5 ms·

"some cases in the hospital where you see people doing diet as they should and not lossing weight at all" would love a link if you have one handy. it seems imp

by alva 10y ago

"some cases in the hospital where you see people doing diet as they should and not lossing weight at all" would love a link if you have one handy. it seems impossible?

greglindahl 10y ago
This is not impossible. In some people, reducing calories (edit: by a lot) leads their body to decide it's starving, lowering their basal metabolism. Humans are a complex system with feedback loops. (edit: note that I'm responding to the 'impossible' comment.)
- wdewind 10y ago
  This is sort of true but not really usefully true. Yes, your metabolic rate will go down slightly when you eat less food, but the idea of "starvation mode" comes from a study done in the fifties on extremely underweight people, who were then put on extremely calorically restricted diets. If the person is within reasonable weight, or overweight, "starvation mode" simply does not apply. People who are in this condition cannot lead normal lives due to low energy, and will frequently have massive health issues due to their body having to give up on a ton of base functions it's doing every day. It's a very extreme thing, and does not happen to many people, especially in America.
  - Apocryphon 10y ago
    Plus, starvation mode takes over a day to kick in. Something like 48-72 hours, maybe?
    - wdewind 10y ago
      Yeah, in the context of usefully effecting the obesity epidemic it's just not even worth discussing because it has no impact.
      - greglindahl 10y ago
        The context of my comment (at least) wasn't "the obesity epidemic", it was "it seems impossible?"
  - Retric 10y ago
    That's true of otherwise healthy people, nothing says that system must work as you describe across all populations. As an example in the other direction. I gained significant weight after getting a foot of my intestines removed while eating the same diet. In this case it was a very good thing as calories out balanced due to incomplete digestion. PS: Albumin levels are not something you generally hear about, but it's very bad when they get low.
  - davnn 10y ago
    I found an article about the "biggest loser study" pretty interesting a few months ago, but didn't investige further. Tldr: It has to do with resting metabolism, which determines how many calories a person burns when at rest. When the show began, the contestants, though hugely overweight, had normal metabolisms for their size, meaning they were burning a normal number of calories for people of their weight. When it ended, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes. First article about the study: http://mobile.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html http://mobile.nytimes.com/2016/05/02/health/biggest-loser-we...
    - deleted 10y ago
      [deleted]
    - wdewind 10y ago
      Step 1: Go on diet Step 2: Lose a bunch of weight Step 3: Go off diet Step 4: Regain a bunch of weight. I'm not trying to be a dick, but I don't think there's a lot going on here that doesn't make sense. None of the contestants were particularly thin at the end of the study. Danny Cahill still weighed 191, which is actually pretty significantly overweight for someone not carrying a lot of muscle mass, which he wouldn't be at the end of a 7 month crash diet. If you get your body very very good at using its fat stores you will lower your BMR. The data doesn't suggest this is permanent or significantly impacted Danny's weight gain, the data suggests that Danny Cahill did not stick to the diet. The Biggest Loser is frequently held up as the gold standard for how not to do things. The weight change is too fast, there is absolutely no support after its over and they frequently optimize for cardio and fat burning over muscle building, which in the short term is effective but in the long term contributes to lowering BMR and making the weight hard to keep off. But ultimately you have to consider that Danny Cahill was still pretty unhealthy at the end of the show. None of this is starvation mode, in which major parts of your life are hugely effected (ie: you would not have the energy to leave the house).
      - mattzito 10y ago
        I'm curious how you rationalize your comments with this: > What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight. > Mr. Cahill was one of the worst off. As he regained more than 100 pounds, his metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. Anything more turns to fat. That does suggest there's something more than just "calories in < calories burned" - that our bodies are willing to adapt to keep metabolic rates low.
- merqurio 10y ago
  I totally agree. Metabolism it's complex and not everything is well understood how is connected. It's difficult to measure and more those little contributions where in aggregate can have an effect.
  - jimmywanger 10y ago
    > It's difficult to measure and more those little contributions The little contributions don't matter. If you don't consume enough calories, you will not increase body fat and tissue mass. Full stop. You can retain fluid because of certain conditions that you have (I lost 30 pounds in one hour! Ask me how) but you will not be increasing fatty body mass.
    - amelius 10y ago
      It's really difficult to consume just enough without your brain showing symptoms of deprivation, e.g. headaches or loss of concentration. Unless you sleep all day.
      - jimmywanger 10y ago
        > It's really difficult to consume just enough without your brain showing symptoms of deprivation What? If you eat the amount of calories that you are expending every day, you'll operate just fine. That's the way your body was designed to work.
        amelius 10y ago
        Not every (work)day lets you burn the same amount of calories. Not every meal provides the same amount of calories, and at the same pace.
        jimmywanger 10y ago
        I think you're missing the point. As long as your caloric intake sort of averages out to your calorie expenditure, you're fine. You don't have to balance every minute and every hour. We're designed to operate at a caloric deficit for hours, if not days at a time. We obviously don't spend all of our time sleeping.
merqurio 10y ago
It's not a scientific statement on this case, it's what i see as MD. It's just an observation.

by alva 10y ago

"some cases in the hospital where you see people doing diet as they should and not lossing weight at all" would love a link if you have one handy. it seems impossible?

greglindahl 10y ago

This is not impossible. In some people, reducing calories (edit: by a lot) leads their body to decide it's starving, lowering their basal metabolism. Humans are a complex system with feedback loops. (edit: note that I'm responding to the 'impossible' comment.)

wdewind 10y ago
This is sort of true but not really usefully true. Yes, your metabolic rate will go down slightly when you eat less food, but the idea of "starvation mode" comes from a study done in the fifties on extremely underweight people, who were then put on extremely calorically restricted diets. If the person is within reasonable weight, or overweight, "starvation mode" simply does not apply. People who are in this condition cannot lead normal lives due to low energy, and will frequently have massive health issues due to their body having to give up on a ton of base functions it's doing every day. It's a very extreme thing, and does not happen to many people, especially in America.
- Apocryphon 10y ago
  Plus, starvation mode takes over a day to kick in. Something like 48-72 hours, maybe?
  - wdewind 10y ago
    Yeah, in the context of usefully effecting the obesity epidemic it's just not even worth discussing because it has no impact.
    - greglindahl 10y ago
      The context of my comment (at least) wasn't "the obesity epidemic", it was "it seems impossible?"
- Retric 10y ago
  That's true of otherwise healthy people, nothing says that system must work as you describe across all populations. As an example in the other direction. I gained significant weight after getting a foot of my intestines removed while eating the same diet. In this case it was a very good thing as calories out balanced due to incomplete digestion. PS: Albumin levels are not something you generally hear about, but it's very bad when they get low.
- davnn 10y ago
  I found an article about the "biggest loser study" pretty interesting a few months ago, but didn't investige further. Tldr: It has to do with resting metabolism, which determines how many calories a person burns when at rest. When the show began, the contestants, though hugely overweight, had normal metabolisms for their size, meaning they were burning a normal number of calories for people of their weight. When it ended, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes. First article about the study: http://mobile.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html http://mobile.nytimes.com/2016/05/02/health/biggest-loser-we...
  - deleted 10y ago
    [deleted]
  - wdewind 10y ago
    Step 1: Go on diet Step 2: Lose a bunch of weight Step 3: Go off diet Step 4: Regain a bunch of weight. I'm not trying to be a dick, but I don't think there's a lot going on here that doesn't make sense. None of the contestants were particularly thin at the end of the study. Danny Cahill still weighed 191, which is actually pretty significantly overweight for someone not carrying a lot of muscle mass, which he wouldn't be at the end of a 7 month crash diet. If you get your body very very good at using its fat stores you will lower your BMR. The data doesn't suggest this is permanent or significantly impacted Danny's weight gain, the data suggests that Danny Cahill did not stick to the diet. The Biggest Loser is frequently held up as the gold standard for how not to do things. The weight change is too fast, there is absolutely no support after its over and they frequently optimize for cardio and fat burning over muscle building, which in the short term is effective but in the long term contributes to lowering BMR and making the weight hard to keep off. But ultimately you have to consider that Danny Cahill was still pretty unhealthy at the end of the show. None of this is starvation mode, in which major parts of your life are hugely effected (ie: you would not have the energy to leave the house).
    - mattzito 10y ago
      I'm curious how you rationalize your comments with this: > What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight. > Mr. Cahill was one of the worst off. As he regained more than 100 pounds, his metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. Anything more turns to fat. That does suggest there's something more than just "calories in < calories burned" - that our bodies are willing to adapt to keep metabolic rates low.
merqurio 10y ago
I totally agree. Metabolism it's complex and not everything is well understood how is connected. It's difficult to measure and more those little contributions where in aggregate can have an effect.
- jimmywanger 10y ago
  > It's difficult to measure and more those little contributions The little contributions don't matter. If you don't consume enough calories, you will not increase body fat and tissue mass. Full stop. You can retain fluid because of certain conditions that you have (I lost 30 pounds in one hour! Ask me how) but you will not be increasing fatty body mass.
  - amelius 10y ago
    It's really difficult to consume just enough without your brain showing symptoms of deprivation, e.g. headaches or loss of concentration. Unless you sleep all day.
    - jimmywanger 10y ago
      > It's really difficult to consume just enough without your brain showing symptoms of deprivation What? If you eat the amount of calories that you are expending every day, you'll operate just fine. That's the way your body was designed to work.
      - amelius 10y ago
        Not every (work)day lets you burn the same amount of calories. Not every meal provides the same amount of calories, and at the same pace.
        jimmywanger 10y ago
        I think you're missing the point. As long as your caloric intake sort of averages out to your calorie expenditure, you're fine. You don't have to balance every minute and every hour. We're designed to operate at a caloric deficit for hours, if not days at a time. We obviously don't spend all of our time sleeping.

merqurio 10y ago

It's not a scientific statement on this case, it's what i see as MD. It's just an observation.