Plateau …

To recap very briefly … Old couch potato is enticed onto a bicycle and it reawakens something within that has been dormant for quite a few years and he likes it.

The regime goes something like this …

• cycle 5 days a week – average 250 km/week in recent weeks.
• weight training 2 days a week.
• Diet – low carb high fat (keto) ovo-lacto-vegetarian, lunch and evening meal nuts in between (usually no breakfast). Protein supplementation to reach ~1.5g/kg of ideal weight.

No calories have been counted.

Too many progress reports would become boring but not enough could give the impression that I was trying to conceal a failure.

Initially, as always, the weight simply fell off …I weighed myself the day I bought the first bike. The diet started three weeks later. The dots represent every Monday since. Somehow I always seem to weigh more on Mondays than on other days, how does that work? If I changed days would that phenomenon follow me?

About five weeks ago the weight loss ground to a halt. 13 kg of ugly weight gone – a guillotine could not have done better (average weight of a human head is only 5kg). Along with it went more than four inches from my waist.

A successful diet is one where an overweight person intentionally loses more than 10% of their body weight – 11kg of 93 = 12% – and keeps it off for more than a year. The foundational study by Stunkard and McLaren-Hume 1959 found that of 100 obese individuals only 2 were in fact successful.

So this is the time to ponder a few important questions.

• Why does weight loss stop?
• What can be done to prevent a big bouncing relapse?

It takes a certain amount of food to maintain a particular weight in the presence of a certain amount of exercise. That’s simple enough but how much varies from person to person and even for one person at different weights. So consider firstly the unlikely case of someone eating the same number of Calories and doing exactly the same amount of work every day. Let’s assume that at the outset Calories in is less than Calories out – the stage is set for weight loss.

There are two forms of energy store in the body glycogen and fat. Glycogen is stored in the liver and muscles.  It is readily available energy, the first to go on a diet and it takes three times its weight of water with it. That’s the easy part. Once we get onto mobilising fat things slow down.

But progress goes on. As weight is lost the energy cost of the work done decreases and the size of the Calorie deficit decreases with it. Weight loss slows and will eventually stop.

In reality it stops well before the point that simple maths predicts for a number of reasons. Humans have not always existed in a world awash with food. We have evolved mechanisms that help us survive food shortages, endure periods of starvation. The recently emptied fat cells pump out lipoprotein lipase, which tells  the brain “hey, we’re starving”. Leptin, the hormone that tells us we have eaten a sufficiency, diminishes. Ghrelin, the hormone that makes your tummy grumble, increases. Peptide tyrosine-tyrosine and cholecystokinine increase. These things conspire to increase your appetite.

Meanwhile the resting metabolic rate goes down in response to reduced thyroid hormone (T3)  and reduced activity in the sympathetic nervous system. Levels of a group of proteins that uncouple metabolism from energy production (analogous to wasting petrol by revving the engine with the clutch disengaged) diminish. In the good times some excess energy was simply turned into heat now faced with a famine nothing is being wasted.

Yet more energy can be saved by reducing nonessential activity.

When the recently obese person is compared to a never obese person of the same weight and body composition their energy economy is quite different. All the differences are to the dieters’ disadvantage. Failure beckons and I’ve traveled that route before.

However, only 98% fail.

So far I’ve relied rather heavily on Exercise Physiology for Health, Fitness and Performance by Sharon Plowman and Denise Smith. The next section owes much to a paper by Wing and Phelan which can be found <HERE>.

They paint a picture that is less bleak, as many as 20% manage to keep the weight off, and they present some of the characteristics of those that do identifying six key strategies for long-term success at weight loss …

1. engaging in high levels of physical activity;
2. eating a diet that is low in calories and fat;
3. eating breakfast;
4.  self-monitoring weight on a regular basis;
5. maintaining a consistent eating pattern; and
6. catching “slips” before they turn into larger regains.

In addition those who initiated weight loss because of a medical trigger such as a relative having a heart attack were more likely to succeed.

Holidays and weekends are dangerous moments and those that maintain the same regime through these periods as they do the rest of the time do best. Once relapse is underway prospects are poor. Depression bodes ill.

I can put a tick against items 1, 4 and 5. Item 6 is really what item 4 is all about and hasn’t yet been put to the test. My most obvious vulnerability is relying on satiety to determine portion size.

But, oh dear, a low fat diet and eating breakfast are not on the agenda.

I have no doubt that these are common practices in those that succeed in long term weight maintenance but my conjecture is that these have not contributed to their success. Clearly these are remarkably self disciplined people. The discipline they have imposed on themselves is a very orthodox one. Dr John Harvey Kellogg told the world that breakfast is the most important meal of the day to the certain benefit of the food producers but there is no evidence that it is to the benefit of the rest of us. On the other hand there is some evidence in favour of intermittent fasting. I tend not to eat after 9pm and defer breakfast until noon giving my pancreas a 15 hour rest on the majority of days.

Fear of fat is another well entrenched orthodoxy. I’ve lost weight on a high fat diet. It defies logic that I can’t maintain weight on a high fat diet.

These two points are examples of well-person confounders – baggage that is carried along with useful characteristics that really do contribute to health.

Or at least I hope that’s the case!