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Study: Yo-yoers lose muscle, regain fat

A solid (and seldom mentioned) point in favor of Health at Every Size (HAES) is that being physically active and maintaining a high, stable weight results in a different type of large body than yo-yo dieting; a stronger body.

Yo-yo dieters lose fat and muscle and gain back mostly fat. The heart is a muscle, and it shrinks during weight loss. So, when weight is regained without anything being done to recover strength and maintain stamina, the heart stays small and the skeletal muscles don't redevelop. And weight regains are almost always done in shame, in self loathing, and in denial. When people who have previously lost weight are regaining it, we generally blame ourselves for everything - it's what we're told to do - but take no responsibility for the large body that's reemerging. Why would we take care of something that we hate and see as proof of our failure and weakness? How can we stay active when we - reinforced by society and the media - are telling ourselves that we have no self discipline and no self respect?

I've seen this happen to family and friends and it has happened to me too, on a lesser scale. I tend to lose and gain smaller amounts of weight, and never really on purpose either way - but I've fallen into the trap of not taking good care of my body when it's at its largest.

So, when saw this article: Weight Regained in Later Years Has More Fat, subtitled "Study: If Postmenopausal Women Lose Weight, They're Better Off if They Keep It Off," I had a completely different take on the study's results than the Rita Rubin, the author of the article. I would have called it something like "Yo-yo Dieting Cycle and Resulting Psychological Shit Storm Lead to People Neglecting Their Bodies When They Regain Weight."

The study of postmenopausal women suggests that when they regain weight -- and previous research suggests about 80% of dieters eventually do -- they don't recover as much lean mass as they lost. As a result, they end up with more fat, even if they're about the same weight as they were before the diet.

People lose lean tissue as well as fat when they shed pounds, the authors of the new study write. In fact, they write, studies have found that lean tissue represents roughly a quarter of total weight loss. Because the loss of muscle and bone can be especially detrimental to older people, "it is important to examine whether the benefits of weight loss outweigh the risks in this population."

The scientists analyzed the body composition of 78 non-active postmenopausal women, ages 50-70, before and immediately after they'd completed a five-month-long diet. The researchers then weighed the women six and 12 months after the weight loss trial ended and analyzed the body composition of those who regained at least 4.4 pounds.

Most Regained Some Weight

On average, the women had lost about 12% of their body weight. By the six-month follow-up, about two-thirds of the women had regained some weight; by the 12-month follow-up, about three-quarters had, including 11 women who had gained more than they had lost.

After one year, 84% of the regainers had put on more than the benchmark of 4.4 pounds. Those were the women whose body composition was analyzed.

The women had lost twice as much fat as muscle when they were on a low-calorie diet. But afterward, they regained more than four times as much fat as muscle.

Previous studies of weight cycling were done in younger people, who tended to regain fat and lean tissue in the same proportion as they'd lost it, says researcher Barbara Nicklas, PhD, professor of geriatrics and gerontology at the Wake Forest School of Medicine.

(I have to admit that I doubt the validity of the studies mentioned in the last paragraph. I suspect that younger people who regain weight also end up with a higher fat percentage. I've seen it in action.)

When I think about these issues, I do like to try to understand the reasons for things; what about our bodies is in our control and to what extent. I think that for most people, the weight regain is difficult or impossible to prevent, but that individuals have a much higher level of control over our physical activity and therefore our strength, stamina, balance, and flexibility.

Now, some people may say "Fitness is not a priority for me." Fair enough. But, for myself, I've found that being at least minimally active really adds to my quality of life, and nobody should deny themselves a basic level of fitness because they don't keep weight off. Very few people can maintain large weight losses. Most people can fit in 1/2 hour a day of walking, a bit of swimming, a recreational sport, some yoga or pilates, a few dance classes a week - and will enjoy both the activity and the benefits it brings.

If I found myself gaining weight for whatever reason - normalizing previously restricted eating, a prescription drug, a medical condition, menopause, whatever - I hope that I would be able to create a strong, balanced larger body with good posture and the ability to do everyday things like stair climbing, fast walking and short jogs without undue strain.

The lesson I'm taking away from this study is to avoid yo-yo dieting by not dieting in the first place. However, people who have already dieted or who feel they must make the attempt may find that it's a good idea to keep fit regardless of what's going on with their weight. I think that this lose-muscle-gain-back-fat effect could be mitigated if yo-yo dieters kept up some physical activity during the regain part of their cycle, and I think that people whose bodies have already been affected by this and who are now fat accepting can reverse it by easing their now-loved and accepted fat bodies into a higher level of fitness, if they choose.

In a way, the article's author is both too optimistic and too pessimistic. She thinks it's reasonable to tell middle aged women to keep off weight that they've lost while dieting, but treats the net loss of muscle in the yo-yo cycle as permanent and inevitable. I think she's got things backwards.

It's interesting to note that the researchers themselves present the study's results in a neutral way, at least in the abstract. The study is called Is lost lean mass from intentional weight loss recovered during weight regain in postmenopausal women? The first and last authors are Kristen M Beavers (it's her paper) and Barbara J Nicklas (it was produced in her lab) and it was published in the American Journal of Clinical Nutrition in September 2011.

UK Study: kids who are put into foster care tend to get heavier

This study isn't new, but it certainly gives good evidence that putting fat children into foster care isn't going to make them thinner.

From the journal Child: care, health and development November 2008;34(6):710-2.
Obesity in looked after children: is foster care protective from the dangers of obesity?
by SC Hadfield and PM Preece.

Unfortunately, the full article does not seem to be available for free online. However, here's the abstract:

Obesity in all age groups of children has become an increasing concern in recent years. Children looked after by the Local Authority (LA) should be protected from health problems while being accommodated. These studies assess the effect on weight of looked after children (LAC) in the care of a Midlands County Council. They assess the frequency of obesity or overweight problems in looked after children following receipt into care and review changes in body mass index (BMI) while in the care of the LA.

The height and weight measurements of all 106 children who had statutory health assessments while in the care of the LA between 1 January 2004 and 30 December 2004 were used to calculate their BMI. The data were plotted onto standard Growth Foundation charts and the International Obesity Task Force Paediatric cut-offs were determined to distinguish overweight and obese children and young people. The date that the child had come into the care system and the number of moves of placement was obtained for each child from the social care. This was related to the total group and the overweight group of looked after children.

Looked after children are more likely to be overweight and obese compared with standard norms, and there are a number of children (35%) whose BMI increases once in care.

Looked after care did not protect a child from the national problem of increasing weight gain and obesity.

Contrary to the common assumption, the families of fat kids may tend to be better at helping them learn to manage their eating and activity than a family who isn't used to having to worry about it. After all, the tendency to put on weight is highly heritable, and adults who have had to deal with it are likely to be more knowledgeable about how to mitigate it. And, of course, stress tends to cause weight gain (maybe even independent of emotional eating) and it's hard to imagine a worse stressor for a kid than being taken away from their family.

It's a small study, but the results don't surprise me.
Good ammunition for debates with people who think this kind of thing is helpful...

New study: body's resistance to food restriction is long term.

In yesterday's New York Times: Study Shows Why It’s Hard to Keep Weight Off, by Gina Kolata

For years, studies of obesity have found that soon after fat people lost weight, their metabolism slowed and they experienced hormonal changes that increased their appetites. Scientists hypothesized that these biological changes could explain why most obese dieters quickly gained back much of what they had so painfully lost.

But now a group of Australian researchers have taken those investigations a step further to see if the changes persist over a longer time frame. They recruited healthy people who were either overweight or obese and put them on a highly restricted diet that led them to lose at least 10 percent of their body weight. They then kept them on a diet to maintain that weight loss. A year later, the researchers found that the participants’ metabolism and hormone levels had not returned to the levels before the study started.

The study, being published Thursday in The New England Journal of Medicine, is small and far from perfect, but confirms their convictions about why it is so hard to lose weight and keep it off, say obesity researchers who were not involved the study.

Obesity not responsible for kidney stones in children

Breaking News!

From a Reuters artilce, Obesity Not Behind Kidney Stones in Kids, Study, by Genevra Pittman:

While heavier adults are more likely to get kidney stones than slimmer ones, that doesn't seem to be the case in kids, according to a new study.

The finding seems "counterintuitive," say researchers who have noticed an increasing number of both adult and kid patients with kidney stones as obesity levels have been on the rise.

As someone who's been following issues related to weight for, oh, pretty much the entire 30 years that I've been reading the news, I was not surprised to hear that the increased incidence of kidney stones in children is not related to obesity. Why? Because it's been known since the eighties - if not longer - that kidney stones are actually caused by weight loss methods, especially low-carb dieting and weight loss surgery. That's why a higher incidence of kidney stones is associated with obesity; because fat people are more likely to diet and have weight loss surgery.

Correlation doesn't equal causation, and in this case even though there's overwhelming evidence that the causation is "counterintuitive," - that kidney stones are caused by weight loss attempts, not by being fat - it is still being confused in the media and probably by some poorly informed doctors as well. Most people assume being fat must always cause health problems and dieting must always solve them. Except, that's not always true. Sometimes it's the other way around. Any undergrad with access to a research librarian could figure out the direction of causation here, yet it's apparently a mystery even to the "researchers" cited in the quote above.

So, what's causing the increase in kidney stones in kids? My guess is that many parents are feeding their whole family low carb, that kids fed that way tend to be thin, and that they also tend to get kidney stones. Because, let's face it. The habits that can keep people thin are not always heathy.

Social contagion? Yeah, right.

Does anyone else remember those "social contagion" studies of a few years ago? The ones that were trumpeted in the press and cited as evidence that obesity, smoking, loneliness and depression are spread through social networks?

I don't know about you, but when I read about those studies, my bullshit-o-meter (a sensitive scientific instrument!) was going NAW! NAW! NAW! and flashing a big red light.

Loneliness is spread through social networks? Seriously? Isn't that kind of self contradictory? And things like obesity and depression, which are not behaviors but conditions that have a very significant genetic component... through social networks? No, I don't think so.

There are so many better reasons that people with these conditions/behaviors might be friends. They might come from the same extended family or ethnic community. They might need to shop for clothing in the same stores. And in general, people tend to seek out others like themselves for friendship. You really have to wonder about the researchers' motivations. Were they were just trying to justify their own snobbishness and social bias?

Well, apparently some experts on statistics thought the same thing, and they've recently published two papers debunking the methods that were employed in the 'social contagion' studies. There's an article in the New York Times, Catching Obesity From Friends May Not Be So Easy, and you can download the full text of both of the new studies for free:

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