The Biggest Loser Study and Its Potential Impact On The Treatment Of Obesity

The latest “surprise” in the study of obesity is discussed in the NY Times article entitled “After “The Biggest Loser” Their Bodies Fought to Regain Weight”.

The surprise is not that most of the participants regained weight, but how amazingly efficient their bodies became at burning calories years after participating on the show.

I’ve written articles in 2014 and 2015 on how extremely difficult it is for people to maintain their weight following successful weight loss. Anyone who has ever followed a calorie restricted diet combined with regular exercise understands that any subsequent weight loss success is almost always temporary. The participants on “The Biggest Loser” learned this the hard way.

On the show, obese participants are put on a strict calorie restriction and follow an intense exercise regimen. They are almost guaranteed to lose copious amounts of weight in a short period of time. After watching the show for the first time, I knew that this was a recipe for disaster and that the likelihood that each participant would achieve a long-lasting healthy bodyweight was just about zero.

Such a calorie restriction alone is unsustainable, let alone the grueling daily workouts. The body’s response to this is to protect itself from future potential caloric deprivations.

The NY Times article is interesting as it describes the various mechanisms within the body that make long term weight maintenance almost impossible for those who have achieved significant weight loss.

Researchers expected to see slower resting metabolisms after the show ended as just about anyone who diets to lose weight will have slower metabolisms when he/she stops dieting. What was shocking was that the contestants’ metabolisms did not recover even as they put weight back on. Contestants end up burning hundreds of calories per day less than what would be expected for their size. This explains the well known phenomenon of yo-yo dieting (ie. multiple weight loss attempts followed by regaining the weight back and more).

Many experts hope that the results of this study will lead to new therapies that treat obesity as a chronic disease. I DON’T SHARE THIS HOPE!

I hope the results of this study will lead to looking at obesity as a symptom of an unhealthy lifestyle – a lifestyle that can be corrected with a truly healthy diet and reasonable exercise. Of course I consider a truly healthy diet as a whole food plant-based (WFPB) diet dominated by fruits, vegetables, whole grains and legumes.

If obesity is treated like a chronic disease, then western medicine will treat it with drugs and surgeries; both come with their share of serious side effects.

Dr. Margaret Jackson, a researcher from Pfizer, is leading a team that is testing a drug that acts like the hormone leptin. When leptin was discovered in 1994, researchers believed that leptin deficiency caused ravenous appetites in recent dieters. It was believed that treating people with leptin would curb their appetites. It hasn’t worked out that way when it has been tested in people. It turns out that when obese patients were tested, they were making lots of leptin. Some researchers have hypothesized that the problem is leptin resistance, not lack of leptin. However, this study showed that at the end of the show, the contestants had very little leptin. As they regained weight, their leptin levels began to drift up again, but only to about half of what they had been when the season began.

Human Metabolism is Astronomically Complex

How likely is it that obesity will eventually be resolved by increasing our knowledge of the function and metabolism of one hormone? I think it is highly unlikely. Human metabolism is much too complex to expect a substance that affects one metabolic pathway to rid us of obesity.

This article discusses another study that found that leptin and four other hormones involved in satiation (helping us to feel satisfied) were lowered in people regaining weight after successful dieting. It also found that a hormone that increases appetite rose. This led Dr. Joseph Proietto to state “The body puts multiple mechanisms in place to get you back to your weight. The only way to maintain weight loss is to be hungry all the time. We desperately need agents that will suppress hunger and that are safe with long-term use.”

What is conspicuously missing from the article is the suggestion that maybe if we feed our bodies with the healthiest foods, and embark on a reasonable exercise program, perhaps the body wouldn’t respond in a way that sabotages efforts of long-term weight loss and maintenance.

Dr. Joel Fuhrman and Dr. John McDougall have treated patients for decades with their versions of WFPB diets. Wouldn’t it be interesting to measure the resting metabolism and various hormone levels of their patients who have lost significant amounts of weight and have kept it off for years?

It’s highly unlikely that Pfizer, or any other pharmaceutical company, will ever fund studies on people who have successfully maintained weight loss by living a WFPB lifestyle – unless of course rice, beans, potatoes and broccoli become classified as drugs that can be patented. If such a study is necessary before physicians begin to take WFPB diets seriously, we will likely be waiting a long time for real progress to be made in our fight against obesity.

The results of such a study would be interesting from a scientific perspective, but do we really need to know the mechanisms involved before recommending a WFPB diet for long term health and weight maintenance?

I don’t think so.

Imagine if I placed this standard on every decision I make – I’d never use my iphone as I probably would never be able to figure out how it does all that it does.

A WFPB diet has worked well for me for over seven years. And just like I plan to continue using my iphone until it stops working, I plan on continuing eating a WFPB diet until it stops working.

Stay Healthy and Strong.

Here is Howard Jacobson’s response to the study.