The Quest to Understand the Biology of Weight Loss (HBO: The Weight of the Nation)

this Choza is heavy as I was a lottery I'm activating 18 plus percent of our children right now are obese if you go with the flow in America today you will end up overweight or obese as 2/3 of Americans do I don't want to be fat for the rest of my life I've got diabetes sleep apnea high blood pressure I get dizzy when I get up everything's hurting now we don't now take this as really serious urgent national priority we are all of us individually and as a nation gonna pay a really serious price how many pounds have you lost in a lifetime Oh Marcie goodness crisis do have a calculator I have lost the same 30 40 50 pounds probably 50 or 60 times upwards of 200 pounds three times in my life forty forty five pounds fifty three pounds course I'm a backsliding sinner so after about a year I was ballooning back up but now and I'm getting that back I've gained all that 45 back that's like probably close to 300 pounds thousands I've lost several zuv Me's I've lost hundreds of pounds and yo-yo dieting and I I just want it I just want to stop anyone who's ever lost weight will tell you that it is harder to sustain the weight loss than to lose the weight itself they'll tell you oh yes I lost weight successfully many times but I can't keep it off as like people who try to stop smoking no - oh yeah I was quite successful about 20 times it might sound silly but weight is so heavy and it's not just on your body emotionally it's so heavy cuz you think about it all the time you're walking down the street you're seeing all these nice little trim people walking down and they're dressed so cutely and you're like I can't wear that if you didn't see that I was working in this company and a girl who sat next to me took a picture of me Monday when I saw those pictures awesome oh I was shocked I was appalled I was really disgusted with myself I felt like I wasn't doing enough to stop it I did the gym thing for months and I didn't get any results I really dunno what to do at one time it was believed that body weight was completely unregulated and was simply a result of an individual's free choices having to do with food physical activity if you were heavy it meant you were choosing more food and less activity and if it if you were light and the opposite of that the laws of physics relate to the regulation of body weight energy in energy out if you are taking even slight excess of energy in versus what you're expending you will gradually put on weight we now know based on 25 30 years of research that body weight is as tightly regulated in many ways as things like blood sugar blood pressure how much sodium is in your blood and a variety of other very complex metabolic characteristics if you compare the metabolism body functions of an obese person when they're obese to that of a person who's never been obese and you correct for the difference in body size there is no difference and this leads us to understand that obese people when obese lean people when lean are protecting in a sense the same to the same extent their existing body weight so that when you reduce the body weight of an obese person and the body weight of a lean person and compare the responses they're absolutely identical so lean people are defending their lower body weight and obese people in precisely the same way by precisely the same mechanisms are defending body weights they would be a hundred two hundred pounds above that of a lean individual at your usual weight body weight is tightly regulated it responds to any attempts to change it so the question is what happens after you've lost weight why don't you just maintain that reduced weight with the same vigor individuals losing weight are not metabolically the same as they were before they lost weight based on the studies that we've done we've shown that there is a very complex response of the body to weight loss once the body undergoes weight reduction begins to respond as if it were being threatened with imminent death the body will defend the fat that's there and try to drive you back to the weight from which you started consider two individuals same gender same age exactly the same bodyweight one of whom is at that body weight as a result of let's say a 10 or 15% weight reduction the other who's been at that weight for their entire adult life the weight reduced individual will be requiring about 20% less calories per day relative to what somebody of that weight who's never lost weight would eat or be 10% less and increase their physical activity by 10% in order to keep it that body weight and the reason for this is that the brain begins to invoke the responses that are necessary to have you regain the weight it slows your metabolism to below what you would expect for your lower body size increases your drive to eat and actually changes the function and parts of the brain that respond to palatability that is how tasty food is how much you like food how much you want food that reduced individual goes out to lunch with her friend and they both order the same meal that will represent a 20% overeating for the weight reduced individual quite normal for the individual who's not in that state 20% may sound like a little but 20 percent excess caloric intake a year will account for the inexorable weight regain as far as we know this phenomenon does not go away so being successful for a year or two doesn't mean that you're going to be able to go back to eating at the rate that would be appropriate for a person who'd never lost weight our studies indicate clearly that with regard to body weight the body has a mind of its own when I started to put on so much weight I started getting worried and kept thinking okay this is the weight where I'm gonna get diabetes and it's all downhill from there and then one day I was online and I found this study and I was like maybe this could you know maybe this could work expected it to me was random Nola's one of over a hundred subjects we've studied in various aspects of this protocol we need to have our study subjects under very tight environmental control so they live in the Clinical Research Center the individuals fed Milkshakes essentially but we make the milkshake ourselves we know precisely how many calories are in every drop of that formula and we feed the individual an amount of that formula precisely calculated to keep their body weight absolutely constant for a period of four to six weeks we adjust those calories up and down until their weight is exactly stable they're not gaining they're not losing and then we do a series of metabolic and behavioral studies then we put them on 800 calories a day of this same formula diet until they've lost a little more than 10% of their way then we maintain them at that reduced weight and at that point we do the same set of studies in order to determine what the changes in metabolism behavior and brain function have been safe inside no torque normals no less put your hands on your knee breathe normally okay this is a very important aspect of these studies because we are not comparing person a at weight one to person B away to where we're comparing person a at weight one to person a at weight to the body's efficiency in terms of energy metabolism and drive to eat with as little as a 10% weight reduction is really quite remarkably altered in a direction that would drive a person back to their starting weight try to keep those rpms up when you lose that way your muscles become much more efficient it means it will cost you about 20 percent fewer calories to walk a mile even correcting for the fact that you're lighter that you've lost weight and we've looked at this in five different ways and it absolutely seems to be true after you lose weight you're not the same person anymore you are a much more metabolically efficient organism and this efficiency will persist probably for the rest of your life these studies indicate quite clearly that there is a decline in energy expenditure an increase in the drive to eat which can account quite easily for the very common experience of weight regain following successful weight loss we believe that your brain reads some signal from your body that tells it how many calories you have stored as energy in the same way the gas gauge in your car tells you how many gallons of gas or how much energy you have left in the tank when that signal Falls your body reacts and it reacts very strongly you've lost ten percent of your body weight your leptin level drops substantially as a result of this you're happy you like what you see in the mirror your doctor likes the fact that your diabetes is better your blood pressure is better your brain doesn't like this if you give leptin to somebody who's at a reduced body weight when their brain is seeing a lower level of leptin than it would like you should have a very dramatic effect the individual is still at their 10 percent lower body weight but their leptin is at a concentration in the blood which is what it was before they ever lost the weight so what we're doing in a sense in a very real sense is attempting now to trick the brain into thinking that the fat that was lost has not been lost the behavior the increased hunger the drive to eat the changes in brain function actually are reverted back to where the individual was before they lost weight and the increase in energy efficiency the decline in energy expenditure is restored back to where it was before the individual lost weight all of a sudden your metabolism increases your muscles become their old inefficient selves your thyroid hormone normalizes there are changes in your appetite and how you feed all these things essentially the metabolic opposition is gone your brain thinks that your body fatness is at a good level thinks you're fatter than you are and so it works with you as opposed to against you so if you look at the MHC one expression and efficiency we've done Studies on individuals who have managed by virtue of very careful attention to their food intake and very vigorous physical exercise regimens the body does not adjust to being in a chronically weight reduced state the effect never goes away and I can understand why somebody hearing this might say oh my god this is bad news now I understand why I'm having this problem but there's no hope and I don't see it that way at all without these insights there would be no hope but I think with them we can begin to devise interventions weight loss effects I take hope from this and otherwise wouldn't keep doing the work and I think people who have this problem should see it this way it's not that there's an answer to this problem around the corner or that we can do something about it in the immediate sense but by understanding it better I think ultimately we will be able to interfere in a way that will make it possible for people quite comfortably to maintain the degree of weight reduction which is critical to their ultimate well-being in health we tell everybody that the likelihood that you're going to sustain the weight loss after you leave here after you leave this very controlled environment is small we'll do everything we can to help you do that you can come and see me every week or two if you want to and I will work with you you can work with our nutritionist but basically it is very difficult I'm terrified to leave this hospital I'm terrified to go back to the world and having my diet depend on just me I mean I got here in the first place because I had no self-control NOLA will face on the outside exactly the problems that she faced before she came in she's gonna be hungry she's gonna be driven to eat this is gonna be a constant fight and the question is whether or not she will be able to overcome the biological drives that are gonna want to put her back to where she started if anybody can sustain the weight loss she can she's committed she has tremendous self-discipline just by virtue of being in this study plus she has an excellent understanding of what's ahead of her just walking out the Hospital and walking around the block there is so many so much fun there's a one-day season McDonald's up the street there's all the food carts outside there's a guy who sells hotdogs in the corner and there's this one that sells honey nuts and you can smell them a block away and you know you're coming towards them the most you can do is just close your eyes you know just walk don't stop and look around you're bombarded by food everywhere you go so it's the idea of going out there and being strong enough to do the right thing food-wise it's really really hard to have gone through the past nine months only to ruin it by eating too much if I regain the weight oh no instead of checking me into this hospital I have to check into an asylum because I would go crazy it's going pretty well at first it wasn't they thought I had a handle on it and then I didn't because then I started seeing the weight picking up I wanted to check myself right back oh oh now it's better I know some of my limits now it was only like five or so pounds the weight that initially went on when I first came out has been coming right back off looking back it was more than worth it I stayed my stuck it out I really have no regrets for doing this study I'm really happy I did you

Channel: HBODocs

Views: 166,701

Rating: 4.675868 out of 5

Keywords: hbo documentary films, docu, docs, weight of the nation, may 14, may 15, weight, fat, troubles, heart disease, type 2 diabetes, diabetes, high blood pressure, blood pressure, liver disease, infertility, cancer, stroke, overweight

Id: 2i_cmltmQ6A

Length: 22min 53sec (1373 seconds)

Published: Mon May 14 2012

Reddit Comments

[u/sevenBegore]

I've recently joined a gym and started changing my diet. Now I'm seeking out any education I can on how the human body stores and burns fat. I find I have more motivation to do something when I understand it's mechanisms.

[u/CheeseFighter]

So the best way to permanently have a healthy weight is basicly never being obese for a too long time?