& Alan Titchenal Tuesday, July 3, 2012
Losing pounds can be easier than maintaining weight loss
Losing weight is easier than maintaining the reduced body weight. Many people have even lost hundreds of pounds over decades but the pounds creep back on (in some cases gallop back) until the old weight has returned, plus some. The challenge of maintaining a reduced body weight is both physiologically complex and emotionally frustrating.
QUESTION: Why is maintaining weight loss so complex?
ANSWER: Many people do not realize that the amount of calories they need both at rest and during physical activity declines with weight loss. Along with a variety of hormonal changes, this reduction in calorie needs is likely a major contributor to regaining weight and adds to the challenge of maintaining a reduced body weight.
Q: What causes reduced calorie needs when a person loses weight?
A: Energy (or calorie) needs are based on the amount of energy needed to maintain the essential functions of all the cells in your body along with the energy needed to move your body around. Muscle cells need more calories than most other cells, even at rest. When weight is lost too rapidly, a significant amount of muscle mass is lost along with some fat. This reduces calorie needs, lowering the amount of calories that can be consumed without gaining body fat.
Q: Is there a better diet to maintain weight loss?
A: A recent study published in the Journal of the American Medical Association challenged the concept that all calories from carbohydrate, fat or protein are the same. Participants in the study previously had lost about 30 pounds and were eating to maintain their weight loss. When they consumed a low-carb, high-protein diet (10 percent of calories from carbs and 30 percent from protein) they expended more calories at rest and overall burned about 300 more calories per day. For the average 230-pound person in this study, 300 calories a day would be equivalent to about an hour of walking.
This observation about protein is not new. Other studies have found that protein stimulates energy expenditure at rest more than carbohydrate or fat.
Q: Why isn't a low-carbohydrate diet recommended for everyone?
A: The low-carb diet caused the participants to have significantly greater levels of the "stress hormone" cortisol. Higher levels of this hormone can promote increased body fat, impair insulin function and increase the risk of cardiovascular disease. However, there was no evidence of these effects in this study. In fact, insulin sensitivity improved and cardiovascular risk factors like triglyceride and HDL cholesterol levels improved.
The main limitation of this study is that the diet was followed for only a four-week period. Its results, however, indicate the lower-carb, higher-protein diet approach for weight loss maintenance is worthy of a longer study.
Q: What else is important to maintaining weight loss?
A: Even if there is no "one size fits all" diet for maintaining reduced weight, there are some general concepts that should help most people. Regular strength and aerobic exercise, along with consuming adequate protein, helps to both increase calorie needs and to maintain more of the calorie-burning muscle mass.
Also, things that help promote weight loss, such as group support or having someone to answer to, may be helpful for weight maintenance.
Joannie Dobbs, PhD, CNS and Alan Titchenal, PhD, CNS
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.Dr. Dobbs also works with the University Health Service
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