Monday, February 25, 2019

More On Set Points And Why I'm Not Fond Of Them

Seems my last post struck many different chords depending on the lens with which it was read.

Some people read it as stating that they're not trying hard enough.

Others read it as there's no point in trying.

Others agreed with me.

So for clarity, here's a bit more.

Me stating that lifestyles matter, that sociology matters, that our lives' patterns matter, and that they in turn help to explain why people often regain all of their lost weight when what's usually an overly restrictive weight loss effort is abandoned isn't me stating that people ought to be able to just tough out overly restrictive weight loss efforts. It's me pointing out that if your weight is currently stable, you're in equilibrium. You have, like we all do, an average daily caloric intake and output which of course includes things beyond your control (including genetics, medical co-morbidities and medications, job requirements and responsibilities, caregiver responsibilities, and more), out of the realm of your conscious ability to control (food marketing, societal and social norms, the constant, usually well-intentioned thrust of food at every turn, and more), and things that are unfair to expect you to control (largely the normal use of food to socialize with your friends and families). These are the sorts of the things that make up something some refer to as your "expososome", and I think the impact emigration tends to have on weight, which depending on your starting and finishing countries may well increase or decrease yours, is a clear example of how it influences your equilibrium. But regardless of your expososome, yes, there are things within your control to change that can affect your weight (though definitely not free from being influenced from many of those out of control factors) like how many meals you cook and your cooking skills, your liquid calorie consumption, your frequency of meals and snacks, the macronutrient composition of your diets, exercise, and more. And it's also true that for some, their lives' realities preclude intentional behaviour change.

What I was talking about yesterday, are the people who regain all of the weight they've lost with any given effort. These tend to be people who ultimately, for various reasons, are unable to continue with their change efforts. Instead, likely, not all at once, their efforts wane, then end, and those people find their way back to all of the original behaviours, factors, and choices that they were living with prior to their changes, which in turn brings back all of their old calories, eventually bringing their weights back to that same place where they were before (or perhaps even slightly higher consequent to metabolic adaptation leading them to burn fewer calories at a comparable weight than prior to their weight loss effort).

Why does this happen?

I think for a significant percentage of people it happens because the changes they employed were too severe. Maybe they were perpetually hungry, or denying themselves foods they loved and enjoyed, or they cut out entire food groups, or they found themselves unable to enjoy a meal out with friends, or regularly having to cook multiple meals (one for them, and one for their family). In short, the efforts many people undertake aren't by definition sustainable. They're for-now efforts, not for-good efforts. And I think the reason so many choose those types of approaches is that society (including the public health and research communities) generally describe total weight loss as the goalpost, and so people take on extreme efforts, because that's pretty much the only way to get there.

On the other hand, those individuals who lose weight and keep it off? While they nearly never are people who lose every last ounce that some stupid table says they should, there are huge numbers of them who've managed to lose a subtotal amount of weight and keep it off. Knowing these people, reading about these people, their most common denominator is that they enjoy the new lifestyles they've crafted sufficiently so as not to perceive them as suffering.

So if you want to lose weight, you're going to have to change some of those things that are within your control to change, but you're also going to have to pick changes that you can honestly enjoy if you want to keep the weight you lose, off. And different people, for a whole host of reasons, will have fewer things they're able to change, not to mention the fact that life and circumstances will also have a say as time goes by. But for everyone, change generally means embracing imperfection, still eating food for comfort and celebration, still socializing with friends and family, and more. And the degree of changes you'll be able to sustain will undoubtedly be impacted by many things beyond your control, and your physiology will undeniably limit your losses and the amount you're able to change without suffering. But that doesn't mean that physiology will prevent you from ever making any changes.

Maybe, if we all aimed for smaller, more realistic, less extreme, but all the while plainly sustainable changes, and as a society we stopped with Biggest Loser style efforts, and we redefined success, we'd see a great deal more of it.