Adaptive Thermogenesis - is it real and how to reverse?

[Daves_Not_Here]

In her post "Help from community re: stagnant weight loss", @Alysan describes how she has stalled at 140 pounds and inquired about Adaptive Thermogenesis.  In searching for it, I came upon Adaptive thermogenesis in humans at NCBI as well as a number of other articles and videos.  It describes how "a formerly obese individual will require ~300–400 fewer calories per day to maintain the same body weight and physical activity level as a never-obese individual of the same body weight and composition."  Meaning, if you've lost weight, your RMR is lower due to your lower body weight, and then lowered further by 300 to 400 more calories.  Yikes, this means I have to eat 800 calories less than before.

To add insult to injury, your appetite is increased over what it otherwise would be for that energy requirement.  Most discouraging is that the maladaption (lower BMR, higher appetite) lasts for years.

The article is great because it describes the various mechanisms by which these conditions are visited upon the person hoping to sustain a weight loss, and substantiates the anecdotes of the Biggest Loser contestants regaining their weight.

I think of all the posts here complaining of a weight loss stall that I have tended to dismiss as loss of focus; however, I'm starting to think there may be something there.  In my case, I seem to be stalled, but I had previously assumed it was because I've not been sufficiently diligent following my holiday gluttony.  So, the obvious questions are:

• Is Adaptive Thermogenesis real?  This could be rhetorical as there seems to be so much supporting anecdotal evidence.
• Are there effective ways for someone in this state to raise their BMR?
• Conversely, are there effective ways to further lower appetite to match the already lowered BMR?  (This would be my preference given that lower BMR may be associated with longevity.)
• Can the whole problem avoided altogether by losing weight in smaller phases and employing periodization as  @Dominique recommends?

[Daves_Not_Here]

@HokieHoo -- you bring up so many great points ("great" being defined as anything I've been thinking about). 

Diversity of messaging -- I agree that different personalities respond to different language - I'm starting to write a book called Weight Loss for Democrats and Republicans.  Each chapter gets written twice, and you pick whichever one speaks to you.  So the Control Calorie Intake chapter for Democrats will be gently saccharine - obesity is a social construct, you are a victim of the corporate agricultural patriarchy, higher body fat enhances buoyancy for sea-level rise, it's going to take a government-subsidized village to support you in your bravery as you confront insurmountable hunger, etc.  The Republican chapter will be more to the point:  "Hey Fatso - get the food out of your face already."

I agree we are biased by our experiences and the relative ease to which our bodies respond to inputs.  I found myself getting frustrated with a friend who started blobbing up.  Then I found out he just started taking insulin and it's very difficult not to gain weight and body fat.  Reminder to myself to get my house in order before judging others.    

You said, "The hardest part for me is that it takes constant effort in calorie counting, food journaling, and that I have to plan my food and exercise every single day. When I am doing those things, weight loss is easy. The daunting part for me is that I think I will have to do this forever. I used to think that I would get to a point where I would be on auto-pilot and not have to count and plan everything."  Yes!  Same here.

"Do you feel like the healthy habits are getting ingrained and that you can spend less time thinking about and planning it every day?"  Yes and no.  Daily exercise is now mindless and automatic.  Same with food selection.  Food portions and logging, not so much.

"Do you count/track less than you used to and still find success?"  I track less eating and have less success -- I'm maintaining at 15 pounds over where I want to be and will need to get back to more meticulous tracking to get it off.  

"Am I the only one who is surprised by how much effort the tracking and planning part takes?"  -- No, I'm in the same boat with food logging.  (Calorie burn is a no-brainer with Fitbit, I just wish they had a pie-hole monitor).  I eat at a lot of restaurants for my job and I find it tedious to deconstruct those meals.  Anytime I can meal prep and log an entire day's consumption at one time helps.

Here's the pep talk (for me as well as you):  proactivity takes more energy than reactivity but pays dividends.  Planning and logging is tedious, but not as bad as obesity. We're lucky we've discovered what works before it's too late (I was on my way to diabetes) - many people who are not naturally lean just throw in the towel.  The findings on adaptive thermogenesis help me understand that weight maintenance requires as much or more proactive attention as weight loss - sounds like bad news, but at least I now have realistic expectations, which increases the probability of success.  And living deliberately is its own reward. 

[HokieHoo]

@Daves_Not_Here Great thoughts all around. Very funny description of your book. So spot on with the Dem/Rep stereotypical responses. This also spot on: "Planning and logging is tedious, but not as bad as obesity. We're lucky we've discovered what works before it's too late.." 

[GershonSurge]

@HokieHoo,

My scale broke in August 2017. I also quite counting calories. I used the notch method on my belt. If I let it out a notch, I ate less and exercised more. The reverse when I pulled it in a notch. When I finally weighed myself in December, I was within a pound of the same weight.

Now, I weigh myself sometime during the day. If I weigh too much, I eat less. If I weigh too little, I eat more. I don't worry about variations due to time of day. I shower whenever it's convenient to fit it in and accept the little variations.

In my opinion, it's good to take the reins off and run free. Give yourself about a seven pound upside limit before putting them back on for a bit. You've probably learned enough to give it a try. On the other hand, you may go back to strict counting. Either way is good.

[HokieHoo]

@GershonSurge I don't think I am ready for the belt notch method yet. I plan on eventually trying to 'let the reins out' as you say- maybe after a few more months of progress. I am trying the slow method and my version of 'letting the reins out' right now is being easy on myself when when I don't make my goal in a given day and ensuring that my methods are not so drastic that I burn out or revert back to old ways. 

[Daves_Not_Here]

@HokieHoo -- I think @GershonSurge has hit on the happy non-OCD medium -- if you frequently weigh yourself, you can skip the food logging and still nip weight gains in the bud.  Kind of like trust but verify.  And with an automatic scale, there is no manual data entry.

[Dominique]

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@Daves_Not_Herewrote:

if you frequently weigh yourself, you can skip the food logging and still nip weight gains in the bud.

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That would be totally me! I almost feel ashamed of not being able to track all my intake, and I’m not particularly number- or tech-challenged. I did try to use MyFitnessPal on a couple of occasions, but gave up before the end of the first day. It just doesn’t fit my way of doing things. I do weigh a lot of foods, but it doesn’t end being logged anywhere.

[HokieHoo]

@Daves_Not_Here I only own a non-digital scale. I considered getting one of those connected smart scales, but I am trying to not get OCD about weighing myself. I fear that a smart scale would be too tempting. Then I would start have to use trendweight and then I would be sad when I go up instead of down. With my crappy scale, I weigh myself once most mornings and if I go up, I chalk it up to the scale being inaccurate, or the 'water weight' that people have pointed out, or that I was leaning to one side (ha!). I am trying hard to focus on the other benefits of weight loss: less joint pain, better fitness, more competitive on the tennis court, clothes fit better, etc instead of the number on the scale. If I pretend/fake it long enough (that the weight number is not important)- maybe it will become true? But I am not kidding myself, that number is important to me and I am trying to avoid making it more important than it already is.

What I really need is a scale that knows my moods and can respond with the correct words that will motivate me in that instant. Sometimes that is, "Hey there, maybe avoid the potato chips today." Other times it is, "That weight isn't going to lose itself!". Other days just complete silence. Maybe that is a new thread- "If your scale could talk....what would it say?" 

Apparently Mary Lou Retton created a scale that talks to you and doesn't tell you your weight. https://www.amazon.com/Weigh-Motivational-Numberless-Scale-Eating/dp/B002BL9J12?ie=UTF8&s=home-garde... and 

[Daves_Not_Here]

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@Dominiquewrote:

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That would be totally me! I almost feel ashamed of not being able to track all my intake, and I’m not particularly number- or tech-challenged. I did try to use MyFitnessPal on a couple of occasions, but gave up before the end of the first day. It just doesn’t fit my way of doing things. I do weigh a lot of foods, but it doesn’t end being logged anywhere.

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@Dominique -- I feel the same way.  I don't need any more clerical work in my life, and my beef with food logging is that it can't be automated.

That said, I think food logging is invaluable for anyone who feels they are stalled in their weight loss as it helps us break through the delusion that we are not overeating.  At least it did me.

[Daves_Not_Here]

@HokieHoo - thanks for the link to the Marylou scale.  I wouldn't have believed such a product was available.  Also noticed how many positive reviews it got.

You mentioned you didn't want to get OCD about weighing yourself -- I would say that if you are stalled, you're going to need to get OCD about either weighing or food logging to break through, and the weighing is the easiest to automate.

Also, I suggest that if you are reluctant to step on the scales for fear of what it might say, then you know that's exactly what you need to do.  Think of it as your daily profile in courage.

It really helped me when I fully understood how water weight fluctuations overwhelm and mask progress, good or bad.  I think you have about 40 liters of water in your body, which fluctuates up and down by 1 liter.  A liter of water weighs 2.2 lbs, which means your weight swings randomly within a 4 pound window.  Internalizing and coming to peace with that reality helps take the anxiety out of stepping on the scales.  This is also why Trendweight is so helpful.

Check out The Hacker's Diet , upon which Trendweight is based, and which explains the water ballooning phenomenon.

[WavyDavey]

A scale that doesn't tell you your weight. Awesome.

[DrYouTao]

Hey,

This is an experienced mathematical/statistical modeller in the healthcare industry. I read more than 500 research papers on fitness, nutrition and wellbeing. Please see my answers interspersed.

• Is Adaptive Thermogenesis real?  This could be rhetorical as there seems to be so much supporting anecdotal evidence.

It's a mechanism existing in both humans and animals. First reported by a French scientist Neumann in 1902. The clinical significance of AT was disputed throughout much of the 20th century until compelling evidence was reported in 1995. Since then, the research around AT became more quantitative.

• Are there effective ways for someone in this state to raise their BMR?

Lean mass costs as much as 7 times the energy to maintain compared with fat mass. If you want to raise BMR, the only way forward is to raise lean mass. Actually, raising BMR is not related to keeping the weight off.

• Conversely, are there effective ways to further lower appetite to match the already lowered BMR?  (This would be my preference given that lower BMR may be associated with longevity.)

AT is regulated by your brain, so get a new one! 

Jokes aside, it's been shown that AT is associated/connected to leptin, HPA axis and so on. However, there is always more to do to elucidate the molecular mechanisms.

The bad news is, bariatric surgery seems to be the only sustainable option for reduced appetite that does not involve AT.

See this paper for details: https://www.ncbi.nlm.nih.gov/pubmed/27136388

• Can the whole problem avoided altogether by losing weight in smaller phases and employing periodization as  @Dominique recommends?

Is there any data supporting this? Would be intriguing seeing some evidence!

I've written a 3-min read lately ( https://www.letsgobeyond.co.uk/blog/3.-how-can-you-keep-your-weight-off ) about the following:

1. What is AT?

2. Who should pay attention?

3. How much is it?

4. How was AT discovered?

5. How is AT regulated?

6. What are the influencing factors?

7. When does it matter?

8. How do I know if AT affects me?

9. What can I do about AT?

10. How can PhD Fitness help?

Let me know if this answers your question.

Tao

[GershonSurge]

@DrYouTao,

As an author of  After reading over 500 research papers, I find it inconceivable you would reference a study which stated it did not reach statistical significance. Yet it's true. 

Sorry about the error.

[DrYouTao]

Could you clarify which paper? 

[GershonSurge]

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@DrYouTao wrote:

Could you clarify which paper? 

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The one you referenced below. First of all, there were only 14 participants in the study. Recommending bariatric surgery on the basis of a 14 person study is worse than malpractice. The Biggest Loser method is not the only or best way to lose weight.

"No significant associations were detected between metabolic adaptation at the end of the 30 week competition with percent weight gained since 30 weeks (A) or percent weight change versus baseline (B) at 6 years. Metabolic adaptation at 6 years was significantly associated with the percent weight gained since 30 weeks (C) or percent weight change versus baseline (D) at 6 years.

[DrYouTao]

I did not recommend bariatric surgery. It was a finding reported in a different study, and was cited in the paper I shared: https://www.ncbi.nlm.nih.gov/pubmed/25236175

As explained by the figure legend you cited, short-term metabolic adaptation at 30 weeks did not predict weight regain in 6 years. Instead, that was strongly associated with metabolic adaptation at 6 years. I hope this clarifies.

[Daves_Not_Here]

@DrYouTao -- hello, welcome, and thanks so much for your detailed response to my original post!

It will take some time for me to get through the material you posted -- I'll review and try to respond with some intelligent follow-up questions.

[GershonSurge]

@DrYouTao,

Perhaps I'm wrong, but you mentioned the bariatric surgery before referencing the research report. It was in a section that contains your own thoughts. You know, like get a new brain. Of course, that was a joke. 

There is one problem with you stating bariatric surgery was a finding in the research report you recommended. The word bariatric is not in the full text of the study. Perhaps you could find it for me. 

While you are there, perhaps you will note that only 4 of the participants consented to have their BMR scientifically measured at 30 weeks. Then it goes on to make an association with the other 8 between their BMR at 30 weeks and their BMR at six years.

You should know that it takes a very high R-squared to attain a statistically supported conclusion with this few participants. 

[WavyDavey]

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@DrYouTao wrote:

• Are there effective ways for someone in this state to raise their BMR?

Lean mass costs as much as 7 times the energy to maintain compared with fat mass. If you want to raise BMR, the only way forward is to raise lean mass.

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I believe this.

[GershonSurge]

Dr. You @DrYouTao,

I read through your website and found out a little about your background. Your passion for curing cancer came from the loss of a loved one. My passion came from having it. Well, not exactly. In 2014, I felt a pain in my abdomen, which I decided was an intestinal problem. I did some research and discovered the cure for intestinal problems was a starch-based way of eating with no animal products, no added oils and some fruits and vegetables. There are a few variations, but they are essentially the same.

I cured my stomach pains within about three months and went on with life while maintaining the way of eating. It's probably quite similar to the diet in Singapore 100 years ago. In Dec 2017, I had an incidental diagnosis of neuroendocrine cancer. For those that don't know about this condition, it's a cluster of cells that act like an endocrine gland and outputs hormones that can cause problems. It can reside in any organ. Mine happened to be in the liver. My tumors were so tiny the doctors didn't even know if they could get a biopsy. There is no radiation or pharmaceutical treatment for this type of cancer. All they can do is try to cut it out when the tumors are big enough. They can give drugs to mitigate the effects of the hormones.

In March 2018, they discovered the cancer was gone. I treated it only with diet. 

I can appreciate why your research has taken you in a reductionist direction. That's where the money is and that's the only area that is getting significant grants. Imagine if AstraZeneca can find some drug that reduces the death rate by a few percent.

Unfortunately, the reductionist paradigm by itself cannot lead to a cure. The mechanisms are impossibly complex and changing every nanosecond. Any treatment will likely make other things worse. Take a step back and consider rates cancer, heart disease and the other degenerative disease in your home part of the world 100 years ago. What has changed? In a broader look, consider why the degenerative diseases have spread throughout the world. It's the FOOD!. The Standard American Diet with the standard American Diseases and the standard American Diet that is nothing more than ethnic doses of fat, sugar and salt. 

The incidence of these diseases is easily found by the ration of animal products/whole plant products eaten. That's it. All the other markers are simply markers for the way of eating.

Don't take my word for it. Read "Whole" by Dr. T. Colin Campbell. Read Dr. McDougall's works. He has been successfully treating cancer with diet since 1980. Read Dean Ornish's books. In 1974 he published research that proved heart disease can be reversed through this way of eating. Read Dr. Esselstyn's books. He is arresting or reversing heart disease at the Cleveland Clinic. This is also proven in peer-reviewed research. 

If you study these works, you can no longer look for a microscopic cure that may come in decades. You will find it doesn't exist. You can change direction and begin to cure disease through the food people eat. If saving lives is important to you, then you will read the books I referenced. Then make your own decision. 

[Daves_Not_Here]

@GershonSurge - you have completely misinterpreted the plain English reading of @DrYouTao 's original post.  And then you go on to argue with your own misinterpretation, and to rebut assertions he never made.

He did not "recommend bariatric surgery", so he has not done anything that is "worse than malpractice". He did not assert "the Biggest Loser method is the only or best way to lose weight".  The gentleman has contributed constructively to our conversation on AT, and now you are nitpicking the validity of a citation, as well as attacking him personally.  Do you think that somehow he will then be persuaded by your argumentation after you have alienated him?

How about the following compromise:  be nice to people who attempt to make constructive contributions (even if they are not 100% perfect in your opinion), and confine your personal attacks to myself, as I am far more deserving of them.