Monday, June 25, 2018
Health

Ups and downs? Not all is lost, yo-yo dieters (a.k.a. 'weight cyclers')

Is it better to have lost weight and regained it than never to have lost it at all?

If you're a chronic dieter, a yo-yoer, a "weight cycler," the short answer is probably yes.

If the weight loss is healthy — done slowly with nutritious foods, plenty of exercise and the right attitude — you'll still benefit in the long run, says Weight Watchers chief scientific officer Gary Foster.

All that stuff you've heard or imagined over the years — that the fat moves from your butt to your belly, that you'll regain more weight every time you give up on a diet, that you're better off just giving in to the weight than trying over and over again? "It's all mythology," Foster says.

Yes, you'll see articles that say otherwise, but the studies they cite are usually inconclusive. When you find five different studies that say five different things, it's the quality of the studies that matters, says Foster, a psychologist who has spent his career researching weight loss and obesity.

Most of that bad stuff that's happening to you — how you look and feel inside and out — is from being overweight. It's not from trying to stop being overweight, he says. "There's no adverse effects from that."

Of course, every weight-loss effort isn't healthy. And that's where weight cyclers run into trouble, says Maurice Bonilla, a board-certified doctor of bariatric medicine based in Tampa.

"It depends on the diet," he says. A medical plan designed and monitored by a skilled physician is safer than a fad that depends on some magical ingredient — grapefruit, cabbage, cookies, baby food — and excludes everything else. And yet desperate dieters tend to latch onto that next big thing, hoping for quick and easy results.

And here's what happens.

If you aren't getting enough protein and other nutrients: A nutrition deficiency in your daily diet can cause symptoms that range from unpleasant (a change in your skin or hair texture) to serious (bone, muscle or hair loss) to dangerous (a compromised immune system).

If you're losing too fast: When you drop weight too quickly, you may not be losing as much fat as you hoped, and you might be losing lean tissue. Your body will slow its metabolism to reserve incoming calories. And you could even damage your heart, kidneys and other organs. (The Mayo Clinic recommends that any rapid weight-loss program be monitored by a physician.)

If you're overdoing it with your workout: Too much exercise and too little nutrition puts your body in starvation mode. It makes losing harder, and you'll feel irritable and fatigued.

These dieting downsides not only make you less healthy, counteracting the reason many of us want to lose the weight to begin with, but they also contribute to the rebound that makes us so miserable.

And make no mistake, weight-loss success isn't just a physical thing. Emotions play a major role.

"We let ourselves down when we fall off the wagon, and we beat ourselves up," says Madeira Beach-based certified fitness trainer, weight-loss coach and nutrition specialist Debbi Doughty-Lewis. Anger, disappointment, embarrassment — she has seen the full range of emotions from clients who have slipped — and as a former weight cycler, she has experienced them herself.

There's also fear.

"People think when they're trying to lose weight, they have to give up their whole life," Doughty-Lewis says. But they can go and have just as much fun in the real world, at parties, on vacation, at a ball game. It takes some time to realize it, she says, "But food really is a small part of it."

Foster says people often develop an all-or-nothing attitude about losing, or make weight a moral issue that requires blame and punishment.

An extremely regimented approach may work in the short-term, he says. "But it's only going to take one slip or two, and all hell's going to break loose and you're going to end up right back where you were."

It's one of the reasons Weight Watchers is putting less emphasis on what the scale says and more on NSVs, or "non-scale victories": Your favorite jeans fit. You didn't have to ask for a seat belt extender on the plane. Or maybe you finally got down on the floor with your grandkids … and got back up.

"Those, in fact, are the most important benefits of a weight-loss journey," Foster says. "Not that I got below 200 today. That number is meaningless in itself. It's what that change in weight and change in lifestyle does for people."

Which is why most weight-loss doctors, dietitians and fitness advocates say it is better to lose, regain and lose again — if the ups and downs aren't extreme — than to give up and stick to an unhealthy weight.

Of course, it's their business to say so. But the argument is sound when applied to most people. As long as you can maintain that healthier weight, even if it's only half the loss you had hoped for, you're more likely to keep your blood pressure and blood sugar under control, cholesterol usually improves and sleep apnea often goes away, among other perks, Bonilla says. Even if the loss doesn't last, those good years will have benefited you in the long run.

You'll also be happier with yourself when you put on clothes that fit and look in the mirror, which, if nothing else, means you'll have one less thing to fret about every day, Doughty-Lewis says. For those who regularly battle their bulge — whether it's 10 to 20 pounds that keep sneaking back or a more serious problem with weight gain — that's no small thing.

"I think the science is pretty clear," Foster says. "(Every organ system in the body) is adversely affected by excess body weight. There's not an exception.

"Once you have that knowledge, you have to say, okay, if I can decrease my risk by decreasing my weight, and I don't have the guarantee that it will stay off forever, would I still do it? I think the answer is a clear yes."

There's also a case to be made for good old-fashioned optimism.

Everybody has a "set point," Bonilla says, a level of weight the body wants to maintain. It takes the body about two years to adjust to a lower weight, and during that stretch, you're going to struggle to lose and maintain.

It's why so many people plateau in the sixth to eighth week of weight loss, he says. Your body is comfortable at that old weight and it wants it back.

But if you can make it past that two-year point, you'll struggle less. And if you can maintain your goal weight for five years, you can be pretty sure your body will reset to that new weight, Bonilla says.

That doesn't mean you can retire to your recliner with a big bag of chips and a liter of soda, however.

Your weight-loss doctor is going to want you to check in occasionally. Your Weight Watchers leader is going to urge you to stick with the program. Your trainer is going to insist you keep showing up for workouts.

But you might be able to relax just a little and maybe consider the cycle broken.

Contact Kim Franke-Folstad at [email protected]

     
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