you describe because that what I did/do and it works for me. That and lots of exercise!

Ali -- first of all, I think you ARE a successful maintainer, contrary to what you said. You've kept off the vast majority of your weight and that counts as a success in my book!

I was so interested in what you said about eating here:
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I on the other hand, take forever to tell when I am full, so I have to use portion sizes to tell me "this is how much I should be eating". I also had to relearn what full felt like "not hungry" basically is the only way I can describe it, my old definition of full is really stuffed. I also learned that my body takes more than 20 minutes to feel full. I am still learning to distinguish hunger from head hunger and from cravings.
I have the same experience as you: it takes me a long time to feel full -- it's more a matter of timing than quantity but if I'm not careful, I'll end up overeating. See, I can eat my planned meal and feel just as hungry when I'm done as when I started. If I didn't make myself STOP there, I could easily go on and eat two or three times as much before I finally feel "full". That's why I still have to use portion control, just like you -- I can't rely on faulty physical cues. But ... if I make myself wait, I'll usually start to feel full in anywhere from 20 minutes to an hour. It can be very hard to wait!

Undoubtedly there is some kind of biological/hormonal signal from the stomach to the brain to stop eating and mine definitely seems to operate on a time-delay. So those are the physical facts of how my body works -- but that's not the end of story, by any means. Like you say, we have free will. I can look at my eating patterns and recognize what's going on and figure out a strategy for how to deal with it. What do I do? Planning menus, portion control -- the very opposite of "intuitive eating". Distracting myself after I'm done eating until the satiety factor kicks in -- coming here to the computer and typing is one way! A cup of tea, a SF popsicle ... everyone's going to come up with unique solutions.

The point is that we can deal with these biological/hormonal/chemical challenges that our bodies throw at us. It takes some anaylsis and planning, but it can be done. Like you said so well:
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I sometimes think the science forgets that we're such amazing creatures and through time and training and dedication we can achieve so much.
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Old 07-12-2004, 10:08 AM   #8  
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Meg: I find the eating 6 times a day things works for me too (right now I am not perfect, but 90% of my kitchen is packed as I am moving this week).. Admitedly it's more like 3 meals and 3 snacks (but not a huge huge difference in calories or anything). Yet I know for some reason that might be due to biology, my brain takes a real long time to feel full and that I cannot solely rely on my physical cues for hunger so like you, I adapt. I guess what angers me about all these studies is that they basically say we should just accept our weight and not at least try to change. We humans are awesome at adaptation and we have an awesome ability to learn new behaviour and to make our lemons into lemonade. I think about scientific, cultural and athletic feats and know that people acheived them through hard work and determination. I actually become inspired to work out more when I saw the Olympics on TV in 2000 and saw all the hard work these athletes put into their training for their "Olympic moment" BTW Meg, thanks for your kind words, you're right, according to a lot of people, I should be back up to 256 by now, but I am not... I am just a wee bit of a perfectionist, gotta remind myself of the good stuff I have acheived !
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Old 07-12-2004, 01:53 PM   #9  
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Ali -- I was thinking about this some more when I was at the gym and you're exactly right when you said:We humans are awesome at adaptation and we have an awesome ability to learn new behaviour and to make our lemons into lemonade. I think about scientific, cultural and athletic feats and know that people acheived them through hard work and determination. What if a someone told Lance Armstrong that what he did after beating cancer wasn't possible? Shakespeare? Gandhi? Van Gogh? (I'd use more sports figures as examples but I'm kind of clueless there ) How about any of the millions of ordinary people who do extraordinary things?

Free will is NOT an "illusion", as Dr. Friedman put it -- it's the bedrock of our lives. It's the gift of being able to make choices and being aware of their consequences.

Until the day that someone sits on my chest and forces food in my mouth, I'm the one responsible for what I eat and don't eat. I'm the one who decides whether I want to sleep in or go to the gym. It's up to me, through all the choices that I make every day, to make my dreams come true or not.

Sad to say, my weight has probably been THE defining issue of my life. But now that I've accepted that the responsibility for losing it and keeping it off starts and ends with me, I know that nothing (not hormones or biology or whatever) can put those 122 pounds back on me. Unless I choose to let them (and I won't! ).
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Old 07-12-2004, 03:31 PM   #10  
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One more thought about biology and choice and then I promise I’ll shut up … (can you tell I've been thinking about this all day?)

OK, let’s accept for now that there is a biochemical/hormonal basis for increased hunger in the reduced obese. Fine — so I’m hungry. What I eat to satisfy that hunger is my choice: will I choose Doritos or carrots? Chicken breast or a Big Mac? Pizza or an apple? One choice will make me gain weight; one will allow me to maintain my weight loss. I don't think there's a need for Whoppers and Krispy Kremes hardwired into our genes. In my opinion, it still comes down to choices, regardless of the biology driving the need to eat.
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Old 07-12-2004, 04:03 PM   #11  
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I don't have much to add to this thread except that I totally agree that it's not 100% in the genes... It is what*I* as a person do on a daily basis that counts... Otherwise I'd be fat too most of my family is... It's genetic ? Yes and NO!! I go for the NO... *I* know what I put in my mouth whether it's good or bad... a chocolate bar OR a carrot... It really isn't rocket science! Or is it? They are trying to make it sound like it is....
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Old 07-12-2004, 10:05 PM   #12  
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My Dad was a simple milkman, reared in rural Ontario, twice an immigrant, who took me aside one day on a golf course after I hit a bad shot into the trees. He told me that golf was a lot like life, if your ball goes into the trees you play from the trees. If life deals you a bad hand you play it as well as you can. You make no excuses. I forgot that for many years, one day I remembered and snapped out of my self pity and started on my way.
Your father sounds like a wise man, Jack! I was raised in rural Ontario, just like your Dad, apparently.
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Old 07-16-2004, 05:46 PM   #13  
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LOVE this thread and am going to share it with my mom--we constantly talk about the genetics of weight gain.

I agree with what you are all saying, and totally feel for Ali and Meg because I am the same way about feeling full. In fact, sometimes, no matter how long I wait, I don't feel full. But I know that I am...and several hours later, when my stomach rumbles, I realize that the feeling of hunger I feel is different than how I have been feeling. That last sentence was almost intelligible...but hopefully you understand what I was trying to say. Portion size is the best way for me to ensure that I do not overeat.

Cutting out the sugar from my diet was the best thing I have ever done for myself, no matter how hard it was. I had to get through the psychology of frustration regarding my inability to eat like a "normal" person and realize that for me, this is normal. Cutting out the sugar has greatly reduced my cravings and allowed me to be successful so far.

Sure, genetics has a bit to do with what happens to us. But free will (especially exercised as Meg said here: "Fine — so I’m hungry. What I eat to satisfy that hunger is my choice: will I choose Doritos or carrots? Chicken breast or a Big Mac? Pizza or an apple? One choice will make me gain weight; one will allow me to maintain my weight loss." ) is what will decide my future, not my genetics. Perhaps the genetics make it harder, but at this point, I'm relishing the challenge.

I must say how much it means to me to have such amazing, strong, role models in you maintainers. We are blessed to have you here to help us on our journeys--you ensure that they are not in vain.
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Old 07-17-2004, 02:54 AM   #14  
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For me, feeling full is not even an issue. If I'm bingeing or stress eating, I just keep eating regardless. I can be stuffed to the gills but if I'm in a mode where I feel out of control, I just keep on eating.

The one single most important point to remember IMO is that (as mentioned in this thread), we DO have the control. Genes or whatever may make it harder for some people to maintain a weight loss, but it's muddled thinking (IMO) to believe that we don't have control (unless, as Meg says, someone is sitting on our chest and force feeding). Eating, in the absence of force feeding, is a simple act of US locating food with OUR own eyes, reaching for it with OUR hand and moving it into OUR mouth, chewing with OUR teeth and swallowing, at which time the process becomes mostly involuntary but it's still taking place in OUR bodies.

It's just ludicrous to think we don't have control over all that ... even if there are tremendous forces at work outside and inside of our poor gene-programmed bodies telling us to overeat and fill up those fat cells!

IMO, the single most important element in weight loss/weight maintenance is the belief that we CAN do it!

Dr. Friedman notwithstanding.
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Old 07-17-2004, 05:57 PM   #15  
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I just wanted to write a quick thank you for addressing this. I had read the exact same thing as as someone who has pretty much hung out since the beginning of the year between 175-180 this article kind of brought me down (I read it in Oprah magazine). Two things I need to remember is that being under 200 lbs since the beginning of the year is a blessing for me, its the first time in about 7 years. The second thing is that gift of free will. And as someone who did not make the most loving of food choices yesterday I see hope in the loss and the maintenance of all of you.

Thanks again,
Chris
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