The Biggest Loser has been a popular spectacle on television encompassing the obesity crisis in America today. The recent study “Diet Versus Exercise in the Biggest Loser Weight Loss Competition.” The primary focus is exercise and the drama surrounding the face-to-face weigh ins.

A recent study published by the National Institutes of Health, focusing on a small subset of the Biggest Loser contestants claim that in the long run dieting is rarely effective. The root of the problem is one of hormones and metabolic suppression. The other revelation diets do not cure obesity.

The brain’s weight-regulation system considers your set point to be the correct weight / body mass for you and has powerful means to keep the body within a certain weight range, called the set point. The range varies from person to person, is determined genetically and by the environment. When the body weight drops below it, the body uses fewer calories and produces more hunger-inducing hormones. If someone starts at 150 pounds and drops to 110, the brain declares a starvation state of emergency, using every method available to get that weight back up to normal. The same thing happens to someone who starts at 400 pounds and diets down to 200, as the “Biggest Loser” participants discovered.

This coordinated brain response is one of the major reasons that people find weight loss so hard to achieve and maintain. But realize that diet is only one part of this. There are so many other dots to connect in this messy puzzle that focusing only on behavior and diet plan lead to less than optimal results.

As a medical doctor, I’ve read hundreds of studies on the brain’s ability to fight weight loss (and not just the abstracts!). I also know about it from experience. I might be considered to be one of the lucky ones. I have always weighed within 10 to 15 pounds from my high school weight. When I adopted an optimize fat metabolism approach to eating, I actually went down to my high school weight. I’ve stayed there since.

How could dieting lead to weight gain? First, dieting is stressful. Calorie restriction produces stress hormones such as cortisol and others, which act on fat cells to increase the amount of abdominal fat. Such fat is associated with medical problems like diabetes and heart disease, regardless of overall weight.

The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Weight conscious athletes such as cyclists, runners, boxers and wrestlers who diet often presumably have no particular genetic predisposition toward obesity. Yet studies have found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports. This is something I have seen quite often in professional athletes. After their careers are finished, they often blow up like balloons. Part of the reason for this, aside from genes, is insulin resistance. Many athletes consume huge amounts of concentrated sugar during their careers. Not to mention all of the artificial crud that goes into sports drinks and bars. Insulin resistance is a major factor and reveals itself shortly after their career is done. Even more, anxiety about weigh and dieting predict later eating disorders as well as weight gain.

Another thing to talk about is that many studies about weight regulation comes from studies of rodents. I see this as problematic, because mice and rats do not eat the same way we do and they do not deal with stress in the same ways; they are not human. Many would argue this point, but as many studies that are out there on obesity, the obesity epidemic is still growing strong in America.

More reasons of why diets fail

In humans, dieting deranges the brain signals that tell us to eat more or less. Our sensory cues become blunted. In the modern environment, many of those cues were invented by big companies in order to make us eat more, like adding specific amounts of sugar, high fructose corn syrup and other artificial molecules. The also get us by advertising, supersizing and making it cheap. The all-you-can-eat buffet are atrocious and simply do not exist to any great extent at least in Europe. Studies show that long-term dieters are more likely to eat for emotional reasons or simply because food is available.

People also diet because they are concerned about health problems associated with obesity like heart disease and diabetes. But America’s view of obesity as uniquely deadly is mistaken. Things that drive early death are poor fitness, smoking, hypertension, low income and depression

In addition, the evidence that dieting improves people’s health is surprisingly poor. Part of the problem is that no one knows how to get more than a small fraction of people to sustain weight loss for years. The few studies that overcame this hurdle like Stanford University’s Chris Gardner (A to Z trial) are few. With the newer trends of lower carbohydrate living and optimized fat metabolism, it will be interesting to see if the weight really stays off.

Pay attention to what you consume most. For example, we all consume a lot of water. Some of us eat a lot of meat or certain types of vegetables. In the case of water, just about every type of medication has been found in our water supply. The reason I bring this up is because if you are taking in something that is contaminated with antibiotics for example, your body will likely gain weight that much easier. The best example of this is when farmers feed our animals low dose antibiotics to make them gain weight. Part of the reason antibiotics cause weight gain is that the animals take a fewer number of calories to cause weight gain. In other words, they are using the calories more efficiently. A proper explanation of this goes way beyond this article, but I am sure that you get the point.

If dieting doesn’t work, what should we do instead? Take it slow. Strive for paying attention to hunger and fullness. Once you know how to handle some of the nuances of how your body is going to respond to certain situations, you can handle them better. Find things that make the situation better. For some it may be a certain tea, for others a coffee with butter. Perhaps a small block of cheese works, or cold water. The big challenge is to find what works for you and stick with it. Gimmicks for the most part do not work. And know that as you progress, know that your brain hormones are going to change. This all takes months to years to take place.

Back to the out of the box stuff. Make sure that your circadian rhythms are in check. I wonder if any of the Biggest Loser contestants focused on light. Walking barefoot on a consistent basis. Then there is adapting to cold. There is a ton of information on cold adaptation and losing weight. Strategic fasting and meditation are two things that can make a world of difference.

So what hope is there for weight maintenance? Absolutely!

Anecdotal reports by people who have succeeded in keeping weight off tend to share common traits.

Making the choice of motivating themselves, surrounding themselves with right people, keeping close track of weight, controlling what food is eaten and quantities, exercising often, putting up with hunger and cravings, and a host of other things.


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