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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.

Why Women Need Fat | Merry Christmas from BFB!

DeeLeigh's picture
DeeLeigh
December 22nd, 2011 | Link | Thanks so much!

Thanks so much!

vesta44's picture
vesta44
December 21st, 2011 | Link | That would explain why every

That would explain why every time I've lost weight in the last 25 years I've gotten weaker and my mobility issues have gotten worse. It's not because I've gotten fatter, it's because every time I've dieted, I've not only lost fat, I've also lost muscle mass. And when I regained the weight (and then some), I didn't regain all the muscle mass I'd lost.
But this tells me that it's not too late to improve matters, if I can just figure out what kind of exercise plan will work within the limitations I have (makes me wish the lake across the street was clean enough to swim in and had a beach). Something to think about, research, and work on. Gives me hope, anyway.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

DeeLeigh's picture
DeeLeigh
December 22nd, 2011 | Link | Vesta, that's a really good

Vesta, that's a really good question and a very real issue. People who are feeling sluggish but who have no major structural issues with their body could pretty much do whatever they enjoy for cardio and perhaps mix in some yoga or pilates and weight training. I know that you've got some mobility issues; perhaps some joint issues?

You may already know everything I learned when I was dealing with my messed up hip. I nursed it along for years by walking in very supportive shoes and I gradually went from mixed impact to low impact to water-based cardio stuff. I found that swimming or aqua aerobics were the best way to get some activity in as my hip got worse, because I could get up to the same intensity I'd have with fast walking or jogging with zero impact. Also, being in the water is nice. (I should note that I actually enjoy group exercise classes. Not everyone does, but there are a lot of other things to do out there)

Pilates is also really, really useful. More so than yoga, in my opinion. Mat pilates uses many of the same exercises that you'd get from a good physical therapist. It strengthens the muscles in the trunk ("core muscles"), which improves posture and helps with balance and stability. It's damage control. With strong core muscles, I found that I was able to keep my left hip better isolated; prevent the pain and (after the hip replacement) the weakness in it from affecting other parts of my body too much. I don't find pilates fun, but the benefits are so great that it's worth the effort for me.

With the cardio stuff, I push my pace at least to where I'm breathing deeply and steadily, and sometimes until I'm sweating. With the strength work (pilates and weights), I try to be very aware of which muscles are working, which muscles are providing support, my body's balance, and the proper form. Teachers and trainers can help with that, too.

That's just my experience. I wish I was better qualified to give advice. Kelly Bliss has a blog with some really good articles on this, and I talked with her about doing some BFB posts at one point. I'll have to follow up on that...

vesta44's picture
vesta44
December 22nd, 2011 | Link | DeeLeigh - I do have some

DeeLeigh - I do have some joint issues, I have arthritis in my knees. They're not yet to the bone-on-bone stage (well, they weren't the last time they were x-rayed, 3 years ago), but the right one swells and aches when I do any standing or walking, and the muscles around my knees aren't as strong as they should be (stairs kill me and climbing into my husband's 4WD truck is really fun [we carry a small step-stool to make it easier for me to step up on the running board]).
I did buy a DVD called Chair Aerobics for Everyone, by Nikki Glazer not too long ago. I haven't had a chance to watch it all the way through yet, though. From what I did get to see of it, I think it might be helpful.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

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