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Conference rocks::weight_control

Title: Weight Loss and Maintenance
Notice:**PLEASE** enter notes in mixed case (CAPS ARE SHOUTING)!
Moderator:ASICS::LESLIE
Created:Tue Jul 10 1990
Last Modified:Tue Jun 03 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:933
Total number of notes:9931

415.0. "YoYo Dieting" by ANT::ZARLENGA (I know I am, but what are you?) Sat Mar 04 1989 22:25

	The April 89 issue of Longevity has a 2 page article on
    YoYo dieting, the dangers, and what to do and what not to do.
    
    	I don't have the time to enter this article here, but it
    should be.
    
    	Anyone who cannot get ahold of Longevity should send me MAIL
    for a copy of the article, and hopefully one of you will be willing
    to type it in (hint, hint...).
    
    -mike z

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415.2"To Diet or Not to Diet"ICARUS::CFIELDCoreyThu Mar 09 1989 16:53225
             <<< ATSE::DOCDISK:[NOTES$LIBRARY]WEIGHTLOSS.NOTE;2 >>>
                        -< Weightloss and Maintenance >-
================================================================================
Note 416.0                  To Diet or Not to Diet                    No replies
ICARUS::CFIELD "Corey"                              216 lines   9-MAR-1989 13:42
--------------------------------------------------------------------------------

    Thanks, Mike for the article.  It makes a lot of sense.  I'm happy
    now that I am losing only 1 - 1 1/2 lbs. per week with Nutri-System.
    The following is the article that Mike was talking about in Note
    415.0
    
    
    			DEATH-DEFYING DIETS
    		       NEW RISKS OF YO-YOING

    							BY JERE DANIEL
    
    If at first you don't succeed, diet, diet again.
    
    Nowhere is this aphorism put more to the test than in the 50 million
    Americans--predominantly women--who devote a good part of their
    lives to repeated, usually futile, attempts to shed unwanted pounds.
    
    About 95 percent of the patients who check into the noted St. Luke's
    Hospital Nutrition Clinic in New York City are failed repeat dieters.
    Thirty-one percent of American women surveyed in a Gallup poll said
    they diet at least once a month.  And in a national magazine survey
    of 15,000 overweight readers, 42 percent confessed they were
    "on-again, off-again" dieters.
    
    Make that read "off-again" dieters.  
    More than half of all dieters ultimately gain back more weight than
    they lose, estimates Dr. C. Wayne Callaway, associate professor
    of medicine at George Washington University School of Medicine and
    former acting director of the National Academy of Sciences Food
    and Nutrition Board.  The unfortunate truth is that the harder and
    more often most people try to take weight off, the more likely they
    are to bounce back to their former weight--and higher.  They are
    victims of a phenomenon causing increasing concern to obesity
    authorities: the yo-yo effect.
    
    It's bad enough that yo-yo- dieting is frustrating and destructive
    to self-esteem.  But its harmful effects are physical as well as
    psychological.  It increases the risk of high blood pressure and
    heart disease; throws the body's metabolism out of whack; and
    negatively affects the distribution of body fat.  Also, the more
    often weight rebound occurs, the more profound the effects.  What
    was begun as a way to prolong life may actually shorten it.
    
    In their efforts to determine what causes yo-yoing and how to prevent
    it, medical authorities have made two interesting observations.
    o Unless done slowly, the weight-loss process itself may be harmful.
    o More effort might be better devoted to urging people to accept
      their bodies as they are.
    "We have become a nation of yo-yo dieters, our weight constantly
    cycling--down, up, down, up--always inching a bit higher than before,"
    says Kelly Brownell, Ph.D., of the University of Pennsylvania's
    Obesity Research Group.  He is directing a national Weight Cycling
    Project to probe the intricacies of the yo-yo phenomenon.
    
    A typical yo-yo dieter might be the 40-year-old housewife who started
    dieting at 16.  She has "tried every diet and pill around."  The
    pattern is always the same:  She loses 30 pounds and bounces back
    with 45; tries another diet and loses the 45,then it's up to 55
    pounds.  Each time it's harder to lose.  "I regain more than I lost,"
    she says, ruefully regarding her 250-pound body.
    
    "If the miracle diets really worked, surely weight loss wouldn't
    be the big business that it is", Dr. Callaway asserts.  "Americans
    spend around ten billion dollars a year trying to lose weight."
    
    One way yo-yoing can be harmful is that dieting in general disrupts
    body metabolism.  When people cut calories deliberately, the body's
    metabolic rate drops dramatically--as much as 20 percent within
    two weeks.  The body adapts as it would during a famine, requiring
    fewer calories to supply the energy it needs.  This is one reason
    dieters often stop losing weight after a few weeks.
    
    Unfortunately, the drop in metabolism often persists even after
    dieters regain their lost weight--or even if they keep it off. 
    At Rockefeller University in New York, Dr. Jules Hirsch and colleagues
    studied grossly obese people who lost an average of 124 pounds each.
    They required significantly fewer calories to maintain their new
    weight--just 2,171 calories per day, less than the 2,280 calories
    normal weight people need to fuel their bodies daily.
    
    "We think yo-yo cycling disturbs the body's metabolism even more,
    making weight loss progressively more difficult," Dr. Brownell says.
    Studies seem to bear this out.  Rats he put on an enforced diet
    took 21 days to go from obese to normal and 46 days to regain their
    former weight after they stopped dieting.  On a second try, the
    same rats took 46 days to lose the same poundage--and only 14 days
    to regain it.  A Swedish study found that after only one yo-yo cycle,
    obese rats were five times more food-efficient than normal rats;
    they could maintain their functions on only one-fifth the calories
    they previously needed.
    
    Pioneer researcher Dr. George Blackburn, associate professor of
    surgery at the Harvard Medical School, found that patients who went
    through his clinic's rigidly controlled weight-loss program twice
    in nine years lost much less weight the second time--5.7 pounds
    per week versus 7.25 pounds the first time.
    
    Dieting, especially crash dieting, subjects the body to a constellation
    of hormonal and physiological changes.  These changes may initially
    help to take weight off and reduce high blood pressure.  But sometimes
    these effects give way to harmful ones as the body tries to make
    do with fewer calories.  Dieting sets off many biochemical changes
    to accomplish this.  "Yo-yo dieting," says Dr. Callaway, "kicks
    in these changes more quickly and may make their harmful effects
    more profound."  Among the upheavals:
    
    NOREPINEPHRINE.  Overeating increases the level of norepinephrine,
    an adrenal gland hormone that constricts blood vessels--meaning
    it helps raise blood pressure.  Normally, during starvation (and
    dieting is voluntary starvation), the brain produces less
    norepinephrine.  Initially, blood pressure falls.  But according
    to Paul Ernsberger, Ph.D, assistant professor of neurobiology at
    Cornell University Medical School, yo-yoing ultimately makes the
    norepinephrine-producing nerve cells permanently overactive; as
    a result, his work with rats shows, blood pressure no longer drops
    as animals go through the down side of weight swings.
    
    INSULIN.  Levels of this hormone, which controls carbohydrate
    metabolism, drop during weight loss.  Fat and muscle cells become
    more insulin sensitive and burn more fat; weight falls.  However,
    when the weight is regained, insulin levels rise and may set off
    an increased production of norepinphrine.
    
    LIPOPROTEIN LIPASE.  An enzyme called lipoprotein lipase governs
    how much fat a body stores in its fat cells.  In response to
    starvation, it signals cells to store more--exactly what the dieter
    doesn't want.  Thus, a woman who has lost weight gains more fat from
    an ice cream sundae than does her thin friend.
    What impact do these changes have on you?
    
    o Yo-yo and crash dieting may cause weight lost from lean muscle
      tissue (even the heart) to be regained as fat.
    o  Regained fat tends to come back more in the belly than in the
       butt.  Abdominal fat may be easier to lose than fat on the hips
       or legs--but it raises the risk of heart disease.
    
    o Yo-yo dieting appears to increase the appetite for fatty foods.
      Given a choice of carbohydrates, protein, or fatty food, rats
      invariably select more fat after dieting.  The phenomenon seems
      to hold true in humans as well.
    
    What specific health risks does yo-yo dieting pose?  Dr. Callaway,
    for one, says the more often body fat is lost and then regained
    as abdominal fat, the greater the possibility of developing diabetes
    and of augmenting factors that contribute to heart failure:
    hypertension and higher cholesterol levels.  Some evidence even
    shows that yo-yoing adds to the risk of endometrial cancer in women,
    though the link is unclear.
    
    In a Northwestern University study, observes Dr. Brownell, the highest
    risk of sudden death from coronaries was among men with the greatest
    up-and-down weight swings.  In the famous 40-year-long Framingham
    heart study, people who lost only ten percent of their body weight
    lessened their heart disease risk by 20 percent.  But those who
    regained that ten percent increased their risk of heart disease
    by 30 percent. 
    
    Dr. Ernsberger cites an even more dramatic study of obese men conducted
    by the West Los Angeles Veteran's Administration Medical Center.
    After losing and regaining repeatedly, 80 percent ultimately developed
    diabetes and 25 percent died of heart disease.  Their premature
    death rate was up to 13 times higher than equally obese non-dieters
    in a Scandinavian study.
    
    Overweight people are twice as likely to develop high blood pressure
    than their leaner peers.  Doctors have thought that excess poundage
    alone caused high blood pressure.  Dr. Ernsberger thinks differently.
    His studies indicate it's not so much that people are heavy but
    that they are dieters.  Loss-gain cycles eventually cause "dieters
    hypertension," set in motion by the stepped-up norepinephrine
    production.  He believes it makes yo-yoers especially prone to
    congestive heart failure.
    
    If weight remains constant--high or low--dieters hypertension goes
    away after about two years.  But recovery is harder with each yo-yo
    cycle.  And since fat cells fill up with more fat after each dieting
    bout, subsequent dieting is tougher.
    
    Given the frustrations and the risks of yo-yo dieting, what's an
    overweight person to do?
    
    The medical consensus is still that if you're 20 percent or more
    above your proper weight, you should trim down.  But, as Dr. Callaway
    puts it bluntly, "Don't go on stupid starvation or fad diets," or
    crash exercise programs.  Combining exercise with a very low-calorie
    diet can trigger dangerously low metabolic rates.  And don't expect
    pills or appetite suppressants to take weight off for good.
    
    Second, you need not shed a lot of excess poundage to reduce high
    blood pressure, cholesterol or blood sugar.  Taking off just ten
    percent of excess weight may do it.
    
    Third, take it slow and easy.  Losing as little as half a pound
    a week may be far more permanent and less risky.
    
    Fourth, don't try to diet unless you're really committed and your
    life circumstances will support a long-term effort, Dr. Brownell
    urges.  If you're under a significant amount of stress--which could
    take your energies away from dieting--it may be better to wait.
    
    Fifth, realize that what you eat may be far more important than
    how much.  Albert Stunkard, M.D., head of the Obesity Research Group
    at the University of Pennsylvania, emphasizes that fat contributes
    more calories than do carbohydrates or proteins, though it provides
    less energy when it burned.  Watch the fat, and the calories will
    take care of themselves.
    
    Sixth, know that some people may be better off not dieting at all. 
    As Dr. Callaway puts it, "The woman who weighed 200 pounds at age
    18 and now weighs 185 may be healthier than the woman who weighed
    120 pounds at 18 and now weighs 150."  In the future, he believes,
    people should be classified not according to how heavy they are,
    but whether they should--and can--lose weight.  Dieting may be
    self-defeating!
    
    Taken without permission from the magazine "Longevity".
    

415.3Thanks, Corey!ANT::ZARLENGAI was dreamin' when I wrote thisThu Mar 09 1989 17:4212
.2>    "If the miracle diets really worked, surely weight loss wouldn't
.2>    be the big business that it is", Dr. Callaway asserts.  "Americans
.2>    spend around ten billion dollars a year trying to lose weight."
    
    	I urge anyone who is considering following the latest fad diet
    to read this paragraph at least once.
           
    	It makes lots of sense.
    
    -mike z

415.4HAMSTR::JAFFEThe Big Blue Buster from CMGThu Mar 09 1989 17:5412
    I am taking this note to the physician in charge of my Optifast
    program tonight and will print her resonse if any is offered when
    possible.  The article makes a lot of sense and increases my
    determination to never again gain the weight I am now losing. Many
    of the points brought out here were covered in depth at the Optifast
    meetings and we were instructed on their serious nature. I am still
    comfortable with the Optifast program and in listening to my body,
    know that I not only look better, I fell bette, my blood pressure
    has come down dramatically, my stamina is increased, my aerobic
    exercise plan has lowered my heart rate and I am still losing 3-4
    pounds per week.

415.5yepEMASS::SICALong and winding road...BUT..!Thu Mar 09 1989 19:282
    	I to must agree.  

415.6The Optifast replyHAMSTR::JAFFEThe Big Blue Buster from CMGFri Mar 10 1989 11:2918
    I gave the print of the Note to the head nutritionist at the St.
    Josephs Hospital Optifast program last night. He read with interest
    the entire report and responded to our group on most of it. He is
    now writing a formal "Optifast" reply that he has asked me to enter
    into this notes file. As soon as I have the copy, I will do just
    that. In the mean time, I continue with the feeling that most of
    what was included in the report is true, although a little reactionary.
    Those of you who are now considering a "New Wave" fasting rapid
    weight loss program be it Optifast or any other, should take this
    information into account before signing up. It would be wise to
    talk about these matteres with your own personal physician and the
    professional staff (I hope there is one) at the program you are
    considering joining. Those of you currently in a rapid weight loss
    program, including yours truly, should heed the warning and the
    danger of gaining what you have lost and regard that as a more life
    threatining situation than never having lost. Use this a motivation
    to keep it off for life.

415.7Ya beat me to it!ATSE::BLOCKBeverly (was Kasper for a while) BlockFri Mar 10 1989 13:138
    
    Thanks for typing this in, Corey, and thanks to Mike for sending it to
    me.  I just got back from several days out with a cold, which is why I
    didn't get it typed in myself.
    
    Beverly
    

415.8LESLIE::LESLIEHistory-&gt;Today-&gt;ChoicesWed Nov 14 1990 11:473
    Strange, no "Optifast" official response.
    
    Why am I not surprised?