On Weight Loss

The traditional viewpoint, that weight loss is possible through forced energy restriction diets, seems plausible on a superficial level, and indeed has gained overwhelming mainstream consensus. Forced energy restriction is said to produce a situation of negative energy balance, that is to say more energy is expended than is consumed, and this results in weight loss. Based on the law of thermodynamics, whereby energy cannot be created or destroyed, this theory of negative energy balance manipulation is the template for the vast majority of weight loss diets. The notion that forced energy restriction is the only way to cause weight loss is so ingrained in the minds of the many that to question such a theory is to expose oneself to the ridicule of not just the expert, but also the layman. However, while the forced energy restriction diet theory of weight loss portrays an air of legitimacy if taken at face value, deeper inspection reveals that the underlying premise upon which the theory is constructed is scientifically flawed.

The main problem with forced energy restriction diets is that they do not work in the real world. While the theory appears to be based on rational and observational science, in reality the evidence for the success of such diets is sadly lacking. The failure rate of forced energy restriction diets should highlight the absurdity of the theory, but in response proponents simply blame the individual for not applying themselves correctly. In scientific research many trials involving weight loss are conducted under strict clinical conditions and as such contain many confounding variables not present in a real world setting. The presence of chaperones and trainers is proven to confound the results, and the clever use of statistics allows a priori bias. A clinical environment is all well and good, but we do not live in a clinic and clinical models are meaningless in the real world where people display complex behaviours, emotions and interactions. In fact, in a real world setting, forced calorie restriction often leads to increased amounts of body fat and deleterious health consequences.

In order to explain why forced energy restriction is not successful, it is necessary to clarify a number of obfuscations made by the forced energy proponents. Firstly, we must define weight loss as it is not always apparent, even in the peer review literature, to what it refers. It would seem reasonable that weight gain really refers to the accumulation of unwanted adipose tissue, that is to say body fat. It should be apparent that weight loss should therefore refers to the loss of this accumulated body fat. Treatment of obesity therefore should really be concerned with the loss of body fat, not body weight. The fixation of many forced energy restriction proponents with weight loss, rather than fat loss, could be dismissed as a simplification of the process for ease of comprehension. However, use of weight loss as a measure of success in forced energy restriction diets obfuscates one of the main problems of such regimens, that is the loss of other body tissues in addition to fat, particularly skeletal muscle, glycogen and its associated water content.

Initial short-term weight loss can be achieved with forced energy restriction because the sudden restriction of energy causes the body to relinquish some of its muscle tissue in order to maintain blood glucose levels. The liver is a processing factory, and as such can take the amino acid alanine, and convert it to glucose to maintain blood sugar concentrations. The only real source of alanine in animals is muscle tissue. Therefore forcing energy restriction upon the body compels it to obtain a source of its preferred energy substrate from other sources, in this case muscle. While some fat loss will occur with this muscle loss, the damage is already done, as muscle mass dictates the amount of energy used by the body at rest. By cannibalising this tissue as a source of energy, the body is in effect burning the furniture to maintain the fire. The resulting fall in resting energy expenditure relates to a lower requirement for energy, because the body now has less metabolically active tissue to maintain. The result is that the forced energy restriction is no longer energy restriction at all.  

Many research studies only monitor energy restrictive diets for a number of weeks, because this falls nicely into the window of weight loss that result from the above phenomenon. Many proponents of such diets claim that after the initial weight loss, individuals simply lose interest in the diet and resume their previous energy intake. And to some extent this is true. But this brings us to the second point that must be clarified to lay a suitable foundation for construction of an alternate paradigm, that of appetite stimulation. Forced energy restriction is not successful in the long-term because it stimulates the appetite and leads to the development of cravings and mental anguish regarding food. The desire to eat is second only in humans to the desire to drink, and restriction of either water or food, results in a drive to attain replacement intakes to such a degree that capitulation is inevitable for most individuals. Again, such capitulation is often dismissed as failure on the part of the individual, a patronising viewpoint that is typical ofthe medical profession.

Forced energy restriction then causes muscle tissue loss and stimulates appetite, which results in weigh regain and failure. According to proponents of forced energy restriction, this scenario is due to lack of willpower by the individual. However, the real problem lies elsewhere. When weight regain occurs, the diet industry cries its crocodile tears of sympathy, and while consoling the individual, reaches down into their back pocket to relieve them of a few more pounds. The men is shiny suits of course have many ‘solutions’ to the problem, all of which involve making them considerably richer and distancing themselves from any meaningful patient interaction. And the food industry actively lobbies government officials to obfuscate their role in the causing the entire mess. The opinions of the politicians are not worth mentioning because they were bought and paid for along time ago. And all the time the mainstream media rollout their group-think attitude because they have no real intelligence to understand the problem.

Distancing oneself from the misinformation and obfuscation of the above groups is the first step in successful fat loss. Realising that successful body fat loss involves making a distinction between forced energy restriction and unforced energy restriction is also critical. Forced energy restriction does not work because it does not address the underlying cause of weight gain, which is insulin resistance caused by a low quality diet. Insulin resistance is a metabolic abnormality which causes inflammation and oxidative stress, and restricting energy forcibly under such conditions of illness, will not result in long-term fat loss. The answer to successful fat loss is correction of the underlying illness, through reversal of the insulin resistance. This means acknowledging that the food industry is to blame for obesity, and accepting that a high quality diet, rich in fruits, vegetables, long-chain fatty acids, and good sources of protein and whole grains, is the solution. High quality diets are known to reverse insulin resistance and slowly relieve the metabolic abnormalities underlying obesity.

Reversal of the underlying insulin resistance will cause the metabolism of the body to return to normal. This will cause the skeletal muscle to oxidise lipids and store glycogen which will increase work output and allow skeletal muscle growth due to increased force development. As a result, the metabolic rate will increase the energy requirement at rest, which will in turn raise the threshold before food is deposited as fat. The increased calories will also prevent the body from using alanine as a fuel source and prevent muscle catabolism. In addition, as fuel usage returns to normal, the natural regulatory mechanisms that control satiety will return, and this allow the body to regulate its own energy needs. Proponents of the forced energy restriction diets seem blissfully unaware that the body is perfectly able to regulate its own energy requirements. The body does not require a dietician in a hospital with a book to regulate energy for it. All that is required is to activate this system is a well thought out high quality nutritional regimen.