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Hunger Hormones II


Friday, June 07, 2013

As promised, I returned to the dentist today and had another look at the magazine article, which directed me to a "recent" New England Journal of Medicine article which turned out to be "Long Term Persistence of Hormonal Adaptations to Weight Loss". It was a study of 50 people (34 completed the 62 week study) who spent 10 weeks on an Optifast diet (about 500 calories a day of a shake and non starchy vegetables).

So the first thing we know about this is it was diet-only weight loss, very low calorie, and they lost about 30 pounds on average. They transitioned to regular food diets and were counselled to engage in 30 minutes of exercise a day. We know for the NWCR that most successful maintainers use exercise to lose weight and exercise a lot, the equivalent of 1 hour walking per day.

Some people dropped out in the weight loss phase and others in the maintenance phase. The average before weight loss was 210 lbs, at 10 weeks 180 lbs, and the average weight of people still in the study ended at 192.5. So they ended keeping just under half the weight off (besides exercise they were counselled to eat low glycemic, low fat foods but no specific calorie restriction.) This is not too far off some definitions of beneficial maintenance as keeping off 10% of baseline bodyweight. I'm reminded of a quote from Weightymatters.com, that weight lost through suffering is destined to be regained.

So as far as the hormones went, after a year the leptin was depressed to the degree that bodyfat was depressed. Leptin is a hormone manufactured by fat cells that decreases appetite in a kind of long term action, countering the stress eating hormone NPY and anandanamide (related to the munchies experienced by pot smokers.) So stress management could be one way to pick up the slack of lower Leptin levels. Some wonder why we can't supplement with Leptin, but it promotes novel blood vessel formation and may be why obesity correlates with cancer and other degenerative diseases.

The research subjects also experienced elevated ghrelin, which is a fast acting hunger hormone. It increases between meals and drops after eating. The GHR in ghrelin stands for growth hormone release. It's probably way more complicated than this, but we know growth hormone is also released by exercise, deep sleep, and patterned meals. It's just my conjecture that stabilizing grown hormone would stabilize ghrelin, but we know these behaviors support healthy weight and also reduce stress.

The study referenced that people who have lost weight have decreased thermogenesis (heat creation). It appears to decrease more than would be predicted by changes to body weight and composition. Thermogenesis again should be responsive to eating regularly and exercise.

There were a lot of other hormones that I'm not familiar with yet. Here's a link to the article.
www.nejm.org/doi/full/10
.1056/NEJMoa1105816#t=article
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Member Comments About This Blog Post:
JUMPINJULIE 6/10/2013 5:48PM

    Very interesting.

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LRSILVER 6/9/2013 6:19AM

    This study confirms other data that shows our bodies are set to regain the weight. It is why maintaining is so hard.

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VTRICIA 6/8/2013 8:22PM

    The interpretation of the study is discouraging if you see Leptin as some kind of dieter's panacea and ghrelin as an enemy.

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AJDOVER1 6/8/2013 5:39PM

    Thanks for including the link!

I know more about statistics than I do about weight-loss maintenance. There are simply not enough people in the study for it to be valid.

Personally, for a number of reasons I exercise a lot more than 30 minutes a day.

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ROSEWAND 6/8/2013 3:44PM

    I have been very uncomfortable with the findings
of this study as the calorie restrictions in the
weight loss period were so severe and restrictive,
even punitive. Much has been made of this study,
I think inappropriately. The results are
demoralizing to say the least.

How would your hormones not become unbalanced
by such an unnatural approach to weight loss.

I successfully rebalanced my hormones during
weight loss in a way that has help support my
weight loss and three years of maintenance
in ways I never would have dreamed possible
in the past.

I gently lost 60+ pounds over about a year period
then gradually added back calories until my
weight stabilized over the next six months.

High intensity interval training really helps
reset your hormones. Following a diet that
supports balancing your leptin also help.
That means moderating carbs, eating only
three times a day, increasing protein at
breakfast, never eat after dinner, avoid
large meals.

I also included mind-body supports that
helped my body actually want to be
as thin as I do. I included supplement
support as well including omega 3's.

I add extra calories to my meals 2 a week
to keep my metabolism from slowing down.
And focus on low-glycemic carbs for the
most part. I also focus on the pleasures
of eating at every meal.

After a long lifetime of struggling with
my weight, I have found the sweet spot
I actually now can eat more food;
enjoy it more; and remain as thin as I
was in eight grade with a 25" waist.




Comment edited on: 6/8/2013 3:46:44 PM

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NILLAPEPSI 6/8/2013 9:36AM

    I can't imagine eating only 500 calories a day. Wow! I won't be doing the Optifast Diet (DIE being the operative part of that word). emoticon

Interesting info, though. emoticon

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KANOE10 6/8/2013 9:36AM

    I thought the article was interesting. If I understood it correctly, that after 12 months of maintenance, your hunger hormones did not decrease to normal and stayed elevated. That could be why maintenance is difficult. Interesting that many hormonal changes lingered on for 12 months.

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