DebraSY

Posts Tagged ‘NWCR’

What Katarina Borer Found: Good News for Maintainers?

In Weight-Loss Maintenance on July 8, 2011 at 12:52 pm

Before I say another word, my conscience tells me to add a BIG trigger caution here.  If you are a size acceptance proponent and are feeling the least bit susceptible to the call of the weight-loss diet fairy, skip today’s post.  If you’re feeling brave, however, I’d love your response as well as that of my maintainer friends.

In my last post I explained Katarina Borer’s methodology for comparing the effects of food intake and exercise on appetite and on certain endocrine secretions.  Dr. Barry Braun describes it as “a multicondition crossover design to cleverly disentangle the relationships between energy imbalance, exercise, energy intake, putatative energy-regulating hormones and perceived appetite.”  Yup.   That’s what it was.  Now, let’s see whether I can explain in plain English what happened and what was correlated and what was not.

In her first study, Appetite Responds to Changes in Meal Content, Whereas Ghrelin, Leptin and Insulin Track changes in energy Availability, Dr. Borer found:  

  1. Human appetite is influenced by the passage of food through the mouth and gastrointestinal tract.  When food went through the mouth, it triggered GIP, a gut peptide that is activated and serves as a marker for GI activity but seemingly has no affecting qualities of its own.  This peptide rose and fell in concert with participants’ reported appetites. 
  2. Participants’ appetites responded to the size of meals that came in through the mouth, but were insensitive to calorie replacements (or saline placebos) that came through an IV.  Moreover, exercise did not increase appetite, but marginally suppressed it.  This led her to state that “between-meal increases in circulating nutrient load and exercise energy expenditure are not under homeostatic feedback control.”
  3. Ghrelin, leptin and insulin respond in slightly different ways to changes in energy availability, but had no influence on participants’ appetites.  Whoa.  Interesting, yes?  Dr. Borer thought so too.

The graph array that interested me most, as a maintainer, however, was Figure 2 (in the second study it was reposted as Figure 4).  I was surprised, in fact, that it was not included as a “finding” in the Discussion section.

It looks fuzzy in my preview, but I was able to click on it to get a blown-up view that was very clear.  Column 4 describes the trial day Read the rest of this entry »

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An Open Letter to Weight-Management Scientists

In Weight-Loss Maintenance on June 15, 2011 at 1:22 pm

Dear Scientist Friends:

Consider this a personal invitation to test a theory, especially if your area of expertise is endocrine and/or you have a personal interest in exercise physiology and weight management.  (Er, and if you’re just one of my regular blog readers, please eaves drop on this letter.)

For several years, I have been synthesizing scientific information and personal experience as a radical weight-loss maintainer, and I would appreciate an experiment designed to better test the relationship between exercise and endocrine, especially those dicey signals that I believe cause most people to regain lost weight – the imbalance of leptin and ghrelin, PYY3-36 and aghouti related protein.  If you know of an experiment that has already explored this relationship, then please provide me a link.  (Disclaimer, as a lay person, my knowledge is embarrassingly limited.  I have not yet read Katarina Borer’s book on Exercise Endocrinology, or any other scholarly text, so maybe I’m naive, but if we do know all that we could know on this topic, it sure hasn’t made it into the mainstream marketplace of ideas.) 

It has occurred to me that there are different kinds of “hunger.”  Those of us who maintain radical weight losses have pretty much mastered how to quell insulin-triggered hunger and vacuous (empty stomach) hunger using macronutrient management.  In short, we use carbs (such as bananas or dark chocolate) to quell immediate, sharp (vacuous) hunger, and we use proteins and fats to keep sneaky insulin-triggered hunger at bay.  But this is not the full story.  If it were, more than 3% of people would be successful at maintaining radical weight loss for five years, the depressing figure that empirical research suggests.

According to the National Weight Control Registry (which could also be called the 3% Club), where I am listed as a participant, 90% of us exercise on average one hour per day.  This finding is one of the most dramatic commonalities among us, more so than eating breakfast (78%), regular weighing (75%) or limiting our TV viewing (62%).  In fact, the only two characteristics that are more common than the hour of exercise are that we have restricted our food (98%) and increased our exercise from our fat days (94%).  (It should hardly come as a surprise that one hour daily represents an increase for most people!) 

Learned people debate the value of exercise compared to food restriction in losing or maintaining weight, assuming that  exercise is a function of energy balance – calories expended v. calories consumed.  Energy balance, however, is not a simple equation, and I think exercise serves an additional, more important, function beyond expending energy.  I think we need to know more about its effect on endocrine.  Read the rest of this entry »

A “Meta” Post About This Blog

In Weight-Loss Maintenance on February 14, 2011 at 10:35 am

In addition to adapting the Rules of Engagement post for a “page,” and looking into how to get rid of the vulture advertisements as cheaply as possible, I have been making my way through the Linda Bacon/Lucy Aphramor paper supporting a Health at Every Size (HAES) approach to weight management.  I hope to post on it soon, but it’s turning out to be more challenging and time-consuming than I’d anticipated.  I am unable to breeze through it without checking at least some of the sources.  I mostly support its premise, and yet it makes me uncomfortable.  I think Barbara Berkeley touched on it in the comments at her own blog.  It reads as a manifesto, and that rubs me (and her) wrong.  It’s kinder and better sourced than Gary Taubes’s Why We Get Fat (also a manifesto), but the Bacon paper is a manifesto nonetheless.  And, as with Taubes’s book, I have no place in it, really, or at least my place is awkward.   Barbara’s ultimate response (in the comments) indicates she will return to her position of promoting weight loss, which is appropriate for her.  It’s her job, her life’s focus, and she does it with kindness and circumspection.  I will likely end up somewhere else, though I don’t know where that is yet.

The good news, the Bacon article isn’t messing with my weight, as Taubes’s book did.  As I read Why We Get Fat, I found myself falling into his regimen, compelled to decline counting calories, trusting my satiety to keep my weight in check (since I was increasing my fat intake).  My weight crept to the top of its range and hovered for days.  Then it went over my current range by a pound.  Ack.  And then another.  Ack.  Ack.  I’ve returned to my own tried-and-true regimen, and have some days seen a number in my range.   I think I’ll stick with what my body has prescribed for me.  Please accept that as my “final answer” and I will accept carb control or size acceptance as yours, and we’ll look at various topics with respect for our choices.  How wonderful that we ARE different, because we are much more likely to see something original between and amongst our experiences, rather than in a fray of dueling manifestos that blind us by calling up our own pig headedness. Read the rest of this entry »

Unsolicited Review, Parts I and III

In Weight-Loss Maintenance on January 20, 2011 at 12:32 pm

My Mother advised me, when I was a child, that if I didn’t have anything nice to say, to say nothing at all.   But then she allowed that if I had constructive criticism to offer, I could do so if I began by saying something positive.  So, I will start by thanking Gary Taubes for the contributions he’s made to my life over the years. 

First I’d like to thank him for allaying my fears of dietary fat.  The world of women’s magazines had (in my yo-yo days) hijacked my brain and persuaded me to feed myself a completely unsatisfying diet.  I believe it was you, Mr. Taubes, who gave me back avocadoes and stir fry and salad dressing that has flavor.  You gave me permission to banish SnackwellsTM from my pantry forever.  How can I ever thank you enough?!       Read the rest of this entry »

Queen for a Day

In Weight-Loss Maintenance on January 11, 2011 at 11:02 am

In the discussion of my last post, Viajera asked me what I would do if I were queen of the National Weight Control Registry.  Ah, what an irresistible question!

I think for those of us who have committed to living in a state of weight-loss maintenance for as long as we are able and have submitted our names to the registry, the NWCR comes to represent many things.  It is our annual call-to-account.  Its presence hangs with us, not like a cloud, an itch, a funny smell or any kind of bad thing, but like the periodic recollection of a smart but nosy sister who lives in a distant city, and with whom we only touch base once a year.  She is guaranteed to ask about our weight – sometimes she grills us at length – and she’ll judge us, gently, if we’ve regained, so we anticipate our meetings with her with mixed feelings – angst, indignation, smugness, humility.   

I can’t say I’ve ever turned down a specific piece of my mother-in-law’s pie because of the NWCR.  I’ve never “prepared” for the arrival of the form by dieting or ramping up my exercise.  I pretty much continue with life as usual, but I have a sense of her always, and I’m sure she affects me.  This is pathetic to admit, but I probably think about the NWCR as much as I think about my own breathing sisters, who each live more than 100 miles away in different cities.  And I gotta give the NWCR credit, she may have all kinds of opinions about my weight, but she hasn’t lifted an eyebrow with regard to my housekeeping (or told me I should hold a garage sale).

In addition to being the nosy sister in Rhode Island, for those of us on her rolls, the NWCR is an affirmation (once all the cheering for our weight loss has long gone silent).  

Perhaps I’m being overly bold and should speak only for myself.  For me, she is affirmation.  I know many (most?) other Read the rest of this entry »

Thoughts on Science, Optimism and Bias

In Weight-Loss Maintenance on January 7, 2011 at 12:46 pm

Happy New Year!  Hope you all had lovely holidays.  It’s good to be back at the blog, and back on the internet, for that matter.  (Long story involving words like #!%^&$!#!!, and a whole lotta bad Karma directed at AT&T.)

Between holiday adventures and internet mayhem, I managed to slip in a post about one of my weight maintenance peccadilloes – my ability to measure fluid in ounces using my gulp mechanism.  I must admit that when I get that personal, I do feel a bit self-conscious and self-indulgent, but I think it’s instructive – for me, mostly, but also for others who participate in the fray.  We broke into a lovely discussion about the admirable pursuit of goals, and when that pursuit crosses an invisible line and becomes something less noble.  I don’t think we reached any conclusions, but I came away recommitted to the idea that I should NEVER suggest, “if I can do this anyone can.”  Even if it’s true that anyone CAN do what I do, maybe not everyone should.  One person’s pursuit of a goal may be, in all likelihood, another person’s gateway to disorder.

Somehow, in the comments, RNegade was possessed to share a couple of science-related links.  (Whew!)  My favorite was this New Yorker article by Jonah Lehrer on the “Decline Effect” that happens to our sense of scientific certainty.   This “Decline Effect” is part of a larger problem with bias in science that misshapes our understanding of a variety of social and medical issues.  I put the phrase in quotes, because, as Lehrer notes, “This phenomenon doesn’t yet have an official name, but it’s occurring across a wide range of fields, from psychology to ecology. In the field of medicine, the phenomenon seems extremely widespread . . .”   

As I understand it, the “Decline Effect” happens when the scientific method, and all its noble precepts, leads a scientist (or team) to discover a statistically significant anomaly, Read the rest of this entry »

Who Are We Here? Hint: “Squeak”

In Weight-Loss Maintenance on November 29, 2010 at 1:58 pm

When I started this blog I was hoping to find some like-minded and supportive individuals. Friends, if you will, who have also found themselves in an odd and skeptical place with regard to obesity and the research surrounding it, a place that doesn’t seem to exist if you accept only the gushy daily headlines about the latest weight-loss “discoveries.” I guess I wanted to find the other weight-loss killjoys at the water cooler, and while many reside at Big Fat Blog and other fatosphere locales, I always felt like an outsider. Talking about my weight-loss maintenance there would have been rude. But I wanted to talk about it. To share my mixed feelings, and find out whether there are others like me who are as confused by our cultural mythology as I am, and who may feel betrayed.

It’s not that I need more friends in my social circle. I have party friends, neighbor friends, tap-dance class friends, etc. I’m even on my church council of Deacons. However, in any certain geography, there aren’t a lot of people who are maintaining weight loss long term. There are even fewer people who are interested in the science of it to the degree I am. Moreover, there aren’t all that many people of any size who hate the weight-loss madness on reality TV and in the daily news the way I do. There are virtually no people where I live who are both weight-loss maintainers and size acceptance proponents, or, even, who are in one of those two groups but talking to each other. I wanted that, but didn’t trust that it existed.

Wow. We do exist! And I am so happy. Some of you have come by way of Big Fat Blog and the size acceptance chat boards. You forgive me my weight-loss maintenance peccadillo and accept me in the size acceptance community, even though I’m engaged in this Read the rest of this entry »

The Roulette Wheel Stops

In Weight-Loss Maintenance on November 22, 2010 at 7:12 pm

Well, THANK YOU for playing my game. It’s time to name a winner. And I gotta say, it’s not easy. Special appreciation to Jocetta for providing thought-provoking links (which I may purloin and post upon). And to DeeLeigh, for keeping Jocetta on her toes. And back at Jocetta, again, for accepting DeeLeigh’s toe-correction with grace!

Thanks to RNegade and DeeLeigh for a heated yet interesting discussion on the strength of the link between obesity and Type II Diabetes. It got us a little off topic, but it’s clearly a great topic for another day. Many of the White Labcoats have pronounced causation when it’s still clearly ONLY association. Maybe we, the lab rats, can gently suggest they research the outside factor(s) that may initiate both.

Yes, the Roulette table was confusing and confounding.  Thank you to all 23 players, many with multiple entries.  Vegas would get rich off of you. 

Now, I wasn’t asking what makes us fat (though I got a lot of good answers). I was asking what has changed to make us fatter in the last four decades. And Friday, I pooh-poohed the idea that our formerly virtuous behavior has collectively eroded. Today, I award a tie and identical copies of the GRAND CYBER GLOAT to Mo, Jocetta and RNegade, the proponents of genetics and epigenetics, which I didn’t even put on the board to begin with. But, indeed, the scientists who are advancing the best thinking are starting from the point of view that who we are, down to our very code, not what we do (unless it’s affecting that code) is making us fatter. Who we are impels us to eat when we know we will store too much energy – for our personal comfort and for the social rewards of a culture that detests fat people. Who we are as organisms (engaged in complex chemical reactions) has, on average, gotten more adept at storing energy. Read the rest of this entry »

Shhhhh, They’re Talking about US! Let’s Listen and then Talk about THEM

In Weight-Loss Maintenance on November 12, 2010 at 1:02 pm

First, I would encourage everyone to come join the roulette table.  You still have time before the wheel spins, the winner is named and I reveal my hypothesis.  BUT, in the meantime, if you have already placed your bet, or you otherwise have an extra 26 minutes to spare, you may wish to watch the entertainment in the Obesity Studies Lounge.  Please know that there is NO particular reason I post the following picture.

Bosley and the Angels

 Or this one:

Lee Majors

Any resemblance of our entertainers to the above pictured cast and/or ex-spouse of a cast member is purely coincidental, and we will only talk about them with the utmost respect. Read the rest of this entry »

My Love/Hate Relationship with the National Weight Control Registry

In Weight-Loss Maintenance on November 8, 2010 at 8:48 am

For me, and I’d love to know whether this goes for other maintainers, one of the things that keeps me from eating with abandon during the holiday season is the impending spring survey from the National Weight Control Registry.  Once a year, Aprilish, we know we’ll be called to account.   (Question:   Since accountability is a recognized precept of weight loss and maintenance, does the implied accountability of the NWCR process corrupt the organization’s own data?  Hmmmmm.  A ponderable for another day.)

Most years it’s the short form:  Have you gained?  Have you lost?  Have you maintained?  How do you feel about that on a scale of one to five (or is it ten)?  The scientists define “maintaining” as not gaining more than five pounds in a single year.  I have ranked their highest success category for all the five years I have participated.  I have been “maintaining” loss for more than seven years and regained ten pounds in that time, but never a full five in one year.   So, with mixed feelings, I accept their mantle and call myself a “success,” though some days I question that.

Some years, it’s the long form where we fill in pages of ovals with a number two pencil and try to break down our weekly food intake into the scientists’ categories.  We try our best to parse the soups and stir fries we’ve eaten into their component parts.  The scientists don’t ask us about the quality of our food – how much is organic, etc.  – just the Read the rest of this entry »