Weight Loss – what works, really?

You may remember Dr.Charles whose blog was here on Scienceblogs.com for a while two years ago. He took a hiatus from blogging, but is now back at it with a vengeance at his new site which I warmly recommend you visit.
Today’s post is interesting – and not just because it is partially about a PLoS ONE paper – Why Exercise is Not the Best Prescription for Weight Loss which fits perfectly within the ongoing discussion about weight-loss and dieting going on a couple of my SciBlings’ blogs right now.
PalMD is going on a diet and monitoring his progress publicly, on his blog.
Dr.Isis tells him he is doing it wrong.
And don’t forget that a couple of years ago Chad went on a successful – and also highly public – diet: see his updates (each with some additional thoughts about dieting) here, here, here, here, here and here.
So, who’s right? What are your experiences? And what can I do with my 6’1″ and 126lbs – weight I’ve had since I was a teenager? Nothing seems to work to help me gain – I eat a lot, actually….


22 responses to “Weight Loss – what works, really?

  1. natural cynic

    anabolic steroids and a lot of iron to push around ;-\
    well, at least do some strength training.

  2. I have mostly given up on weight loss, and concentrate on gaining strength and endurance. My weight holds steady but I get around better. Must be some improvement in cardiovascular function and upper-body strength helps me in lots of ways. I am making small habitual adjustments in diet though. Learning to leave food on the plate, etc. Don’t know what the long-term effect will be.

  3. [quote]And what can I do with my 6’1″ and 126lbs – weight I’ve had since I was a teenager? Nothing seems to work to help me gain – I eat a lot, actually….[/quote]
    If it wasn’t that I like your blog and you seem like a nice person, I’d say something really snarky. 😉 Even in jest, that sentence can make some of us feel like crap. It’s almost as bad as the time I was shopping with my wife and she couldn’t find anything off the rack that would fit. They were all too big. Meanwhile I as ordering out of the Big adn Tall catalog and hadn’t bought clothes off the rack since I was 10.
    The only thing that has ever worked for me was counting calories. I have gained and lost 200+ pounds 3 times in the last 25 years. Each time by reducing caloric intake. But every time I hit an “average” weight, I would get these cravings and go on uncontrollable binges. After trying every other antidepressant, wellbutrin has helped with the binging.

  4. For your problem, Bora, what worked for me was turning 40. Didn’t work for some other people, so maybe not a universal solution.
    Doing some regular strength work is a good idea for your health, regardless of whether you add much muscle. And you may not. While my strength has varied greatly, muscle mass hardly at all.

  5. There is some research indicating that something is going wrong in your brain when the uncontrollable urge to overeat strikes: http://www.jneurosci.org/cgi/content/abstract/29/1/43
    I have recently lost 17kg. It hasn’t been hard because I’ve generally lost my appetite. I need to lose about 17 more. It’s getting hard because even when I’m taking in less than 1,000 calories a day, my weight seems to be at a standstill. I know that I need to start exercising but have recently injured my back at work and am very afraid of further injuring it (any activity makes it BURN with pain).
    I believe that overeating and subsequent obesity are more than just matters of “will power.” Anybody who has experienced the uncontrollable binge probably has the same hunch that I do: There is something going wrong in your brain.
    All of my life I enjoyed a normal weight until 1)I gained about 90 lbs when pregnant and after I lost that weight (after my 2nd child) 2) I gained 80+ lbs on a medication. Even with the recent weight loss, I am 50 lbs over my ideal weight. I do not subscribe to the fat acceptance movement. Being fat puts one at major risk for dozens of health problems (besides the usual cardiac ones that are always sited, there are also various cancers, arthritis, respiratory problems and others.) I have taken care of patients from ages ranging from 17 to 103, from weights ranging from 47 lbs (anorexia, she died) to >850 lbs (our scale couldn’t measure any higher). I have never, ever seen an overweight person in the over 90 age range. I have seen hundreds of people in their 50’s die of medical problems directly related to obesity. At any given time, two thirds of the patients in our 18 bed ICU are either obese or morbidly obese. The serious health conditions (and I’m talking about the ones that make you critically ill) related to obesity are becoming just as common as the problems/diseases caused by smoking — and we see more diseases caused by alcohol abuse than by smoking.
    I smoke too. Just want to be sure all my bases are covered.
    I will never understand why my DH can eat whatever he wants and stay so slender. Surely there is some explanation other than his obvious moral superiority. Thank god our kids are thin. Even if they are too thin (one of them is), nothing is worse than the unrelenting misery of being fat.

  6. Increasing your nitric oxide level might help.

  7. Oops. I meant to “strike” damned skinny and leave the rest. Still haven’t mastered the internets.

  8. Ha! I came to this page to tell you about the Time magazine citing PLoS and mentioned article.
    Oh, well, I still remember those times when my Dad was ecstatic when in few occasions I managed to almost reach 60kg, while I was constantly inhaling tons of food, having Kinderlada jar (yes, jar!) as a snack between meals on everyday basis… being practical illustrations of famous Djole’s song (burek masan i tepsija sampita, pivo mlako, crno). And it came as surprise when, just like Catherine, thought that scale was wrong for gaining 22kg in 2.5 months being pregnant with George (paperdisciple.etsy.com), but it was still in normal range for my height. Ups and downs in next 15 years were mostly due to extensive stress (bombardment, loss of my Dad) and illness (viral inflammation of the heart muscle), but still it was always inside of range for the normal weight UNTIL, just as Robert, I turned 40. Whooosh! Like someone remodeled me – all of the sudden fat began piling up in places it has never before, my appetite almost vanished, and again I am overweight :O I do walk and I do a lot of physical work (try sanding the wood and sweating), but it looks like moving nowhere regarding weight. Oh, well…

  9. I decided to get serious about shaping up a month ago, after having gotten up to 159 lbs (on a 5 foot 1 inch frame) over the last year. Almost all of that extra weight came from eating out. I met a new guy and we ate out a lot. Too much apparently.
    So now what I am doing is tracking my calories to stay between 1300 and 1500 a day. I am not hungry at all. I eat plenty but I have simply switched to better foods. I even eat bacon! Sparingly but I do eat it. I drink light beer (not Bud Light, however) when I do drink beer, which is less than I used to. I am down about 10 pounds so far in a little more than a month. I have also increased my workouts. I do some classes, like spinning and I also swim.
    My goal each week is to burn an additional 1500 calories or and workout at least 200 minutes. That typically is 4-5 days per week for up to an hour. I need to lose about 25 more pounds.
    The only thing that really works is lifestyle changes. Simply making better choices will work better in the long run than trying to deprive yourself of anything. The thing that really makes it hard is restaurant fare. Not only is everything really high in calories and fat but the portions are HUGE. So when we go out, I check out the menu and try to find something that is not too bad (and that I would like) OR I only eat a small portion of the order and bring the rest home.

  10. Hey Bora! Good looks and health come in ALL sizes. Your body type is your body type. Just make sure you get regular physical check ups! And please check out the website of the organization I just joined and whose conference I just attended: the Association for Size Diversity and Health, http://www.sizediversityandhealth.org/index.asp. There’s a good base of scientific sources on the website, which provide evidence for the paradigm of Health at Every Size (HAES). I am gearing up to write a lot about the science that examines this paradigm on my blog, Fat Science.

  11. Have to add here socio-cultural, the food quality, consumerism and lifestyle aspect of gaining weight especially in United States.
    Since I work for United Nations – FAO section you all know that quality of the food is not the same in Europe, US and e.g. in Serbia. Before I moved to USA for my Master thesis research I was super slim, almost anorexic. Not that I wanted to – but as Bora said: i ate a lot and my metabolism and way of life was super fast and walked a lot. I was eating all high caloric food to gain some weight and nothing helped. I was tall, slim girl.
    When I arrived to States in 2003, I looked like an alien super skinny to Chapel Hill folks. After a few months, I looked like a human (I filled my bones with some flesh). After a year – I got overweight: I gained 22 pounds. US folks would say that I’m not fat for my height (5’11”), I look great, but when i landed back to Serbia after a year or so spent in States first thing my mom couldn’t recognize me, then saying how fat I became.
    There you go, for your notice: I never consumed fast, junk food whilst being in States: I cooked, I ate at University, watched what I eat, it’s true that portions in States are 3 times larger than in Europe, but I also think that the food there contains lot of chemicals and/or hormones that made my body swollen, gaining weight just like that.
    Later many people from diaspora were consoling me that everyone who comes to States gains 20-30 pounds in its first year. I don’t know if this is a myth, but ever since it is hard to get back to my old metabolism of super slim and skinny girl in 20’s, but rather of curvy so called Italian women Mediterranean type.

  12. I’ve heard Dr. Charles is a smart dude, but his analysis of that PLOS article is crap.

  13. Robert: Bora already hit forty….a few years ago. Still skinny. He’s been in the US almost 20 years. Still skinny. He eats a lot. (Yes, his mother had him tested for worms.) There is no shortage of opinions on the subject of why people get/stay fat, lose weight/gain it back. People who lose a significant amount of weight and keep it off are as rare as the skinny guy over forty who can eat whatever he wants and never exercise. The question is WHY? Maybe if we were asking better questions, there would be some answers that actually lead to solutions (for the problem of obesity).

  14. Wow! I think I’m envious of being 6 1 and 126 lbs. Might be a wee bit on the slender side, but I’m 6 1 and working on getting under 200 lbs. One thing that is helping me is testosterone replacement therapy. The gut is starting to shrink, which is great. My wife, who is not into blogging, was way out of balance with her hormones, but she came across a site that got her working with her doctor to get her hormones right and she has lost over 60 lbs, and feels great. I’ll ask her what the site was, and post it…
    PS: She has kept it off, with no funky dieting, for almost a year now……..

  15. Rogue Epidemiologist

    I have 24 pounds I wish you could borrow (or take off my hands — and belly, thighs and back-cheeks). I’m 5’3″ and trying desperately to get down to 126lbs.
    That PLoS paper makes me sad because I am very physically active, work out at the gym twice a day 3 or 4 times a week AND play team sports. But finessing the right diet is tough. I can’t cut too much or I won’t function, and of course too much is a common problem.

  16. This past year, for the first time in my life, I’ve become officially overweight, at BMI=26. I’m also in one of the fittest and most physically active periods of my life, even though I’m middle-aged. I don’t feel middle-aged, but I do feel heavy, and I’m going to have to cut my diet and boost my exercise levels even more. Part of my job entails teaching gross anatomy to medical and dental students, and oftentimes I’ll spend 4-5 hours per day running around the anatomy lab, helping with dissections. I appear to have more stamina than students who are half my age, yet I’m no longer slender like many of them. I can’t eat what I would like to eat either, else I’d be huge.
    I know that I can reduce my weight back to healthy levels, but nevertheless, I think I’m fighting some genetic traits that helped my peasant ancestors survive. My recent ancestors often lived on potatoes, dairy products, eggs, and garden vegetables (beets, cucumbers, etc.) for extended periods, and on such a diet I tend to thrive and gain weight. Processed foods would make the situation worse, so I try to avoid them. I would do best on a vegan diet, but I’ve tried that several times, and find it difficult to manage with a full work schedule.
    Although I think that many men are conscious of their weight, and willing to share their struggles with weight management, women, at least in US society, are subject to more criticism about their weight. I think women are less likely to be in denial about being overweight or obese. I know that even when I’ve been at the high end of “normal” weight, and especially now that I’ve tipped into “overweight”, I receive a lot of unsolicited advice about diet and exercise, often from people who have no idea about what I eat, or how much I exercise. When I’ve been underweight (in grad school), people tell me that I look “so much better”. Basically, the take home message for me is that a middle-aged man can look like a walrus with a beer gut, and people will tell him he looks great, whereas a middle-aged woman had better be underweight, or she’s a fat cow.

  17. I’m one of those people who are on the other side of the issue, i.e. how NOT to lose too much weight. Last year, I rock climbed a lot and ate too little– I lost way too much weight and had to gain it all back.
    However, two months ago, I was 4 pounds heavier and a lot less in shape than I am in now. I decided to get into shape. I signed up at a gym and started going 4-5 times a week. Since I started, I’ve been very consistent, only missing a day or two if I was sick. I’d do two days of weights (and I lift until I feel like Jell-O), one day yoga, and 1-2 days of exercise bike/pilates/power-walking (due to asthma, running is not good for me). I work out enough that I’m pleasantly sore every week. Granola became a larger part of my diet because it would last me 4 hours before I was hungry again– and my portion size changed– I started eating smaller meals more often. A rough guess is that I eat 1400 calories/day. I really can’t imagine eating 2000 calories per day, unless I eat a T-bone. Anyway, for me, everything started with exercise; the rest came later.
    My sister also losing weight, and the big difference between us is that my job is more physically active — I’m on my feet, walking, all the time. Unlike her, I don’t snack all through the day. Drinking sodas hurt, so I stay away from those; I only drink fruit juice (sometimes watered down) and Gatorade. I rarely eat fast food and I stopped eating so much ice cream. I eat my Mom’s food, and she’s a health nut. My favorite grocery store is Trader Joe’s or Whole Foods. There’s no love/hate relationship with food– it’s there when I need it, and I don’t eat when I’m not hungry.
    What works for me is a general lifestyle “thing” + lucky genes + a certain psychology/physiology + the nature of my job + personal likes/dislikes. I don’t think there’s one big secret thing everyone can do and like magic, it works. Everyone has different facets of their lives they need to take into account, different choices.

  18. it’s not that easy to lose weight. It takes a lot of effort.

  19. lose body fat

    I think healthy eating and being physically active is the correct way for long term weight loss. Going after crash diets or rigorous exercises may be fine in short term and people may benefit in terms of weight loss, but in the long run they have to work at improving their lifestyle habits so that they remain fit and slim.
    A lot of people say rapid weight loss is bad for you, so I guess the slow and healthy approach with permanent lifestyle changes is a good way for people.

  20. rapid weightloss

    When trying for weight loss, always try for permanent loss and not look for temporary solutions.

  21. Sanjeev kapoor

    Weight loss problem is really booming these days. It also have some serious consequences. so, we must not take it seriously but take appropiate steps towards it…

  22. For men who like a regular trip to the pub, it is time to consider alternative Friday night activities. Alcoholic beverages are full of calories and are heavy on the gut. If you’re wondering where the term “beer belly” comes from, look around at your regular pub buddies and chances are most of them have their guts sticking out of their belts.