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Losing a lot of weight with very low calorie diets is hard, but not regaining it over the next couple of years is next to impossible. Your body will try all th

Losing a lot of weight with very low calorie diets is hard, but not regaining it over the next couple of years is next to impossible. Your body will try all the tricks in the book, it will reduce your metabolism to way below that of the person of the same weight, it will amp up your hunger hormones so much that you will think and dream about food 24/7. Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism.

klmr 8y ago
This new diet is specifically tailored to avoid this yoyo effect. It’s currently not yet clear whether this is indeed the case (hence this expanded epidemiological study) but preliminary results indicate that this is indeed the case. In other words, this specific diet (severely limited calories as well as restriction of food to almost completely liquids) reportedly helps sustaining the weight loss long-term (and is allegedly effective for around 50% of patients).
- jobigoud 8y ago
  Are you saying they stay on 800kcal/day for long-term? I'm skeptical. Usually the problem is when you switch to the maintenance diet.
  - klmr 8y ago
    No. The 800 kcal/day liquid diet is kept up for three months. However, the resulting weight loss is sustained long term.
philip1209 8y ago
Type II diabetes is a diet-related illness. If you cure the illness with diet, then switch back to what you were eating before - of course, diabetes will come back. These dietary changes need to be seen as new habits, not temporary changes.
- pknopf 8y ago
  Exactly this. My A1C went from 8, to 4.9. My blood sugar rarely goes out of wack, even when abused. I eat low carb, and fast intermittently. It's my life-style now. After eating a while for an extended period of time, my blood sugar is much more stable, regardless what I eat.
lol768 8y ago
>Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. Are there any studies in this area I can read that discuss the figures you've mentioned?
- cstansbury 8y ago
  >>Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. > Are there any studies in this area I can read that discuss the figures you've mentioned? One example may be found in Dr. Jason Fung's book, "The Complete Guide to Fasting." Chapter 5 describes a case regarding the American TV show, "Biggest Loser", where overweight contestants lost loads of weight during the show with a low calorie diets and exercise. All except one contestant gain the weight back. Below is the reference to the study cited in Fung's book. https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21538 https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21538
- belltaco 8y ago
  I referenced some things in this comment https://news.ycombinator.com/item?id=18571376 https://news.ycombinator.com/item?id=18571376
SketchySeaBeast 8y ago
And that's why weight loss techniques need to be treated like a new lifestyle, instead of a goal you hit and then finish. I lost 60 lbs a couple of years ago and found that 20 of those had recently crept back on, so I went on another shorter diet to get myself back on track. It's totally doable. You have to be aware and keep correcting.
- striking 8y ago
  Garry's blog post about this was particularly insightful.[0] He shares a graph of his progress and how it goes both forwards and backwards, as well as the things he's learned along the way. 0: https://garry.tv/2018/10/17/fatty/ https://garry.tv/2018/10/17/fatty/
  - SketchySeaBeast 8y ago
    > When you’re weighing yourself every day you need to understand that you’re creating a weekly/monthly average. What you ate yesterday isn’t going to show up on the scales the next day. If you ran around the park yesterday, don’t expect to have lost weight today. I only weighed myself once a week for this reason. Every day can be demoralizing if you have a bloat day, but once a week gives enough to have a pretty regular drop. Whatever behaviour you do can't be considered on a day by day basis, it needs to be considered as a week of good behaviour, and then weeks and then months. You gotta stay consistent every day over the long term to expect results.
    - tacon 8y ago
      I think daily weighing is important because it is hundreds of daily decisions to not eat that need to be made. Our current society makes food available at all times, and daily weighing is one part in actually thinking about our body and being mindful for at least twenty or thirty seconds each day. With the ridiculous calorie density of modern processed foods, a few minutes of mindless eating can add an enormous calorie load, without even beginning to feel full. We hackers can geek out on the math in the Hacker's Diet[0], which goes into various smoothing algorithms and plotting styles to show the daily weight and smoothed trends. [0] https://www.fourmilab.ch/hackdiet/ https://www.fourmilab.ch/hackdiet/
pknopf 8y ago
I lost 40 pounds in 3 months, then another 20 in 3 months. I've kept the weight off for another year. I still eat healthy and in moderation (and occasionally fast). I avoid sugars and high-carb foods and my body has been hovering at the same weight. Maybe, for some people, it's harder to keep the weight off (assuming diet is the same)? Or, maybe some people don't have the mental will-power to stay on the diet that lost them the weight?
- chosenbreed 8y ago
  Superb. Clearly in your case you summoned the necessary will to lose all that weight. But I think another important factor is that you established a new lifestyle/better eating habits.
  - vonmoltke 8y ago
    > But I think another important factor is that you established a new lifestyle/better eating habits. How is it not a given that you need to do this? Your lifestyle and eating habits got you to that overweight state in the first place. Of course you will return to that state eventually if you don't permanently change them.
  - diminoten 8y ago
    "Summoned" implies it's only possible for people who know the arcane secrets, I'm not personally a fan of removing people's agency when talking about something like this.
    - sidlls 8y ago
      In some cases at least consider this is like discussing the agency of a person addicted to narcotics.
      - diminoten 8y ago
        Generally, no.
    - 8y ago
drenvuk 8y ago
Citations for the 5 to 7% would be nice. Here's a meta analysis that states otherwise. https://academic.oup.com/ajcn/article/74/5/579/4737391 https://academic.oup.com/ajcn/article/74/5/579/4737391
- dsp1234 8y ago
  Per that study, "This analysis of 5-y weight-loss maintenance indicates, on average, that obese individuals maintained weight losses of 3.0 kg, representing a reduced weight of 3.2% below initial body weight. These individuals were successfully maintaining a weightloss averaging 23.4% of their initial weight loss at 5y" Put another way, after 5 years, the average weight loss was ~3kg, with an average weight gain of 78.6% of the original lost weight. Also, in general, an obese person who is obese before, and after 5 years has a weight that is ~3kg is likely still obese. So this study basically just says that an average person isn't successful at keeping a large amount of weight, and gains most of it back. The specific statistics stated by the commenter above may not be correct, but the sentiment is definitely true. That said, the study does confirm that very low energy diets (~800 meal replacement) beat out hypoenergetic balanced diet (~1200-1500 normal food) in long term weight maintence. Which is what the article is suggesting being implemented. So it's still not a great long term solution, but it's the better of the two non-exercise based solutions which this study evaluated.
  - Jill_the_Pill 8y ago
    One consideration is that obesity has a snowball effect. I think I remember reading once that the average annual weight gain at midlife is 3 pounds. So over a 5-year period, those who made the attempt may have actually been down 15 pounds, plus the 3kg, from where they might have been if they'd continued on their trajectory.
- belltaco 8y ago
  I am on mobile and I don't have a root source for the below paragraph, maybe someone can dig it up. > The statistics for dieters who lose weight rapidly, according to Wellsphere, a website sponsored by Stanford University, is worse. Only 5 percent of people who lose weight on a crash diet will keep the weight off. Crash diets include any unhealthy diet, from severe calorie-restriction diets to diets that consist of only a few kinds of foods. Another study showing 5% looks like it was an old study from 1959. Anyway, there are more modern studies proving the point. And that people gain even more weight back than they started with. http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-Researchers-7832 http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA... >Several studies indicate that dieting is actually a consistent predictor of future weight gain,” said Janet Tomiyama, a UCLA graduate student of psychology and co-author of the study. One study found that both men and women who participated in formal weight-loss programs gained significantly more weight over a two-year period than those who had not participated in a weight-loss program, she said. >Another study, which examined a variety of lifestyle factors and their relationship to changes in weight in more than 19,000 healthy older men over a four-year period, found that “one of the best predictors of weight gain over the four years was having lost weight on a diet at some point during the years before the study started,” Tomiyama said. In several studies, people in control groups who did not diet were not that much worse off — and in many cases were better off — than those who did diet, she said.
DiffEq 8y ago
That is why there needs to be some visible and lasting penalties...as in if you have a disease like diabetes that you can prevent or fix by simply eating better and not eating so much - then you are responsible for any and all medical costs associated with it. We don't allow insurance claims if you purposefully wreck your car or burn your house down; why do we allow this when it comes to your health?
- vidarh 8y ago
  If you think "simply eating better and not eating so much" is "simple", you don't understand people. All our evidence is that it is by no means simple for most people. It's a problem that's about as hard to deal with as drug addiction. Furthermore, it is a social problem, in that we as a society allow businesses to exploit peoples weaknesses without covering the social costs of the problems they are causing, and given that how people around you act strongly influence how able people are to stick to a diet. To then act as if this is down to some imaginary free will is irresponsible.
  - DiffEq 8y ago
    Well I "simply" don't eat the stuff or over eat. O.k so maybe I am some anomaly but I don't think so. Sure some people take a little more incentive and that is why I propose to provide them with some incentive - which would be that if they knew, or saw, that their health care costs are no longer covered if they cause their health issues then a large amount of people would start changing their ways. People need to be made responsible for their decisions; this means they must pay for their actions - if they are not held accountable then they, in general, will not act in a responsible way. Making people responsible will turn the social tide.
Brigadirk 8y ago
I thought I was getting too fat in 2015. I went on an "eat half" diet. Literally lost weight eating pizza and drinking beer, just less than I needed. Lost 12 kilos. After this, I just ate as I felt like, with intermittent periods of damage control, where I'd revert to the diet for a few days here and there to either budget an upcoming event (e.g. Christmas), or pay for a recent one. Works for me. Only note is to watch out with sugar & alcohol, as both can turn on the 'fuck it I WANT THIS NOW' mode, at least for me.
brandonmenc 8y ago
> Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. The mechanism = not staying on your "diet" permanently.
distant_hat 8y ago
This. I've known a bunch of people who lost a large part of weight (without surgery) and kept it off and they basically turned into different people (more fun though). They restricted their eating, they worked out, often went for hikes etc. But their lifestyle was completely different before and after. They didn't bitch about turning down dessert or things like that. They seemed to actually just be a different person.

klmr 8y ago

This new diet is specifically tailored to avoid this yoyo effect. It’s currently not yet clear whether this is indeed the case (hence this expanded epidemiological study) but preliminary results indicate that this is indeed the case. In other words, this specific diet (severely limited calories as well as restriction of food to almost completely liquids) reportedly helps sustaining the weight loss long-term (and is allegedly effective for around 50% of patients).

jobigoud 8y ago
Are you saying they stay on 800kcal/day for long-term? I'm skeptical. Usually the problem is when you switch to the maintenance diet.
- klmr 8y ago
  No. The 800 kcal/day liquid diet is kept up for three months. However, the resulting weight loss is sustained long term.

philip1209 8y ago

Type II diabetes is a diet-related illness. If you cure the illness with diet, then switch back to what you were eating before - of course, diabetes will come back. These dietary changes need to be seen as new habits, not temporary changes.

pknopf 8y ago
Exactly this. My A1C went from 8, to 4.9. My blood sugar rarely goes out of wack, even when abused. I eat low carb, and fast intermittently. It's my life-style now. After eating a while for an extended period of time, my blood sugar is much more stable, regardless what I eat.

lol768 8y ago

>Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. Are there any studies in this area I can read that discuss the figures you've mentioned?

cstansbury 8y ago
>>Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. > Are there any studies in this area I can read that discuss the figures you've mentioned? One example may be found in Dr. Jason Fung's book, "The Complete Guide to Fasting." Chapter 5 describes a case regarding the American TV show, "Biggest Loser", where overweight contestants lost loads of weight during the show with a low calorie diets and exercise. All except one contestant gain the weight back. Below is the reference to the study cited in Fung's book. https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21538 https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21538
belltaco 8y ago
I referenced some things in this comment https://news.ycombinator.com/item?id=18571376 https://news.ycombinator.com/item?id=18571376

SketchySeaBeast 8y ago

And that's why weight loss techniques need to be treated like a new lifestyle, instead of a goal you hit and then finish. I lost 60 lbs a couple of years ago and found that 20 of those had recently crept back on, so I went on another shorter diet to get myself back on track. It's totally doable. You have to be aware and keep correcting.

striking 8y ago
Garry's blog post about this was particularly insightful.[0] He shares a graph of his progress and how it goes both forwards and backwards, as well as the things he's learned along the way. 0: https://garry.tv/2018/10/17/fatty/ https://garry.tv/2018/10/17/fatty/
- SketchySeaBeast 8y ago
  > When you’re weighing yourself every day you need to understand that you’re creating a weekly/monthly average. What you ate yesterday isn’t going to show up on the scales the next day. If you ran around the park yesterday, don’t expect to have lost weight today. I only weighed myself once a week for this reason. Every day can be demoralizing if you have a bloat day, but once a week gives enough to have a pretty regular drop. Whatever behaviour you do can't be considered on a day by day basis, it needs to be considered as a week of good behaviour, and then weeks and then months. You gotta stay consistent every day over the long term to expect results.
  - tacon 8y ago
    I think daily weighing is important because it is hundreds of daily decisions to not eat that need to be made. Our current society makes food available at all times, and daily weighing is one part in actually thinking about our body and being mindful for at least twenty or thirty seconds each day. With the ridiculous calorie density of modern processed foods, a few minutes of mindless eating can add an enormous calorie load, without even beginning to feel full. We hackers can geek out on the math in the Hacker's Diet[0], which goes into various smoothing algorithms and plotting styles to show the daily weight and smoothed trends. [0] https://www.fourmilab.ch/hackdiet/ https://www.fourmilab.ch/hackdiet/

pknopf 8y ago

I lost 40 pounds in 3 months, then another 20 in 3 months. I've kept the weight off for another year. I still eat healthy and in moderation (and occasionally fast). I avoid sugars and high-carb foods and my body has been hovering at the same weight. Maybe, for some people, it's harder to keep the weight off (assuming diet is the same)? Or, maybe some people don't have the mental will-power to stay on the diet that lost them the weight?

chosenbreed 8y ago
Superb. Clearly in your case you summoned the necessary will to lose all that weight. But I think another important factor is that you established a new lifestyle/better eating habits.
- vonmoltke 8y ago
  > But I think another important factor is that you established a new lifestyle/better eating habits. How is it not a given that you need to do this? Your lifestyle and eating habits got you to that overweight state in the first place. Of course you will return to that state eventually if you don't permanently change them.
- diminoten 8y ago
  "Summoned" implies it's only possible for people who know the arcane secrets, I'm not personally a fan of removing people's agency when talking about something like this.
  - sidlls 8y ago
    In some cases at least consider this is like discussing the agency of a person addicted to narcotics.
    - diminoten 8y ago
      Generally, no.
  - 8y ago

drenvuk 8y ago

Citations for the 5 to 7% would be nice. Here's a meta analysis that states otherwise. https://academic.oup.com/ajcn/article/74/5/579/4737391 https://academic.oup.com/ajcn/article/74/5/579/4737391

dsp1234 8y ago
Per that study, "This analysis of 5-y weight-loss maintenance indicates, on average, that obese individuals maintained weight losses of 3.0 kg, representing a reduced weight of 3.2% below initial body weight. These individuals were successfully maintaining a weightloss averaging 23.4% of their initial weight loss at 5y" Put another way, after 5 years, the average weight loss was ~3kg, with an average weight gain of 78.6% of the original lost weight. Also, in general, an obese person who is obese before, and after 5 years has a weight that is ~3kg is likely still obese. So this study basically just says that an average person isn't successful at keeping a large amount of weight, and gains most of it back. The specific statistics stated by the commenter above may not be correct, but the sentiment is definitely true. That said, the study does confirm that very low energy diets (~800 meal replacement) beat out hypoenergetic balanced diet (~1200-1500 normal food) in long term weight maintence. Which is what the article is suggesting being implemented. So it's still not a great long term solution, but it's the better of the two non-exercise based solutions which this study evaluated.
- Jill_the_Pill 8y ago
  One consideration is that obesity has a snowball effect. I think I remember reading once that the average annual weight gain at midlife is 3 pounds. So over a 5-year period, those who made the attempt may have actually been down 15 pounds, plus the 3kg, from where they might have been if they'd continued on their trajectory.
belltaco 8y ago
I am on mobile and I don't have a root source for the below paragraph, maybe someone can dig it up. > The statistics for dieters who lose weight rapidly, according to Wellsphere, a website sponsored by Stanford University, is worse. Only 5 percent of people who lose weight on a crash diet will keep the weight off. Crash diets include any unhealthy diet, from severe calorie-restriction diets to diets that consist of only a few kinds of foods. Another study showing 5% looks like it was an old study from 1959. Anyway, there are more modern studies proving the point. And that people gain even more weight back than they started with. http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-Researchers-7832 http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA... >Several studies indicate that dieting is actually a consistent predictor of future weight gain,” said Janet Tomiyama, a UCLA graduate student of psychology and co-author of the study. One study found that both men and women who participated in formal weight-loss programs gained significantly more weight over a two-year period than those who had not participated in a weight-loss program, she said. >Another study, which examined a variety of lifestyle factors and their relationship to changes in weight in more than 19,000 healthy older men over a four-year period, found that “one of the best predictors of weight gain over the four years was having lost weight on a diet at some point during the years before the study started,” Tomiyama said. In several studies, people in control groups who did not diet were not that much worse off — and in many cases were better off — than those who did diet, she said.

DiffEq 8y ago

That is why there needs to be some visible and lasting penalties...as in if you have a disease like diabetes that you can prevent or fix by simply eating better and not eating so much - then you are responsible for any and all medical costs associated with it. We don't allow insurance claims if you purposefully wreck your car or burn your house down; why do we allow this when it comes to your health?

vidarh 8y ago
If you think "simply eating better and not eating so much" is "simple", you don't understand people. All our evidence is that it is by no means simple for most people. It's a problem that's about as hard to deal with as drug addiction. Furthermore, it is a social problem, in that we as a society allow businesses to exploit peoples weaknesses without covering the social costs of the problems they are causing, and given that how people around you act strongly influence how able people are to stick to a diet. To then act as if this is down to some imaginary free will is irresponsible.
- DiffEq 8y ago
  Well I "simply" don't eat the stuff or over eat. O.k so maybe I am some anomaly but I don't think so. Sure some people take a little more incentive and that is why I propose to provide them with some incentive - which would be that if they knew, or saw, that their health care costs are no longer covered if they cause their health issues then a large amount of people would start changing their ways. People need to be made responsible for their decisions; this means they must pay for their actions - if they are not held accountable then they, in general, will not act in a responsible way. Making people responsible will turn the social tide.

Brigadirk 8y ago

I thought I was getting too fat in 2015. I went on an "eat half" diet. Literally lost weight eating pizza and drinking beer, just less than I needed. Lost 12 kilos. After this, I just ate as I felt like, with intermittent periods of damage control, where I'd revert to the diet for a few days here and there to either budget an upcoming event (e.g. Christmas), or pay for a recent one. Works for me. Only note is to watch out with sugar & alcohol, as both can turn on the 'fuck it I WANT THIS NOW' mode, at least for me.

brandonmenc 8y ago

> Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism. The mechanism = not staying on your "diet" permanently.

distant_hat 8y ago

This. I've known a bunch of people who lost a large part of weight (without surgery) and kept it off and they basically turned into different people (more fun though). They restricted their eating, they worked out, often went for hikes etc. But their lifestyle was completely different before and after. They didn't bitch about turning down dessert or things like that. They seemed to actually just be a different person.