Interesting Biggest Loser analysis

[shipo]

Here's a link to the article:

• http://www.cnn.com/2017/11/03/health/biggest-loser-diet-exercise-study/index.html

Thoughts in no particular order:

• For those of y'all who've had to wade through my various musings over the last few years, you know I am an advocate of exercise is greater than diet when it comes to weight loss and maintenance once the weight is lost.  Not surprisingly, many of my posts have generated more than a bit of controversy, or at least heated debate.
• The results of the analysis on the Season 8 contestants shows the combination of a low caloric diet and a high output exercise regimen caused rapid weight loss, however, that came at the cost of a significant slowing of the individual's metabolism.
• Once the contestants left the competition, their metabolisms did not rebound, even after six years.
• Post competition, the estimates by the analytical team "estimated that contestants would need to engage in 80 minutes of moderate activity or 35 minutes of vigorous activity each day beyond what they were doing at baseline."  The article goes on to say, "This is far beyond the leading guidelines for physical activity..."
• From my perspective, I think it would be interesting to study a group of obese individuals who eat a normal well rounded diet and use exercise as the main tool for weight loss.  My bet is they'll lose weight, albeit not as fast as the folks on the TV program, but the weight they lose will be far more maintainable due to the their ability to maintain a more normal metabolism.

Okay folks, I'm putting my fire retardant Nomex suit on now and ducking for cover; have at it with your comments.  🙂

[WavyDavey]

I found this section to be noteworthy:

"The "maintainers," who kept off about 25% of their preshow weight on average, increased their physical activity by roughly 160% from before the competition. Those who regained the weight increased their activity only 34%. They were 1.1% heavier on average than their original weight."

I could take this as for or against your argument @shipo. Sure, those that increased exercise kept off  more weight, but look at the numbers! 160% increase is very significant change. But for someone that obese, a 34% increase in exercise from previous levels probably isn't worth that much--clearly not enough to help them keep the weight off. So exercise works, but it takes a heck of a lot of it.

I'm actually an advocate for what you're saying @shipo, as I believe exercise is the only thing that will provide enough stimulus for metabolic change that is needed to maintain weight.  You can disrupt a lot of metabolic homeostasis with exercise, and that process can be continued for a long time. You can only disrupt so much by calorie management, which seems to work better short-term than long-term.

Sorry to have you don that flame-resistant suit for nothing. Maybe @Daves_Not_Here can turn up the heat a little? 😉

[shipo]

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@WavyDavey wrote:

I found this section to be noteworthy:

"The "maintainers," who kept off about 25% of their preshow weight on average, increased their physical activity by roughly 160% from before the competition. Those who regained the weight increased their activity only 34%. They were 1.1% heavier on average than their original weight."

I could take this as for or against your argument @shipo. Sure, those that increased exercise kept off  more weight, but look at the numbers! 160% increase is very significant change. But for someone that obese, a 34% increase in exercise from previous levels probably isn't worth that much--clearly not enough to help them keep the weight off. So exercise works, but it takes a heck of a lot of it.

I'm actually an advocate for what you're saying @shipo, as I believe exercise is the only thing that will provide enough stimulus for metabolic change that is needed to maintain weight.  You can disrupt a lot of metabolic homeostasis with exercise, and that process can be continued for a long time. You can only disrupt so much by calorie management, which seems to work better short-term than long-term.

Sorry to have you don that flame-resistant suit for nothing. Maybe @Daves_Not_Here can turn up the heat a little? 😉

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Thanks for the response @WavyDavey, I don't see how a 34% increase equates to an increase in weight of 1.1% over baseline kills my argument; if anything I'm thinking it supports it.  Think about it this way, if the folks who gained all of their weight back after the season had simply increased their exercise by 34% I rather doubt they would be 1.1% heavier than their baseline.

The way I read the above, they slowed their metabolic rates so severely they needed more than 34% additional activity just to keep from getting heavier than when they started.

I don't know, maybe I just misread the findings.

[WavyDavey]

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@shipo wrote:

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@WavyDavey wrote:

I found this section to be noteworthy:

"The "maintainers," who kept off about 25% of their preshow weight on average, increased their physical activity by roughly 160% from before the competition. Those who regained the weight increased their activity only 34%. They were 1.1% heavier on average than their original weight."

I could take this as for or against your argument @shipo. Sure, those that increased exercise kept off  more weight, but look at the numbers! 160% increase is very significant change. But for someone that obese, a 34% increase in exercise from previous levels probably isn't worth that much--clearly not enough to help them keep the weight off. So exercise works, but it takes a heck of a lot of it.

I'm actually an advocate for what you're saying @shipo, as I believe exercise is the only thing that will provide enough stimulus for metabolic change that is needed to maintain weight.  You can disrupt a lot of metabolic homeostasis with exercise, and that process can be continued for a long time. You can only disrupt so much by calorie management, which seems to work better short-term than long-term.

Sorry to have you don that flame-resistant suit for nothing. Maybe @Daves_Not_Here can turn up the heat a little? 😉

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Thanks for the response @WavyDavey, I don't see how a 34% increase equates to an increase in weight of 1.1% over baseline kills my argument; if anything I'm thinking it supports it.  Think about it this way, if the folks who gained all of their weight back after the season had simply increased their exercise by 34% I rather doubt they would be 1.1% heavier than their baseline.

The way I read the above, they slowed their metabolic rates so severely they needed more than 34% additional activity just to keep from getting heavier than when they started.

I don't know, maybe I just misread the findings.

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Yes, but how much more percentage to prevent weight gain, if 34% isn't sufficient? 50% more, 75% more...?

It seems to be floating somewhere between 34-160%, which is a really big variance. That was my only point.

[shipo]

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@WavyDavey wrote:

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It seems to be floating somewhere between 34-160%, which is a really big variance. That was my only point.

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The thing is, both of those numbers are artificially skewed high due to the significant reduction in metabolic rate of the folks who were on the extreme diets.  Had the diet never happened, they would be in much better shape.

[Daves_Not_Here]

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@WavyDavey wrote:

Sorry to have you don that flame-resistant suit for nothing. Maybe @Daves_Not_Here can turn up the heat a little? 😉

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Thanks @WavyDavey for the opportunity, but I hope I'm not getting a reputation for being contrary.

@shipo -- Thanks for posting an interesting article and topic - I probably represent an opposing opinion, but I realize I'm distinctly in the minority, at least here in an online community that is naturally inclined towards exercise and fitness, as would be expected for a device such as Fitbit.  My opinion is skewed by my experience of having lost weight, increased exercise, and then gaining the weight back in spite of my increased activity level.  I like to say I'm the fittest fat guy in California.

I question a widely held assumption -- that a higher metabolism is generally preferable to a lower metabolism.  My impression is that longevity is associated with a lower metabolism.  If I had the choice of eating and burning 2,000 calories per day to maintain ideal weight versus 2,500, I don't know why I'd rather have to eat 25% more day in and day out.  And all the vigorous octogenarians I've known have been lean light eaters.

Also, it seems frenetic to me that we should have to spend so much time exercising and burning calories just to maintain ideal weight.  I enjoy my active lifestyle and how brief daily exercise makes me feel, but time is precious and if I need to work out for 35 to 80 minutes every day just to control my weight, I'd rather just eat less.  My parents generation was comparatively leaner than today's youth and they did not spend hours in the gym.  And I just don't buy the idea that previous city-dwelling populations were somehow more inherently more active than today's.

One last item I've never seen addressed in all the stories about how Biggest Loser contestants had lowered metabolisms for years after they had regained their weight:  was their "new" metabolic rate abnormally low?  Or was it just lower than their previous metabolic rate?  How do we know they didn't start off with an abnormally high metabolic rate (and matching appetite)?

Again, I realize I'm in a small minority.

[WendyB]

I agree with @Daves_Not_Here

I will admit I did love watching the show and I do miss it. But I knew it was totally unrealistic.

Who has that much time to exercise? Well I guess I do now that I'm retired. But do I want to? NO

I have my exercise goals set for me and I meet them everyday unless I travel. That's what I want

Sides if I did what they do I would for sure get bored and give it up altogether

[shipo]

I guess one of the points I was trying to make is if the crash diet and resultant reduction in metabolic rate hadn't happened in first place, the former contestants wouldn't have to exercise anywhere near as much as they do regardless of their current weight.

As for personal experience, I lost 70 pounds back in 2013 exclusively through exercise, in fact, during that period I had to ramp up how much I ate so I wouldn't lose weight too fast.  Fast forward to now, four years later and I am not doing quite as much exercise as back then, however, I am still eating significantly more than I did before I started losing weight, and yet I have easily maintained my weight loss.

[Daves_Not_Here]

@shipo -- your experience is really inspiring!  My opinion is that losing weight is easy, keeping it off is hard.  Anybody that has been able to sustain a 70 pound loss over time has my respect, and I hope I will be able to emulate you.  I several questions, if you will indulge me:

Can you share your exercise regimen and how many calories it burns?  I'm curious if your weight control comes from the calories burned by the exercise itself, or from an overall increase in your metabolism.

As to food, do you count calories or eat to satiety?  And do you follow a particular diet (low-carb, low-fat, etc.) or exclude certain foods?

Finally, do you weigh yourself often, and change things if the scale starts moving?  Or are you pretty much on autopilot?

I appreciate any insight -- as I approach my target weight, I'm trying to plan how I will maintain it.  My previous mistake was thinking my activity level alone would sustain me and I took my eye off the ball.  

[shipo]

@Daves_Not_Here, wow, lots to ground to cover.  🙂

Before I answer your questions, I need to lay a little groundwork:

• In my teens, twenties, thirties, and early forties I ran off and on, alternating from so busy I couldn't run for a couple of years at a time to the other extreme when I did ten Olympic distance triathlons in 1990.
• In my mid forties I had a bad slip and fall while picking my kids up from daycare and broke my tibia, spiral fractured my fibula, and partially tore off my foot.  The surgeon who screwed me back together told me I'd never run again and I would walk with a limp for the rest of my life.  The broken leg happened in early 2003.  In the years following the break, I barely ran at all (every time I tried I'd end up injured), and between 2003 and 2013 I gained nearly 100 pounds, and I'm only 5'8".

My weight loss year (2013):

Three things happened all at the same time; I went from two jobs (one in Boston and one in Concord, NH) to one in Concord, we sold our house (kids were all gone) and moved to a small caretaker apartment on a 70 acre horse farm where I had to take car of the horses three days per week, and finally, I started running again on dirt trails around the farm.

The cool thing I discovered about running on dirt trails is a multitude of sins are covered up because of the irregular surface of the dirt plus the extra shock absorption of said dirt.  Long story short, I was able to ramp up from say a quarter of a mile at a time to six to eight miles per run  within about three months.  As my conditioning improved I started extending my runs and by the fall of 2013 I was running ten miles per day on a very regular basis, typically logging over 250 miles per month.

Also by the fall of 2013 I found if I didn't significantly up my food intake, I would feel light headed, almost to the point of feeling like I might pass out.  I didn't religiously track my calories, but prior to starting running again I was typically eating well in excess of 3,000 calories per day, and by that fall I would typically eat over 4,000; sometimes reaching 5,000 or more.  All the while I was still losing weight.

Speaking of weight, I didn't have the guts to get on the scale early in the year, but by May, after several months of running I did climb on and was shocked to see my weight at 250 pounds.  By fall when I was forced to ramp up my caloric intake I was down to 200, and by the end of the year I was down to 180 where I've pretty much stayed since then.

As for foods, I believe in a well rounded, multi-food/omnivorous, full-fat, whole food type of diet, and as such, nothing was off limits except I tried to keep sweets to a minimum.

2014 and on...

My running has continued to progress; I had initially wanted to work my weight back down to the mid 160s as I wanted to start racing on a regular basis, however, between a full time job, taking care of the horses, spending time with my wife, and of course running, I just couldn't devote the time and energy to training myself to get up into the elite class of runners my age.  Even still, in October of 2014, at the age of 57, I ran my first half marathon, on a hot and humid day in the 80s no less, and managed to finish in 1:42, so even with an extra fifteen to twenty pounds on me and sub optimal training, I was pleased with my time.

Regarding getting on the scale, I rarely weigh myself, back in 2013 I got on the scale maybe once per month, now it is more like once per year.

Regarding calories in and out, per my Fitbit, I typically burn more than 3,000 on a light day, typically burn more than 4,000 on a day of strong training, and have occasionally crossed the 6,000 calorie day threshold.  So, to sort of answer your question regarding metabolism, I feel I've managed to keep it fairly high, even though I'm now in my 60s, and coupling my typical metabolic rate with the running and barn work I do, I've able to keep the weight off for over four years now.  🙂

Here's a before and after, the "before" was taken in May of 2013 and the "after" was taken just under a year later in May of 2014 (just before I crossed the line of my first sub 22:00 5K of my 50s):

[Daves_Not_Here]

@shipo - WOW!  Thanks for the background.  I thought I was impressed with the 70 pounds off and keep it off, but it pales in comparison with your journey back from such a huge life setback.  I think it illustrates the impermanence of our external circumstances.  You must be doing the Snoopy Dance in your heart.

(We have a similar background in that 35 years ago, I badly broke my ankle and refused the recommendation from my surgeon to fuse it.  I can't run and have been walking with a limp until a month ago.  I can ski and cycle, so I don't feel compromised.  My comeback is nowhere as dramatic as yours, but I wasn't an avid runner before the injury, so my setback wasn't nearly as severe)

You had started this thread to discuss the relative contribution of exercise versus diet to weight management (at least that is what I have inferred).  My opinion is that diet trumps exercise, and you are clearly a counterexample to that hypothesis.  But, I think you are an outlier and your results would be difficult for ordinary people to replicate because most don't have the lifelong passion for running that you do, nor the time and desire to burn the quantity of calories at your level.  And I think "outrunning" the calories you take in when you eat to satiety takes a higher level of exercise than most are willing or able to do.

For example, before my injury, I had been running 1 to 3 miles a day, but frankly hated it.  These days I go to the gym, but I can't wait to get out of there.  I'm now 58 and it still ain't growing on me.  I like the benefits of exercise but not the process.  I'm pretty active, but the only time I'll burn more than 300 calories during exercise is when I'm skiing or cycling with a group of friends and not thinking about the exercise.   So, if I had to rely on exercise for weight control, I'd get obese, which incidentally is what happened.  I have to control my eating.

So I am modifying my opinion:  Diet trumps exercise, except for those for whom exercise is a passion.

Again, thanks again for answering my many personal questions!

[shipo]

Yeah, looks like we have some history in common.  🙂

The only comment I might make is I don't really have a passion for running; I just happen to be good at it.  Add to that the fact I have a passion for food; pretty much all cuisines world wide tickle my fancy.  For me, I find it far-far easier to run a few extra miles than to cut off a few hundred calories from my daily intake.  Keep running or reduce eating, for me the lesser of two evils is to keep running.  🙂

[Baltoscott]

Thanks for starting the thread, @shipo.  The Biggest Loser contestant studies fascinate me.

With my daily bike commutes I probably exercise at a level similar to you, and I have managed significant weight loss in the past by focusing on exercise.  In 1998 I dropped about 50 lbs (over 200 to about 155) by upping my monthly bike milage from about 350 miles to 800 - 900 miles for 3 or 4 months and then dropping back down to around 400 miles a month.  I was also eating fewer calories because I mostly eliminated carbs from my diet, but I wasn't counting calories so I don't know how much a drop it was.  I maintained a weight in my normal BMI range -- between the low of 155 and 174 -- for a couple of years before it began to creep back up and eventually got into the 180s and low 190s.  Some years it would get close to 200 and I would push it down to the 180s and even 170s for a while by exercising more, but it always came back.  Last year (about 18 after the first experiment) the weight topped 200 again and over 2017 I've pushed it back down to about 160 lbs mostly by focusing on diet.  My exercise has never stopped over this 19 year journey but it has gone up and down and I've had a hard time getting into and staying in the healthy BMI range (under 174 lbs for me).  Part of the reason, I think, is that heavy exercise can be time consuming and often leads to injury.  And injuries can mean a lot less exercise.  The problem is that it is really hard (for me a least) to stop eating to compensate for the decrease in energy burn due to injury or temporary lack of time for exercise.  So I'm thinking a better approach to maintenance will be focusing more on the calories in part of the equation.

The New York Times also did an article the BL study.  Link here.  Basic take away is the same; a fairly high activity level correlates positively with maintaining weight loss.  But the NYT article also featured the story of Season 8 Biggest Loser winner Danny Cahill.  (Not part of the study, which tracked Season 3 contestants).

Here is Cahill's story:

"Danny Cahill, who is 47 and lives in Tulsa, Okla., is among those who found it increasingly difficult to keep up the sort of regimen he needed to avoid gaining weight.

He won the “Biggest Loser” competition in Season 8. He weighed 430 pounds when the show began, and lost 239 of them.

For the four years after the show, he exercised more than two and a half hours a day and gained back just 40 pounds.

Then the injuries began, forcing him to cut back his workouts to one and a half hours a day. His weight crept up to 235 pounds.

The next year, “my body just started breaking down,” he said. “I had a foot injury, a wrist injury. I couldn’t keep it up.” And he was exhausted.

His weight went up to 300 pounds. For the last two years, his weight has remained stable at about 340 to 350 pounds, “but only because I am eating as very little as I can,” he said.

“That’s the disheartening part,” Mr. Cahill said. Losing the pounds is one thing. Keeping them off?

“I am still struggling with it,” he said."

Cahill's story is similar to mine (though a lot more dramatic).  Although I agree that a significant amount exercise is important and necessary to maintain a big weight loss (probably at least 60 minutes/day), it is hard to maintain the 2-3 or more hours a day of exercise it seems to take to lose weight.  Half the season three contestants couldn't do it and regained all the weight they lost (and added some) even though they exercised 35% more than before the whole thing started.  The authors don't explain why they couldn't keep the exercise up, but lack of time and injury seem likely factors.  

[Daves_Not_Here]

Yes, what @Baltoscott said!  This illustrates perfectly for me the difficulty of controlling weight primarily through high activity level.  I find Cahill's struggle to be both tragic and frustrating.  The poor guy literally burned entire weeks of his life in pursuit of a very reasonable goal (just maintain a healthy weight for crying out loud), leading to injury and failure.

(I hope I do not come across too strongly in what I write below)

My opinion is that the strategy Cahill was advised to pursue (devote hours per day to continue to run himself into the ground in a futile effort to control his weight) is fatally flawed.  The guy obviously had the personal character, willingness and fortitude to improve himself and his health.  He just had a bad plan.

I believe that one reason it is far easier to lose weight than to keep it off is that our marketplace of ideas contains a wealth of effective strategies for weight loss.  And a dearth of those for weight maintenance.  (The operative modifier being "effective")

I'll admit to being somewhat peeved by the interpretations of the narrative surrounding the BL findings.  The narrative is, "BL contestants found that the process of fast and dramatic weight-loss reduced their metabolisms such that, even after they had regained their weight, their metabolisms were lower than prior to the weight loss."  This has lead to 3 popular interpretations:  (1) they shouldn't have lost the weight so quickly, (2) because of their lowered metabolisms, their efforts to maintain a healthy weight are hopelessly doomed to failure, (3) a constructive recommendation for success is, ah ..., we got nothing.  It's a big ambiguous, hopeless, futile mystery.

(here's the obnoxious part, skip if you are of tender sensibilities)

My interpretations of the received interpretations are (1) this is no less than the active promotion of learned helplessness, (2) to tell someone that weighs 400 pounds that they need to lose weight slowly to avoid a metabolic slowdown is to say, "take my advice and in 2 years you'll still be morbidly obese, but hey, you'll have a faster metabolism", (3) SO WHAT if their metabolisms have been lowered?!?  If we understand what our energy demands are, and figure out how to eat at that level, then we won't regain the weight.  My beef is that I hear precious little amongst weight loss "experts" on how best to pull this off.

(blood pressure coming back down to triple digits)

I believe the answers are right here in this community.  There are a number of people who have lost significant weight and have been successfully maintaining their target weight over time.  Some, like @shipo , are able to maintain primarily through exercise. Others, like @Baltoscott and @Dominique appear to be actively monitoring their weight and food in addition to their exercise.  I'm curious what people find that works.  (sounds like a great idea for its own thread!)

[Mukluk4]

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@shipo wrote:

• From my perspective, I think it would be interesting to study a group of obese individuals who eat a normal well rounded diet and use exercise as the main tool for weight loss.  My bet is they'll lose weight, albeit not as fast as the folks on the TV program, but the weight they lose will be far more maintainable due to the their ability to maintain a more normal metabolism.

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I went from 340 to 280 without changing my diet.  I significantly increased my exercise level from 0 activity minutes to 200ish a week, pre-fitbit so best guess.  I'm now over 1k minutes a week, modified my diet a bit (I still eat fast food at least once a week) and have dropped an additional 20ish pounds over the last 6 months while focusing on reducing body fat %.  

Yes it can be done, but you have to work extra hard (think athlete level) to get there.  My week consists of 3 60-minute weight room sessions, full court basketball at least 4 days a week (60-120 minutes), and almost daily 4 mile walks with the dog.  I easily burn 4500 calories a day to build that deficit.

At my activity level, I have to focus more on recovery and maintaining strength more than trying to hit a weight number, so I've read more on what trainers do with athletes and so on (read the Rock Challenge and what Russell Wilson did this off-season as examples).   For me to hit the "ideal" weight number, I'd have to lose all of my fat and about 20 lbs of my lean weight to get there.  

[shipo]

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Mukluk4 wrote: 

At my activity level, I have to focus more on recovery and maintaining strength more than trying to hit a weight number, so I've read more on what trainers do with athletes and so on (read the Rock Challenge and what Russell Wilson did this off-season as examples).   For me to hit the "ideal" weight number, I'd have to lose all of my fat and about 20 lbs of my lean weight to get there.  

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Yeah, if I was to hit even the top end of my my "normal" BMI weight I'd have to lose a lot of lean weight to do so; not something I'm necessarily interested in doing.  Said another way, the next time I'm at my ideal BMI, I'll most likely be rotting in my grave.  🙂

[Daves_Not_Here]

Light bulb!!  I just realized that I have been committing a major logical blunder/fallacy, the likes of which would embarrass a normal person, fortunately I have no shame.

I had been assuming that whatever works/doesn't work for me applies to the general knucklehead population.  I ate to satiety while increasing my activity level and became obese, so I therefore assumed that others will have the same adverse result.  Reading responses from @shipo, @Mukluk4, and @WavyDavey , it's now clear to me that for a certain segment of people, exercise can be used as the primary lever to maintain their target weight.  I can now think of some of my cycling friends who eat indiscriminately but remain lean.

It's obvious now that I see it:  some people never become overweight in spite of a lack of exercise or "healthy" eating.  Others can eat freely as long as they exercise.  And a third group needs to actively manage their eating even as they exercise lest they expand to fill the room.  I'm in the third group, and given the initial obesity of the BL contestants, it seems they would be too.

Shocker: one size doesn't fit all.

[shipo]

@Daves_Not_Here, to be sure if I don't exercise I'll "grow to fill the room", much like most of my aunts and cousins.  Not sure why, but my siblings and I do not follow the family tradition of becoming obese (errr, well, at least not staying there, before I started running again a few years ago I was in the "Morbidly Obese" category); funny thing, we all work out; the "cousins" don't do a lick of that nasty thing called "exercise".  🙂

[WavyDavey]

I totally agree with you on that @Daves_Not_Here. And the interesting part is, a person doesn't always stay in one category. 

Prior to exercise, I could eat 2000-2500 calories and still hold on to every ounce of fat. Now with strength training 4x/week, if I don't eat 3000, unplanned weight loss occurs. Been eating a lot of second dinners lately... 🙂

And I'd suggest there's more to it than one's genetic preference for controlling things through diet or exercise. Psychology is a big part. Someone like myself (or maybe @shipo), have more enjoyment from weight management by exercise. And going with methods that your mind and body appreciates, increases chances of long-term success.

[Baltoscott]

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@WavyDavey wrote:

I totally agree with you on that @Daves_Not_Here. And the interesting part is, a person doesn't always stay in one category. 

Prior to exercise, I could eat 2000-2500 calories and still hold on to every ounce of fat. Now with strength training 4x/week, if I don't eat 3000, unplanned weight loss occurs. Been eating a lot of second dinners lately... 🙂 

...

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@WavyDavey -- there really does seem to be something special about weight training, maybe HIIT too, though I don't really do that.  I've stopped weight training at various points of my life due to injury -- usually followed by me getting heavier -- but once I get the weights back into the routine, even just 3 or 4 hours a weeks seem to make a huge difference in how much I can eat.  Though I suspect part of it is macros too.  Eating more protein while weight training gives the body the right fuel at the right time.