What’s All This Talk About Slow Metabolism?
A study first published online three months ago in Obesity ignited a storm of discussion about slow metabolism. Now along with the original study by Erin Fothergill and colleagues, the latest issue of Obesity is chock full of new data and intelligent commentaries on the subject. It’s a lot to digest, but it’s well worth the effort.
Journal editors, Donna Ryan and Eric Ravussin, open the issue with a reflection on new insights into metabolic adaptation after weight loss. They provide good insight on implications for trying to maintain a reduced weight and say:
Laziness is clearly not a factor in the weight regain seen in contestants of “The Biggest Loser.” In fact, it may be challenging to find a more dedicated group of individuals. Thus, an emerging frontier in obesity research is weight loss maintenance. We need to better understand the biology behind weight regain if we are to improve treatment.
In another commentary, Angelo Tremblay builds on their comments about the importance of weight maintenance. He describes why obesity is a chronic disease, not yet readily curable:
The reported thermogenic adaptation over time also reminds us that the metabolic vulnerability of individuals with obesity persists even after their condition has supposedly been cured by weight loss.
Michael Rosenbaum and Rudolph Liebel publish important new research in this issue. Their work points to important differences between acute changes in metabolism with weight loss and the changes that come with maintenance of a reduced weight.
Finally, Manfred James Müller comments on the work by Rosenbaum and Liebel. He explains the need for fresh thinking about metabolic adaptation. He asserts that “from now on, taking both points of view [acute and long-term changes] into account will be wise.”
Contrast this rich scientific understanding of metabolic adaptation with glib advice dispensed routinely to the public. The difference is stark.
“Is it possible to be overweight because of a slow metabolism? Probably not,” says Donald Hensrud, MD, on the Mayo Clinic website.
Bless his heart, Hensrud probably means well. But he and countless others are dispensing bad information that’s simply unhelpful. It’s way past time for them to catch up on the science of obesity.
Click here for the editorial by Ravussin and Ryan, here for the commentary by Tremblay, and here for the commentary by Müller. Fothergill’s study may be found here. The study by Rosenbaum and Liebel may be found here.
High Energy, photograph © Lew (tomswift) Holzman / flickr
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August 2, 2016
August 02, 2016 at 7:04 am, Angela Meadows said:
What I’m not seeing in all this commentary is any form of apology, or even acknowledgment, that fat people have been saying this for decades, but they’re accused of lying about their efforts, and labelled as non-adherent or non-compliant. Perhaps there should be a commentary on actually listening to your patients with an open mind.
August 02, 2016 at 7:40 am, Ted said:
Angela, thanks for sharing your thoughts. For writing just the sort of commentaries you suggest are needed, I have had people tell me that I am unfair to primary care providers. https://conscienhealth.org/2014/07/how-trustworthy-is-a-doctor-who-judges-you/
Recognizing the problem is important and equally important is working for a solution. I’m not waiting around for hopelessly biased providers to apologize. Patients should move on to someone who can provide better care. Growing numbers are working earnestly to do just that.
August 02, 2016 at 1:54 pm, Stephen Phillips said:
Research fellows from the American Association of Bariatric Counselors have identified a new metric they call the Metabolic Factor, which can be thought of as the “missing link” in understanding why some folks are thin and others thick despite similar caloric intake. It can also explain why many dieters and bariatric surgery patients relapse and regain weight lost. Obese individuals with a low metabolic factor or hypo-metabolic lends supports to a genetic predisposition to a very prevalent category of obesity The tools and the methodology we developed to diagnose and quantify an individual’s Metabolic Factor are currently available. We expect this discovery to be a “game changer” in the understanding, of obesities and helping patients and bariatric health professionals make informed choices regarding care and treatment”
The research is published in Obesity Surgery http://link.springer.com/article/10.1007/s11695-016-2111-6
For a real clinical understanding and application of this research try this video
https://www.youtube.com/watch?v=mjpYO35Zx5k
Stephen Phillips
American Association of Bariatric Counselors
August 03, 2016 at 2:20 pm, Brian Edwards MD said:
The Reduced obese state has been well known for many years. I learned about it at The Obesity Society Meeting In Orlando in 2011. Gina Kolata wrote about Rosenbaum and Liebel’s work in her excellent book Re-Thinking Thin from April 2008. I learned from these sources and developed the Sponge Syndrome. When the Obese become the Reduced obese they retain the billions of excess fat cells in the form of shruken fat cells that are low in leptin. This deficiency makes the brain believe the body is starving and will not stop believing it is starving until the billions of excess fat cells are replenished with fat. This is why the reduced obese regain weight despite exercise and relatively low calorie intake.