Can We Prevent Weight Gain Over the “Holidays”?

Like clockwork, every year, starting in early November and running well into the new year, newspapers and magazines are packed full of articles to warn us about the well-known holiday season weight gain and what to do about it.  This year was no exception.  In this entry, I want to highlight what I think were some of the most interesting articles.  I don’t need to remind you that we in the U.S. are, as a group, on the heavy side.  How did we get that way?  Many studies have documented our  slow but steady weight gain beginning in early adulthood, averaging about 2-2.5 lbs each year.  That doesn’t seem like a big deal, but you can do the math- 2 lbs/yr X 30 yr = overweight. Studies have also shown that most of the annual weight gain actually does take place in November and December.  So, can we do anything about holiday-induced “weight creep?”

The first article I recommend to you is entitled “the Fat Trap,” and was written by Tara Parker-Pope (NYT Magazine, Sunday January 1, 2012).  Ms. Parker-Pope bemoaned the fact that it is difficult to lose weight and summarized a study carried out by a group of European investigators (Sumithran P et. al.: Long-term persistence of hormonal adaptations to weight loss.  N Engl J Med 2011;365:1597-1604).  Fifty overweight people were put on a 10 week weight loss program.  The investigators measured a large number of hormones related to appetite at baseline, 10 weeks, and after 62 weeks.  They found that weight loss was associated with both increased appetite and increased levels of the appetite-stimulating hormones.  Unfortunately, most of the patients regained the weight they lost and still had increased appetite and increased levels of the appetite-stimulating hormones at 62 weeks.  The investigators concluded that mediators of appetite encourage weight gain.  Ms. Parker-Pope put it more bluntly: once we become fat, most of us despite our best efforts will probably stay fat.

The second article I recommend to you is entitled “New way calories can add up to weight gain,” written by Ron Winslow (Wall Street Journal Wednesday January 4, 2012).  Mr. Winslow summarized a study published that day in the Journal of the American Medical Association or JAMA (lead author George Bray from the Pennington Biomedical Research Center, Baton Rouge, LA).  The investigators fed 25 men and women about 1000 excess calories every day for 56 days but with diets that varied in the percentages of protein and fat  they contained (carbohydrates were about 40% of total calories for both diets.  The investigators found that although the subjects ingesting the low protein diet gained the least weight (about 7 lbs), they had as much gain in fat mass as the subjects on the normal and high-protein diets, whose excess weight gain was largely related to a gain in lean body mass.  The investigators concluded that “fad” diets with widely varying proportions of fats, carbohydrates, and fats, may not be the way to go in dieting, but rather, should focus on decreasing total calories and fat content.  In addition, the data showed that the BMI, a traditional way of assessing a patient for weight status, may not be very good at picking out those who have high body fat mass as opposed to high lean body mass.  As an aside, on the same page as the Bray study report, is a report by the same journalist, Ron Winslow,  on a Swedish study touting the health benefits of bariatric surgery for weight reduction (“Procedure’s benefits go beyond weight loss”).

The third article challenges Parker-Pope’s pessimistic view of weight reduction efforts.  It is entitled “Be it resolved,” and was written by John Tierney (NYT Sunday, January 8, 2012).  The article is all about the power of New Year’s resolutions to help people lose weight.  Tierney recently co-authored a book with Roy F. Baumeister entitled “Willpower: rediscovering the greatest human resource”.  I confess that I have not read the book, only the newpaper article.  Dr. Baumeister is a social psychologist at Florida State University.  The lengthy article presumably summarizes the book’s message: setting goals is most useful if the goals are accompanied by firm (written down) resolutions,  and that it is possible to reinforce one’s willpower; studies have shown that setting goals without concomitant resolutions, is far less likely to result in long-term successl.  I cannot say that I was much impressed with the recommendations other than that they are logical but  rather complicated,  and it is my guess that anyone willing to do all the things that are recommended to make the resolution work, doesn’t dare fail.  I can’t think of any good reasons not to try the resolution advice.

The last article also appeared in the Sunday January 8. 2012 issue of the NYT.  It was entitiled “Young, obese and in surgery: youth procedures rise, despite doubts,” written by Anemona Hartocollis.  I found the article well written but very disturbing.  I will offer no other comments.  Read the article and let me know what you think.

Conclusions

So, it’s another year, another few more pounds, and no new sure-fire ways to trim down and stay trimmed-down.  As I have tried to emphasize in a number of earlier entries on weight loss therapies, almost every diet out there works in the short run but fails in the long run.  I am convinced that for most people, the best way to lose weight and keep it off is to REALLY, REALLY want to lose weight (?maybe goals and resolutions?) is to aim for weight loss of no more than 1 pound per month (my wife’s mantra), to eat only moderate amounts of healthy foods (a la Michael Pollen) with only small amounts of meats/fatty foods, few if any highly processed foods (particularly potato chips and french fries-a painful task), no sugared sodas and sport drinks, AND to exercise regularly- at least 30 minutes 3 days/week.  Good luck.

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