Is Losing Weight a Losing Battle?

WINNING THIS FIGHT IS NOT AS SIMPLE AS THIN PEOPLE THINK!

THIS is a war waged on many fronts. Fasting sheds the unwanted pounds in a hurry. Liquid diets melt them off at a goodly clip. Runners jog them off. Walkers do it at a slower pace. Calorie-counters keep tabs on their food intake. Some resort to more drastic measures. Jaws have been wired shut to thwart weak wills when faced with food. Operations have bypassed certain areas of the digestive tract, have stapled stomachs, and have performed procedures that suck out globs of fat from fat deposits. With all these options, victory must be imminent.

But not so fast! Fat cells once defeated come storming back. Pounds lost return, often with reinforcements. The battle rages back and forth, as temporary successes are followed by disheartening failures. The struggle drags on, discouragement sets in, and weary dieters are ready to capitulate. They shouldn’t. The way is long and the road is rough, but victory lies ahead for the hardy ones who persevere. So gird up the loins of your mind and remember, the harder the fight, the sweeter the victory. At the outset of your battle against fat, you must also brace up your mind to maintain a sense of self-respect and self-worth. You may have to endure the social slights and slurs of a society obsessed with thinness.

You must resist unthinking hostesses who urge you to eat what you shouldn’t. You must survive the prejudices of cruel critics who brand you as gluttonous.a The former would defeat you with kindness; the latter, prejudge you on outward appearances.

You must ignore the simplistic proclamations of the uninformed: “If you didn’t overeat, you wouldn’t be overweight!” They make it sound simple, but it is very complex. It is true that if you do not eat more calories than you burn up, you will not gain weight. In many cases, however, not all calories eaten are burned up. For various reasons, many of them are stored as fat in fat cells. So for the overweight, it can at times be a lonely battle, except for supportive friends aware of the odds against which they struggle. And those odds may be formidable indeed.

Preliminary to plunging into the complexities of the struggle, however, there is this question to be weighed: Do you need to lose weight? In some countries thinness has become a fetish. Some become thin to the point of being undernourished, or even go to the extreme of anorexia nervosa or bulimia. Rather than weight alone being the basis for judgment, the percentage of fat in the body is considered by scientists to be a better guide. They define overweight as obesity when in men 20 to 25 percent of body weight is fat and in women when 25 to 30 percent is fat.

Certainly, specific weights given in tables based on height and weight alone are inadequate. As one researcher says: “What the tables don’t tell you, though, is that two people of the same weight and height can differ greatly in their degree of obesity and overall physical condition. Lean tissue and muscle weigh more per volume than fat, so weight alone is not a very good measure of health or fitness.” A more reliable guide​—though still imperfect—​are those tables that consider age, sex, and body type, and give a range of acceptable weights, such as the one on page 7.

Many persons assume that fat cells (called adipocytes) are very lazy things, just lying around in the body taking up space​—far too much space! Fat tissue (called adipose tissue) is more than a storage depot for triglycerides (fats). About 95 percent of adipose tissue is nonliving fat, but the remaining 5 percent is divided between structural material, blood and blood vessels, and living cells active in the body’s metabolism. These cells can be very greedy, grabbing on to and converting to fat the dietary nutrients from blood circulating through the capillaries that intersperse adipose tissue. Certain hormones promote either the synthesis of fat or its release as fatty acids into the blood to meet the body’s energy needs. Instead of being lazy, to the despair of some people, their fat cells work overtime!

In the past it was thought that once established in the body, fat cells did not increase in number, only in size. Later research has proved otherwise. As one scientific source says: “Enlargement of the storage capacity of adipose tissue is accomplished first by enlargement of the adipocyte contents of storage fat, triglyceride, and later on, when available adipocytes are filled to full capacity, by the formation of new fat cells.” When nearly empty, the adipocytes are very small, but as they add fat, they can increase their diameters tenfold, which means an increase in volume by a factor of about one thousand.

There are certain fat depots in the body where fat tends to collect. In men the waistline is one. In women it is the hips and thighs. Such persons may shed fat, but these locations are the last to release theirs. Researchers have discovered that fat cells have on their surfaces small molecules called alpha and beta receptors. Alpha receptors stimulate fat accumulation; beta receptors promote fat breakdown. Those favoring fat accumulation predominate on the fat cells of the hips and thighs of women and on the abdomen of men. One woman lost 15 percent of her body fat but virtually none from her hips and thighs. A man cut his weight drastically but kept his paunch.

Counting calories is not the simple solution to losing weight that many think. Calories are not equal. Eat 100 calories in carbohydrates and you may store 77 of them as body fat​—23 are burned in digesting the carbohydrates. But consume 100 calories in a pat of butter and 97 are stored as fat​—only three are consumed for digesting. The reason: Dietary fat is already chemically close to body fat, so it is stored as such much more easily. Counting calories is only part of the story. The source of those calories also counts. Calorie for calorie, fat foods are more fattening and less nourishing than carbohydrates. In one study, men overfed on a high-carbohydrate diet for seven months gained 30 pounds, but men overfed on a high-fat diet gained 30 pounds in three months.

Liquid diets shed weight more rapidly, which frequently causes complications. During the 1970’s liquid-protein diets were promoted, and by the end of 1977 approximately 60 deaths were attributed to them. Ventricular arrhythmias, that is, rapid and irregular beating of the heart’s ventricle chambers, were believed to be the immediate cause of many of these deaths. Current liquid diets have been improved by the addition of not only protein but also carbohydrates, fats, vitamins, and minerals. Even so, such low-energy diets with their fast weight losses still have their drawbacks.

The drastic calorie reduction of diets producing fast weight losses slows body metabolism​—the decline begins within 24 hours, and in two weeks the metabolic slowdown can be as much as 20 percent. One doctor questioned about low-calorie liquid diets commented on this: “Your metabolism will slow to a crawl on so few calories, and you’ll find yourself irritable and fatigued. Also, up to 70% of your long-term weight loss will be muscle, not fat.” Dieters are wanting to lose fat, not muscle. Muscle tissue is the body’s best calorie burner. Losing it slows your basal metabolic rate​—the measure of energy used to maintain routine bodily functions, such as breathing and cell repair. This accounts for approximately 60 to 75 percent of energy consumed by the body.

This metabolic decline is why dieters often stop losing weight after a few weeks of severe dieting. One woman, who since she was 16 had kept her weight down by dieting, gained 25 pounds with the birth of her first child but quickly lost it, then gained 50 pounds after the birth of her second child and could not lose it. She reports: “At one point I went to a weight-loss clinic where I was cut to 500 calories a day. I lost ten pounds the first month, two the second month and nothing the next two months despite faithfully following the program. When my calorie intake was raised to 800 per day, I steadily gained 2 pounds per week till I had gained back the 12 I had so painfully lost. So discouraging!”

In addition to a slowed-down metabolism, an enzyme, lipoprotein lipase, that regulates fat storage, may become more active in storing fat after crash dieting. For both these reasons, some people regain lost weight when normal eating is resumed. In fact, the majority regain the weight they lost​—95 percent for the very obese and 66 percent overall. The weight regained, however, is mostly fat, not lost muscle, which means a reduced metabolism that encourages more fat storage.

One researcher noticed that those who had lost weight on previous diets and regained it had greater trouble losing it again on later diets. “Could dieting inhibit later weight loss?” he wondered. Tests were conducted on obese rats. On their first diet, it took 21 days to lose the excess weight and, after going off the diet, 45 days to regain it. On a second diet, it took 46 days to lose it and only 14 days to regain it​—twice as long to lose it and three times as fast to put it back on!

Does it work the same with people? On low-calorie diets, 111 patients lost an average of 3.1 pounds [1.4 kg] a week, but on the same diet a second time lost only 2.1 pounds [1 kg] per week. Follow-up tests with two other groups of people verified those results.

Many of the experts call obesity a disease, say it is in the genes, is inherited, and that the body has a set point for weight that may destine you to fatness. But not all scientists agree on the theories on obesity. The Annals of the New York Academy of Sciences says that overweight itself, whatever its original cause, may be responsible for the changes in body chemistry: “The obese state, once established, may be stabilized by secondary metabolic changes that the obesity itself generates.”

Annals also questions the set point theory: “This Annal provides little evidence in support of either hypothesis.” Glandular problems are cited as causes of overweight, especially the thyroid, which has a major role in controlling metabolism. The point is raised by some, however, that its failure might be caused by overeating. Dr. Riggle of Texas comments on this: “The thyroid governs metabolism, as well as the pituitary. But we have to remember that people who get into poor nutritional habits cause these glands not to get the nutrients they need to manufacture their products. So the glandular problems can start with the dietary indiscretions.”

Overeating is the simple reason for obesity that so many people, including researchers on obesity, associate with it: “For most obese people, however, the accumulation of excess weight and adipose tissue most likely signifies a prolonged, and often, insidious process: excessive consumption of calories, during a sufficient number of days, above and beyond those used for muscular or metabolic work.” (Annals of the New York Academy of Sciences, 1987, page 343) The health hazards they thereby lay themselves open to are sobering indeed:

“Obesity is associated with a number of health hazards. It may impair both cardiac and pulmonary function, modify endocrine function, and cause emotional problems. Hypertension, impaired glucose tolerance, and hypercholesterolemia are more common in overweight individuals than in individuals of normal weight. Thus, it is not surprising that obesity may contribute to morbidity [disease] and mortality in individuals with hypertension, stroke, type II or non-insulin-dependent diabetes mellitus, some types of cancer, and gallbladder disease. Over the long term, obesity is also considered an independent risk factor for atherosclerotic heart disease.”​—Journal of the American Medical Association, November 4, 1988, page 2547.

Sounds ominous, doesn’t it? And not just because of the big words. Obviously, losing weight is a battle that needs winning. Are there ways that will help you gain the victory?

[Footnotes]

[Blurb on page 4]

INSTEAD OF BEING LAZY, FAT CELLS IN OVERWEIGHT PERSONS WORK OVERTIME

[Blurb on page 5]

COULD DIETING INHIBIT LATER WEIGHT LOSS?

[Blurb on page 6]

THE HEALTH HAZARDS ARE SOBERING INDEED

[Chart on page 7]

HEIGHT AND WEIGHT TABLES

Height Weight

MEN

5 2 128-134 131-141 138-150

5 3 130-136 133-143 140-153

5 4 132-138 135-145 142-156

5 5 134-140 137-148 144-160

5 6 136-142 139-151 146-164

5 7 138-145 142-154 149-168

5 8 140-148 145-157 152-172

5 9 142-151 148-160 155-176

5 10 144-154 151-163 158-180

5 11 146-157 154-166 161-184

6 0 149-160 157-170 164-188

6 1 152-164 160-174 168-192

6 2 155-168 164-178 172-197

6 3 158-172 167-182 176-202

6 4 162-176 171-187 181-207

WOMEN

4 10 102-111 109-121 118-131

4 11 103-113 111-123 120-134

5 0 104-115 113-126 122-137

5 1 106-118 115-129 125-140

5 2 108-121 118-132 128-143

5 3 111-124 121-135 131-147

5 4 114-127 124-138 134-151

5 5 117-130 127-141 137-155

5 6 120-133 130-144 140-159

5 7 123-136 133-147 143-163

5 8 126-139 136-150 146-167

5 9 129-142 139-153 149-170

5 10 132-145 142-156 152-173

5 11 135-148 145-159 155-176

6 0 138-151 148-162 158-179

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Reprinted with permission from Society of Actuaries and Association of Life Insurance Medical Directors of America