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Some Answers About Genes, Environment, Obesity and Maintenance

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Old 07-17-2007, 08:13 AM   #61
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I've read through this entire thread now and it ties in very nicely with "Rethinking Thin" that I just finished. As so many have pointed out: at first it's disappointing to find proof that it WILL be harder to maintain the new weight but it's also a comfort to know that the problems are real and not just something in our heads.

And in knowing all this new information I feel more equipped to deal with maintaining my goal weight, because forewarned is forearmed.

Thank you for an inredibly valuable thread, you are a star Meg!
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Old 09-22-2009, 03:24 PM   #62
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Originally Posted by Meg View Post
Back to the equation Stored Body Fat = Food Intake – Energy Expenditure - the energy expenditure (I’m going to abbreviate it as EE) part is made up of three parts: resting energy expenditure, non-resting EE, and thermic (the digestion of food). Resting EE accounts for about 50 – 60% of the calories we burn in a day, thermic accounts for about 5%, and non-resting EE makes up the remainder.

Here’s the deal - it takes 50 calories per kg of LBM to maintain the body weight of either a normal or an obese person. BUT … it takes only 42 calories per kg of LBM to maintain the weight of a reduced obese person.

...

Now we know that it’s a FACT and we know why – our non-resting EE slows down by 15 – 20%.

I know this thread hasn't had any replies for quite some time - and I'm a newbie - but as a mathemetician, I'd like to point out a contradiction here :

If all of the new 'efficiencies' (15%) in the reduced-obese come from the NON-resting EE and the non-resting EE makes up about 40% of the total (5% thermic, 55% resting EE) - then the actual caloric difference would be about 6% (15% of 40%) not 15% total. Of course the 42 cals versus 50 cals per kg of LBM says differently, so I would be a bit curious as to which is actually correct.

I would BET that the 6% figure is correct, otherwise, it would mean that the muscles of the reduced-obese are actually about 40 PERCENT (40% of 40% = 16%) more efficient than 'normal' people and I find that number hard to swallow. That means the reduced-obese should be uber-long distance athletes as they are so much more efficient than normal people in muscle efficiency.

Anyways - just my two cents.

I also think people need to understand that as in many such scientific studies - there is probably going to be so much individual differences within the studied group that applying it to youself is problemmatic. You can see this in this forum quite well - same goal weight - very different caloric requirements to keep that final goal weight depending on the person.

I'll tell you what opened my eyes the most so far - the difference between me at 220 pounds and me at 210 pounds is about 60 calories a day - and so on down to my goal weight. I deprive myself of a slice a bread a day and I will drop almost 20 pounds over the next year or two. That is SO trivial, I know I can do that. As a maintainer, we will all get to the point where we decide how many slices of bread (or miles of walking) are worth how many extra pounds. The science is interesting and motivational, but I'm not convinced it is RELEVANT to all (or even most) of us.

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Old 12-17-2009, 04:12 PM   #63
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This was a very informative post, and it gives me something to think about when I get to maintanence. No wonder why I lose weight so slow
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Old 05-20-2010, 03:06 PM   #64
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This thread was very interesting and encouraging. I'm sure, like anything else, this information will not apply to everyone, but for those that it does apply to, it's so helpful. I never officially reached the obesity category; I sat at the high end of overweight. Regardless of that, I relate to the information shared. Maybe that has more to do with losing more than 10% of my body weight, as someone else mentioned as a marker. All I know is that with my weight loss, it's still easy for me to gain and harder to lose/maintain.

Having said that, I will say that when I did maintain my loss for that first year, it was both easy and hard. It was easy to maintain as long as I continued eating relatively the same as I had while losing. It was hard in the sense that I had to continue eating the same as I had while losing. I'm like others here who have mentioned the need to stay in a tight calorie range, and if even slightly above that range for a day or two, my weight would immediately start going up. Being armed with this information, I feel like I will handle maintenance better this time around...once I get there again. Honestly, regardless of the reason why this is true for some, the reality is that just knowing that something is "off" makes it easier to accept and deal with the reality of it. So, I don't really care if I know for sure what "it" is, as "it" is probably multiple factors anyhow, but it sure helps just knowing that my gut instinct is finally being backed up by scientists who are understanding more and more that there is something to all of this.
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Old 07-12-2010, 11:00 AM   #65
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I haven't read the whole thread yet as I have 3 sweet little interruptions happening whenever I sit down to read...so I'll just ask my question anyway...

How does the body know when you are ready to maintain? Or does it go by when the calories in vs. calories out ratio shifts? I mean, for example, I lost 90 lbs. a few years ago, but I was not anywhere near goal. However, when I became even slightly lax, I started to gain (and, by lax, I mean simply not exercising -- though calories remained at a lower level). Did my body think that I was maintaining due to shift in that ratio? Does this mean that breaks in trying to lose weight are counter-productive and that we need to push on until we reach goal and then only slightly modify for maintenance? Or does the body wait until it is at the right weight for itself and then start this business of slowing down the metabolism?

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Old 01-09-2011, 09:47 PM   #66
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Interesting sticky.

I don't know if anyone around here has the answer but I wonder if the reduced energy expenditure is gradual during the weight loss period?

Can we compensate for the reduced EE rate with a hormonal replacement - say maybe a higher thyroid prescription to raise the RMR is 60% to compensate for a lower EE?

Finally is there a cummulative effect of the loss of EE by yo-yo dieting? For example, I once reduced from 200 to 135 (hence EE is now at 42%) and then gained back and now reducing back down. I guess I am restarting with EE at 42% but will there be an additional reduction (another 15+%) in EE rate by the time I am once again a formerly obese person?

Thanks for any info or opinion in this matter.
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Old 08-03-2011, 09:45 PM   #67
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I know this is an old thread and hope it is okay to append it...

Like any complicated process with lots of variables (and individual differences) involved, it will take scientists a long time to really unravel all the issues here.

I'm posting as there is data from the National Weight Loss Registry that address this issue but comes to a different finding:

Wyatt, H.R., Grunwald, G. K., Segale, H.M., Klem, M. L., McGuire, M. T., Wing, R.R., & O'Hill, J. (1999). Resting energy expenditure in reduced-obese subjects in the National Weight Control Registry. American Journal of Clinical Nutrition, Vol. 69, No. 6, 1189-1193.

Their conclusions:

---QUOTE---
These results show that in at least some reduced-obese individuals there does not seem to be a permanent obligatory reduction in RMR beyond the expected reduction for a reduced lean mass.
---END QUOTE---

Thus, like many things in life, your mileage may vary....

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Old 01-30-2012, 12:50 PM   #68
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Chiming in late to say that I don't think Robert was being snarky. He was questioning Dr. Leibel's findings in the time-honoured spirit of scientific debate. As a medical writer I work with scientists all the time, and they EXPECT to have their hypotheses picked apart. It shouldn't be taken personally.

I also happen to agree with much of what Robert says, and I've read other studies showing that metabolic rate DOES return to normal (normal for the lower weight) after weight loss. To me, the idea that metabolism basically reflects your body weight and composition makes more intuitive sense than the idea that your body resets its metabolism at a lower level after you've lost weight. Even less plausible to me is the notion that the body "wants" to become obese again just because it was obese in the past.

I'm always open to new information, but I continue to believe that many if not most people regain weight because they're actually consuming more calories than they think (or admit) they are. I know how easy it is for me to add up to 500 extra calories to my daily total without being fully aware of it -- things like coffee with milk and sugar, tea with honey, a glass of wine, a few spoonfuls of dip, a handful of crackers, "evening out" the margins of the leftover lasagna...

In any case, I think it's perfectly OK to disagree about facts, and to express that disagreement, as long as we're not making personal attacks.

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Old 01-31-2012, 07:35 AM   #69
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Originally Posted by freelancemomma View Post
I also happen to agree with much of what Robert says, and I've read other studies showing that metabolic rate DOES return to normal (normal for the lower weight) after weight loss.
My own experience indicates that, eight-plus years after reaching my current weight, my metabolism is still suppressed. I have tracked my calories closely and I eat exactly at the level indicated by guidelines from several sources (which come up with similar numbers). I'm maintaining at the level indicated for a woman of my age, weight and height who exercises "for at least 30 minutes a day". Trouble is that I exercise intensely (both cardio and weights) for an average of 1.5 hours a day.

I have a feeling that if I only exercised for 30 minutes a day, or exercised at a more moderate level, I'd have to cut my calories a lot.

Of course, that's only my experience and it's hardly a scientific study, but it does bear out the "suppressed metabolism" theory.
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Old 04-07-2012, 06:58 PM   #70
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Default Just adding to my last post...

I thought I had posted this before, but apparently not.

In this blog post, Dr Arya Sharma, another obesity specialist, quotes the work of Dr Leibel.

In the comments section, someone asks whether the metabolisms of previously obese people may re-set themselves over time. Dr Sharma responds:
@M: unfortunately, the ‘hypometabolic’ state appears to be for life - so ‘no cure’
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Old 04-07-2012, 08:57 PM   #71
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I suspect that more research will find that there's a great deal of variability between thel pre- and post- weight loss metabolisms (and in how much metabolism f unctioning is lost) based on the degree of obesity and the number of weight loss attempts the individual has made. The person who lost 50 lbs and did it in one try may have a very different post-metabolism that the person who loses 150 lbs and took thirty years of yoyo dieting to do it.

There are much older studies that have found similarly (that repeat dieters, on average, end up with much slower metabolisms than people who've lost the same amount of weight but who have a history of many previous failed weight loss attempts.

I'm only an experiment of one, (and I'm not yet one of the completely reduced-obese), but my metabolism is a much different animal than it was in the past.

For more than thirty years I have read the theory and the research supporting the theory that repeated dieting erodes metabolism. This intuitively makes sense, because when I returned to old eating habits, I didn't just regain to my old weight, I regained to a higher weight. Now it's possible that I didn't really return to old habits, I returned to eating "intuitively" and the dieting may have causes hunger increases not only (or instead of) metabolism decline.


I know "this time around" my metabolism is the lowest it's ever been (far less than a 20% decline). It's so shocking to me that I don't share the information with anyone but my doctor, my TOPS (taking off pounds sensibly) and 3FC, because I don't think anyone else will believe it:

The calorie level I'm on now (about 1800 calories, though I've recently droppped it to 1500 of relatively low-carb) is the same calorie level that I once routinely lost 5 to 8 lbs per week (and up to 11 lbs the first week).

I noticed gradual declines over the 41 years I've been dieting, but this current attempt is by far the worst.

As a young person (under 30), I couldn't blame my metabolism. I ate huge quantities of food, and I knew it. It was an appetite problem because I was always either uncomfortably hungry or I was gaining weight. To even maintain my weight I've always had to drastically curtail calories. And the pms week was the hardest. I felt as desperate as an animal caught in a trap, willing to chew it's foot off to escape.

I didn't start truly succeeding without the constant threat of relapse until I found ways to manage the hunger (rather than ignore it, like everyone in my life and in the medical community advised). Birth control and low-carb dieting are the only ways I've found to reduce the "rabid hunger" that has plagued me for as long as I can remember.

I don't know how common my experience is, but I'm still shocked by it. My experience doesn't seem plausible even to myself. When I was younger and heard older women complaining about how they couldn't lose weight on much less than I was eating (and losing on) I thought "yeah right," and imagined them "forgetting" to document what they were "reallly" eating. It was easier to believe that they were lying (at least to themselves) than to face the possibility that weight loss could be that difficult.

There's still an ingrained cultural belief that "weight loss is easy" and that those who find difficulty with weight loss have a defect of character that makes them lazy, crazy, stupid, or at the very least, careless.

The research (for thirty years) has been finding more and more proof not only that weight loss is difficult, but some of the reasons why... and yet it's all treated as "controversial" because it's assumed that the results "take the blame" off the obese or overweight person. As if blame were more important than the truth.

I don't care whether my weight is all my fault or none of my fault, I'm stuck being the only person who can be responsible for it, so I've got to do what I've got to do, but I'm more than a little tired of people telling me how "easy" it is or should be to lose weight.

I've done some incredible things in my life and all of them combined (including my bachelor's and master's degree in psychology and my work as a probation officer and substance abuse counselor and then retraining as a computer programer) were a snap compared to sustained weight loss/maintenance.

Ironically the message I've gotten since I was a kindergartener was that hunger was irrelevant and I had to learn to ignore it. I couldn't ignore it, and I thought THAT made me defective. Instead, I had to learn to see hunger (especially what I have come to call "rabid hunger" the hunger associated with pms and high carb intake) as a forbidable adversary. Hunger is my enemy and I need to have a wide range of weapons to fight it.

Hunger isn't irrelevant, and sometimes beating hunger means outsmarting it (eating high-fiber low-calorie foods with lots of bulk, avoiding the flavor and food triggers that increase hunger like very sweet foods, the sweet/salt/fat combination talked about in the book The End of Overeating...


I think one of the main reasons weight loss success statistics are so dismal, is that as a culture we don't take it seriously enough. We assume weight loss failulre is due to defects in character and lack of effort rather than the truth "this stuff is damned difficult." It's especially difficult to do alone, and there's been a culture of shame that results in few people seeking help (at least not until the problem has gotten exponentially worse).

I would love to see TOPS and similar weight loss and weight loss maintenance groups in the grade schools, and every single currently or formerly obese or overweight person in such a group and not ashamed of it.

I'd love for weight issues to stop being connsidered "dirty little secrets" (especially since they're not really secret at all).

And now I'm really getting off topic, but I do think that the best thing to happen in the field of weight loss is for the subject to be less taboo. I think the weight loss research lags behind other fields of study because of the controversy.
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Old 04-08-2012, 09:00 AM   #72
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Kaplods, I too think society is a big reason as to why so many fail at getting to their goal weight and then those that do often return from the experience heavier than before.

However, I wonder if the one of the reasons also has to do with the expectations of weight loss. In most people's minds weight loss seems to be a certain process: 1) Decide to lose weight, 2) Be miserable for days/weeks/months/years, 3) Look hot. I think when most people expect it to be like that that it's going to be difficult when that doesn't happen.

I think besides how hunger is viewed that society often fails to recognize that a host of mental issues can arise when one is losing weight. One's brain, for example, doesn't always recognize that they are getting smaller. While not recognizing oneself in a photo is a jarring experience, that happens to people who have also gained weight. Do they ever not recognize themselves in the mirror though? I've had that happen at numerous points during my weight loss and that is one of the weirdest experiences in my life—looking in the mirror and seeing that I was essentially living in someone else's body.

This connected with me when I read about the most recent face transplant. The team who performed it talked about treating the patient's mind as well as it would be very hard for him to accept a new face, something that wasn't "his." Without that treatment he may join those who wanted their transplanted appendages (there are cases of people who received donor hands and other body parts that wanted them gone because they did not view them as part of their body) removed.

I realized that weight loss is probably very similar in that respect, especially if one loses a substantial amount of weight. 20 pounds doesn't really change a person all that much, but lose over 100 and one looks drastically different. It can be tough mentally to accept that even if the person is extremely happy with their success.

We pour over statistics here, trying to find out what the most successful maintainers and losers have in common. I wonder if we should evaluate them mentally instead.
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Old 04-08-2012, 12:50 PM   #73
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We pour over statistics here, trying to find out what the most successful maintainers and losers have in common. I wonder if we should evaluate them mentally instead.

I have mixed feelings about the role of "mental" factors in weight loss. I used to believe that weight loss was almost entirely a "head game." In fact, I pursued psychology as a career choice (getting a bachelor's and master's degree in behavioral and developmental psychology respectively) BECAUSE I was hoping to figure myself out. I also saw counseling psychologists at various points in my life.

Counseling helped me a lot in other aspects of my life, but really had very little effect on my eating/weight. I just assumed my problems had to be "deeper."

When I first encountered "fat acceptance" doctrine, which argued that dieting is making people fat and progressively fatter, I wasn't ready to give up dieting, but I did decide to try birth control (out of desperation for symptoms of severe pms/pmdd. I had been avoiding bc for pms treatment since my teens because of the possibility of weight gain).

Instead of gaining weight, I found that monthly "rabid hunger" was greatly diminished.

I also eventually gave up dieting as well, and my weight stabilized.

I wondered if I had never dieted, would I have been a bit chunky but never obese?

I don't know, but I was TERRIFIED of dieting again because dieting in the past had always resulted eventually in weight gain. In a very real sense, I "dieted" my way to nearly 400 lbs.

When I incidently lost 20 lbs after treatment for sleep apnea (which my doctors told me to expect but I thought they were nuts as I'd never accidentally lost weight in my life), I wanted more, but I couldn't go back to traditional dieting.

I had to experiment to find a "not dieting" way to lose weight, and it took two years to find a way to acheive more weight loss without "trying" to lose weight.

I settled upon a very gradual method of change that focused on "not gaining" rather than on losing, and while I was at this business of not gaining, I would try to lose "just one more pound." I banished guilt and shame and focused on successes no matter how small.

Yes I had to do some mental wrangling to succeed, but so much of the difference has been physiological that I think the physiological is often overlooked.

I have fibromyalgia and any drastic change in just about any aspect of my life - whether it be the weather, pollen levels my sleep, emotional state, activity level, exposure to illness, my food intake... any change at all tends to trigger flares of pain and fatigue. So I HAD to make gradual changes.

I wonder though if even the healthiest bodies resist change. My human anatomy and physiology experience is rather weak, despite the college coursework I had to take, but I know that there are many processes in the body work to maintain homeostasis. I know that from a psychological viewpoint, behavior change is difficult - even small to moderate behavior changes are often difficult to initiate and harder to maintain.

I think we've developed a cultural mythos that fat people are defective or broken in some way (even perhaps mentally ill).

I think the answer is much simpler than that, and referred to in the OP. Being hungrier than "average" had survival value for millions of years and then suddenly, in the last few decades the rules have changed. Food has become unnaturally abundant, but population isn't growing as fast as the food supply, because of widespread birth control use. In a natural world, overpopulation occurs long before widespread obesity could ever become a problem. Obesity also was self-corecting because you it made it more difficult for you to find food and to avoid becoming food. So you either lost weight or you were taken out of the gene pool by being eaten.

We've also changed the composition of our diet, eating more and more foods that mess with the insulin response and other factors involved in hunger.

In the book, The End of Overeating, David Kessler talks about "conditioned hypereating," that all mammals tend to overeat when presented with the flavor combination of sweet/salty/fatty. Flavors that were once only associated with celebration foods, and now have become every day foods. And ironically, animals that are under stress respond even more strongly to the flavor combination.

Even this there may be a survival trait we have evolved. In a natural world, carbohydrates, fats, and salt are generally very rare commodities. We may have evolved a "stock up" instinct because our bodies recognize these foods as nutritional goldmines (at least they would be, if we lived in a natural world, where these substances were rare).

Unfortunately, there's a cultural bias against research that is aimed at looking for non-psychological causes of obesity. Every research study that looks for physiological and genetic causes faces intense scrutiny and public outrage for "providing excuses" for people being overweight. We don't want to believe that the causes are physiological, because then we couldn't blame the fat person for being fat or for having difficulty losing weight.

I think we want to blame obese people much more than we want them helped. We'd rather obese people stay fat so we can hate them for being weak.

In my experience, the worst ridicule I ever received was for doing things not expected of a fat person. It wasn't when I was stuffing my face that I got the worst verbal abuse - it was when I was breaking the stereotype trying to do something about my weight. When I was riding a bike or swimming or dancing or eating carefully.

I suspect that the social and physiological aspects are stronger than the "mental" components (especially since five decades worth of research trying to find and identify "mental problems" among the obese, has largely yielded very few differences. Depression is about the only mental issue that is found in higher incidences among the obese - and researchers don't know whether the depression causes the obesity or the obesity causes the depression - proabably a bit of both).

I'm not diminishing the role of mental factors. In fact, there still is a large "mind game" component, I just don't think that obese folks have any more mental problems than non-obese folks (except the ones caused and contributed to by the obesity itself).

I think an overabundance of nutritionally empty food, and an inactive lifestyle is killing many people - and not just the fat ones. Autoimmune and metabolic diseases are reaching epidemic proportions and among normal weight persons as well as the obese.

In some ways, the thin folks may be at the disadvantage, because they (and even their doctors) may assume that they're healthier than they are, because they "look ok.

To some degree, obesity may be the red herring. We're only focusing on the weight, not the underlying problem (affecting thin and fat alike) of inactivity and a food supply in which poor quality foods are overly abundant and affordable, and healthy foods are the most expensive.

And traditionally, we haven't cared HOW people attempted to lose weight. To some degree that's still true. Instead of losing weight to improve their health (and therefore choosing healthy ways to do it) we have encouraged people to lose the weight by any method (even dangerous ones). In fact, speed of weight loss is often the only factor by which weight loss methods are evaluated. We literally don't care if the weight loss method kills us sooner, as long as it gets the weight off by swimsuit season.

There are a lot of problems with our social attitudes toward weight, and weight loss, and I think they overshadow the "mental problems" of individuals.

But changeing society is a lot harder than changing an individual. And humans don't like "swimming upstream" so in general, we'd rather consider ourselves broken than society.
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Old 04-08-2012, 05:01 PM   #74
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Their conclusions:
---QUOTE---
These results show that in at least some reduced-obese individuals there does not seem to be a permanent obligatory reduction in RMR beyond the expected reduction for a reduced lean mass.
---END QUOTE---
KP
That's been my personal experience: no permanent reduction in RMR despite lots of yo-yoing. Until science proves me wrong (which hopefully will never happen), I choose to believe that our metabolisms CAN and probably WILL return to normal after major diets and regains. I find this belief much more encouraging and comforting than the notion that our dieting history has permanently screwed our metabolisms.

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Old 04-08-2012, 05:32 PM   #75
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Thank you Meg,
I am not maintainer, I have lost 24 lb or some thing. But, I was always eating max 1400 calories. I used to workout 5 days a week. Now, my trainer tells me do workout just 3 days a week. I am not losing any more.
But, I feel I am already sailing in the same boat.
Pl let me know what you feel.
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