We can put people on the moon but we can’t help them control their weight. Our population is growing – faster in total mass than in total numbers. A lot of people spend a lot of time, money, and energy dieting – mainly restricting calories. Guess what? They end up heavier than the people who don’t even try to diet. Some people have gone to the extreme of having fat removed by liposuction. Guess what? They gain it all back. What’s the problem? It doesn’t seem fair.
If you are trying to lose weight you have two powerful forces against you: mother nature and your brain. You have almost no chance – unless you understand what’s going on with your basic physiology and survival instincts. The medical problems associated with obesity are too big to ignore. Pardon the pun. In this weeks prestigious Lancet Medical Journal they report a study that obesity (presumably mainly abdominal obesity) causes us to age faster. This results on average in 9 years shorter life span. Obesity is associated with:
Of course with insomnia and depression it’s a chicken and egg problem. Insomnia increases cortisol which can increase weight, but obesity also can cause sleeping problems, especially difficulty with breathing. Remember, to understand the way things work with our bodies and minds you need to understand immediate causality, e.g., carbohydrates increase serotonin and protein decreases it. But even more important than immediate causality is ultimate causality. Why does this phenomenon exist in the world? What is its purpose?
I hate to use the word evolution because for many people – ironically especially in this country – it causes a defensive reaction. It is as though to believe in evolution is to not believe in God. But evolution has nothing to do with religion or faith. Evolution is the process of adaptation over time. This is the same process that leads to resistant strains of bacteria or viruses. If you really want to understand the problem of obesity and weight control you have to understand its role in our adaptation over the millennia.
What exactly is fat?
Why do we have a lot more of it – again especially in this country? Unfortunately one of the reasons is that we Americans diet more than other people anywhere else in the world or in all of recorded history. Fat is the main way we store energy. We also store energy as glycogen made up of glucose (sugar/carbohydrates). But glycogen is stored in water and for every pound of this stored energy we store 4 pounds of water. Not very efficient is it? But because it is more quickly accessible in an emergency we need to have some.
Our total energy stores of glycogen would only get us through one day. If we burn glucose (glycogen) anaerobically (without enough oxygen) as in sprinting or hard weight lifting we burn it many times faster because we’re only partially breaking down the glucose molecules (to lactic acid). Breaking down big molecules to small molecules releases energy. Building up bigger molecules requires energy. A sprinter in a 100 meter dash uses up all their glycogen in 10 seconds. So most of our stored energy is fat, and gemerally women have more of it than men. This is presumably related to hormones and the fact that women provide the nutrition to their babies. In the old days women were usually pregnant or nursing following puberty all the way to menopause. There is a story, possibly apocryphal, about a group of pioneers traveling to California. They became trapped for months by an avalanche, and of all the pioneers, only the women survived.
Why do some people store more fat than others? Why does it matter where you store it? It starts with genetics, and the concept of polymorphism. The survival of the group is enhanced by having a variety of traits. It is better if everybody is not the same. Some people are more naturally lean and therefore more mobile. Other people store more energy as fat – protection against scarcity of food.
What is our “weight-o-stat”?
It seems like simple math: calories in vs. calories out. Too many calories taken in and you gain weight. Burn more calories than you take in and you lose weight. 3,500 calories equals one pound, so 500 extra calories taken in per day (e.g., 3 cola drinks, 3 beers or glasses of wine), and you gain 1 pound per week. An extra five miles or so walking, jogging or the equivalent per day and you lose 1 pound a week. The problem is the formula is wrong. Just as a thermostat will turn an air conditioner or heater on and off to maintain a preset temperature, we have a rheostat (or “weight-o-stat”) in our brain – in the hypothalamus – that adjusts our appetite and metabolism to maintain a preset weight.
You can change the setting but guess what, dieting (in the context meaning calorie restriction) raises your weight setting. It’s all about homeostasis (meaning same state). Our brains maintain our body to electrolyte balance and many other things including our weight. When we restrict calories our survival brain mechanism assumes it means there is not enough food available – if that’s the case we better turn down our metabolism to save energy (i.e., fat) and when food becomes available we better eat as much as possible. This process is also activated when we go several hours without eating. One solution is to eat smaller more frequent meals. Eat at least 3 times per day. If you take in the same total calories in 4-6 meals/snacks you will increase your metabolism. Research has found that people who don’t eat breakfast end up weighing more. Solution – eat breakfast including protein and fat, not just carbohydrates.
Another concept in brain physiology is plasticity. The brain changes in response to experience. Our ancestors were outside all day every day and they were physically active. We on the other hand are mostly indoors and relatively sedentary. We are much more mentally active – which generates a lot of stress. Stress causes release of cortisol (stress hormones) and insulin, both which cause weight gain. Because our exposure to bright outdoor light is miniscule compared to that of our ancestors, the survival brain thinks a lot (or most) of us are hibernating. What does hibernation mean? To the survival brain it means the environmental conditions are not suitable for productive activity, such as food gathering. The natural response is again to turn down our metabolism to save energy (fat) and when food is available to eat as much as we can.
Low brain serotonin levels cause carbohydrate craving and eating carbohydrates raises our brain serotonin, dopamine, and endorphin levels – we can become food addicts. Bright light and carbohydrates increase serotonin, and vigorous physical activity increases endorphins. So is bright light one of the answers? Yes. This means being outside more without glass between you and the reflected sunlight (you don’t have to be in the direct sunlight) contributes in keeping your metabolism healthier. If it is impossible for you to incorporate sunlight into your daily routine, full spectrum artificial light can be substituted. (More about this later).
Another behavior that causes weight problems is getting inadequate sleep. You need 7-8 hours of quality sleep per night. Even one night of inadequate sleep raises cortisol levels which can increase weight, so another solution to weight control is getting good sleep every night even with a sleeping pill. (See my article on best sleep meds)
How do we lower our “weight-o-stat”?
Probably the most important component is physical activity. “But I hate to exercise”, you might say. Well don’t call it exercise, call it work – vigorous house/yard work or call it play – go dancing, but having a vigorous life style tells your brain that you are a mobile person. Being physically active is the best way to reset your “weight-o-stat” lower.
As hard as it is to lose weight, maintaining weight loss is even harder.
Studies at UCLA and the University of Colorado found that the only thing that correlated with maintaining weight loss was 30-60 minutes per day of vigorous physical activity. Most individuals have to work up to the ability to sustain physical activity for a period that long at a vigorous intensity.
How do I Start to Become More Physically Active?
First, you need to be checked out by a physician, especially if you have risk factors for heart disease, including high blood pressure, diabetes, high cholesterol, smoking, abdominal obesity, etc. Second, you need to start slow. One of the most common reasons for failure is too much too soon leading to extreme overuse, soreness and even injury. Walking is probably the best activity, because it is easier on joints. You don’t have to do it all at once. You can walk around your house or outside while talking on your cell phone, or you can park further away at work or at the mall.
How to Keep the Weight off
A very disenhartening statistic is that 95% of people who lose weight gain it back. Fortunately someone had scientific curiosity to do a study to find out what is different about the 5% of people woh maintained weight loss. Dr. Jim Hill at the Center for Nutrition at the University of Colorado has established a National Weight Control Rigistry for the 5% of individuals able to maintain significant weight loss. To qualify for the study, participants had to maintain a minimum of 30 pounds for at least one year. There are over 6,000 individuals registered who have maintained a 67 pound average weight loss for an average of 5 1/2 years. What is different about this uniquely successful group? CNN did a special report on these individuals in a program called "the 7 Habits of Highly Sucessful Dieters" and here is what they said:
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Expect Failure and KEEP TRYING! 90% of the Successful Group had failed several times.
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Don’t Deny Yourself. This means if you are craving chocolate have some chocolate. Moderation is the key, and having a little of the things you crave most can prevent binges.
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Weigh Yourself Often. For maintenance purposes it is probably helpful to weight yourself at least 3 times per week, but when trying to lose weight it is better to weight somewhat less often. For example once a week or once every 2 weeks.
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Exercise or be Physically Active for 1 hour per day. This may seem tough, but learning to incorporate physical activity in you life is vital to no only maintaining a healthy weight, but preventing chronic disease and living a higher quality of life.
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Add Little Bouts of Activity During Daily Routines. This means taking the stairs instead of the escalator. Pacing the house while you talk on your cell or cordless phone or taking a 5 minute walk on your lunch break.
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Eat a healthy Diet. Among other things, eating healthy means decreasing the amount of saturated and trans fat in your diet and eating fewer foods high in simple carbohydrates and more foods high in complex carbohydrates.
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Eat 5 Times per day Starting with Breakfast. Eating smaller portions more frequently keeps your metabolism active while maintaining a more stable level of blood sugar which not only keeps you burning more calories, but results in feeling better too.
More about genetics, the best quality foods to eat, and medications that can help will be discussed in Part Two. See Weight Do’s and Don’ts
