I am asked this question a lot. The short answer is an abnormal resting metabolic rate. The long answer is more complex and will need some explaining. The following is a generalized explanation of the reasoning for obesity and weight management. I hope it answers the question for you.
The human body is very efficient in utilizing energy (calories). The calories a person ingests (caloric intake) is measured against the energy utilized by the body for normal activity (resting or basal metabolic rate=BMR). The brain determines how much caloric intake will be needed to maintain the current BMR. Additional calories (energy) will be set aside for later use (stored in muscle and liver as Glycogen or in adipose cells as lipids=fatty tissue). When energy is not available the body will utilize the stored calories for metabolism. The truth is that the body will never easily give up this preserved energy it worked so hard to store. Nature has created such an efficient machine that the body would rather digest its own muscle and connective tissue before depleting these valuable (fatty tissue) energy deposits. The reason for this is simple. Humans are designed for famine survival.
When food is scarce (local restaurants and supermarkets are closed) only those individuals with a fuel efficient system will survive. The body’s first priority is to prepare for a prolonged famine. To achieve this goal the body utilizes the glycogen sources first. This usually will provide energy for only 1-2 days. If starvation (less than 800kcal/day) is prolonged then the body begins to metabolize body proteins (muscle fiber and connective tissue) and muscle wasting begins. Muscle wasting is what gives a person that gaunt, hollow appearance of malnutrition. Surprisingly the human body can maintain a severe obesity state but be severely malnourished.
During a low caloric intake period (diet/fasting) the body will dramatically lower the resting or basal metabolic rate which means that energy for daily activities is limited. This causes feelings of fatigue, and lack of energy. This results in less activity to avoid any unnecessary protein break down. If the caloric intake remains low then the body will deplete more muscle proteins and connective tissue. Only after significant amounts of body proteins are depleted will the body utilize the adipose tissue (fat stores) that it preserved for just this purpose. The resulting lowered metabolic rate makes it harder for the person to achieve significant long term weight loss. Weight loss during the first 3-4 weeks of a low calorie diet will include residual stool, glycogen, body protein stores and minimal fatty tissue.
There is very little an individual can do to alter these facts. This strategy is good for famine but what does this mean for people not exposed to daily starvation who have access to unlimited calories (food) at any time of day or night? Obesity! The human body has not changed its ways just because food is plentiful and widely available.
A few “blessed” individuals have genetically higher metabolic rates and can consume larger calories without the body storing the excess as fatty tissue. These individuals have metabolic rates less affected by caloric consumption and will resist producing large fat stores. Understand that these individuals are hated by most of us and will most likely not survive the next famine (small consolation). The majority of us, on the other hand, have metabolic rates that will change depending on caloric intake. We also need to understand that our basal metabolic rate changes with age and activity levels. This means that the majority of us will have a metabolic rate that will slow down with age. A higher BMR in our early years usually leads to unlimited caloric consumption (overeating) when we are younger and when these eating habits are well ingrained, then we grow older and our BMR begins to slow. If eating habits are unaltered then the body begins to store all that extra energy as fatty tissue which leads to obesity.
This is nature at its best or worst as the case may be.
So, if this is all natural then how do we fight nature?
The answer seems simple, consume fewer calories. The problem is, if an individual can restrict their diet then two things usually occur. The body senses starvation mode and decreases the BMR. The brain senses famine and stimulates the search for food (hunger). Fad diets (very low calorie diets) and “starvation approach diets” (skipping meals, HCG Diets) leads to short term weight loss (glycogen depletion, water loss and early protein loss) but will lower the BMR. Once the hunger issue sets in, most will eventually succumb to the urge to take in larger than normal volumes of food (binge eating), this results in large caloric intake at a time when our BMR is low, resulting in a larger than normal amount of excess energy being stored in adipose tissue (fatty tissue).
Once we have “failed” our fad diet we realize that any short term weight loss has been offset by weight regain usually at a weight more than where we started. Frustrating isn’t it?
Industries and markets have been created to convince individuals that there is an approach to circumvent this process and that all it takes is money. If you buy the perfect meal plan or medication, then the weight will fall off without hunger issues and will stay off forever. These plans are expensive and usually don’t appear to work for anyone except the individuals used as spokespeople hired to sell the idea.
So, is there any hope? Yes!
Is it hard? Yes!
Does it take time and energy? Yes!
Is it expensive? It doesn’t have to be. Let me explain.
In my opinion there are 3 main reasons for weight gain.
1. Food selection. High calorie (great tasting), nutritionally poor foods that are high in carbohydrates (sugars and other fine tasting stuff) tend to stimulate hunger. The body (always vigilant for potential famine) senses the intake of easily metabolized sugars and stimulates the hunger centers in the brain to encourage larger consumption. That is why sodas and other rich in carbohydrate foods make us hungry (appetizers). Eating this type of food usually does not lead to satiety (sense of fullness) until large quantities are consumed (buffet dining). An easy solution is to increase protein food selections. High protein diets will usually decrease hunger for longer periods.
2. Eating Behavior. Eating the right foods but in the wrong way can still lead to weight gain. Skipping meals is the most common mistake. This leads to lowered BMR and increased hunger. The hunger peaks in the evening causing late night snacking right before bedtime. High calorie intake before sleep leads to increased conversion of calories to fatty tissue.
Grazing is also a common problem. Eating a little bit over a longer period and repeating this process throughout the day. Three meals a day with three snacks equals grazing. By eating smaller portions the satiety centers are not triggered and a perpetual mild hunger state encourages continued eating. An easy solution is to eat 3 meals a day. A small breakfast is better than no breakfast. A protein bar is a good between meal snack or meal replacement selection. Make sure the protein bar is not high in sugar content. If hunger is a problem in late afternoon or late evening then appetite suppressants can be considered.
Large volume meals are a growing problem in this country. The aspect of supersizing a meal seems to be common place for adults and kids alike. Eating a large meal tends to increase the amount of calories consumed and since we tend to eat quickly, the satiety centers in our brains are not triggered until are stomachs are beyond full. This results in feelings of extreme fullness 15-30 minutes after meal completion. It would be better if we felt this way during the meal but we are not usually wired that way.
3. Metabolism. Decreasing calorie intake will lower your metabolism. Increasing calorie intake will raise your metabolism to your base line. Starvation diets (Less than 800kcal per day) can cause weight gain by lowering metabolism and promoting binge eating with carbohydrate rich foods. A better option is reducing your caloric intake to 1800-2200 kcal per day and eating the right foods appropriately. Regretfully this will still lead to a decreased metabolic rate. I am sorry to say that there are no medications or special diet plans that I am aware of that maintain metabolic rate for everyone. Exercise and muscle mass are the predominant variables in determining BMR. As little as 10 minutes of structured daily activity (treadmill, stationary bicycle, elliptical, etc.) daily has been shown to maintain resting metabolic rate at a normal level. Keep in mind that this type of activity burns few calories and is only designed to keep your metabolic rate from declining. The addition of 30-40 minutes of strenuous cardio activity (breaking a sweat) will burn calories and accelerate weight loss. The individual that exercises 5-10 minutes daily will have a higher metabolism then the individual that exercise 30 minutes twice a week. (Frequency is more important than duration when discussing metabolism)
Advantage to Indirect Calorimetry Testing
Basal metabolic rates (BMR) can be tested (indirect calorimetry) in the office setting and can indicate whether dieting is a good idea for weight loss or if utilizing mechanisms to increase the metabolic rate is a better option. If the BMR is above 2,000 Kcal per day than reducing caloric consumption will result in weight loss that will be primarily adipose tissue.
If a patient continues to consume fewer calories and their metabolic rate is too low (less than 2000 Kcal/day) than the patient will not be able to achieve any significant weight loss other than muscle wasting. The body defends the “fat” stores by reducing the metabolism. Persistent dieting will only result in further muscle loss and any weight decrease will be short lived.
In Summary, diet and exercise should not be considered temporary events only to be tried before weddings, beach vacations or high school reunions. A common sense approach to eating right and minimal daily activity will usually halt weight gain and may facility weight loss in most of us. The down side is that following this approach will cause increased hunger issues for a large majority of the population. The control of hunger can be manipulated to some extent by protein rich diets and eating behaviors, but some people will benefit greatly from appetite suppressants. Appetite suppressants come in many shape and sizes with different side effect profiles. A safe, effective regime can usually be found for each individual, but that is another story and a different article. There are also a few proven natural supplements that may help some individuals maintain or even increase their metabolism.
For more information please contact us at the “Weight to Go” program. This program is part of the Weight Loss Center
www.WeightLossCenterOK.com
Best Regards,
Dr. Russell Gornichec
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